Background
Visual impairment is a common health-related disability in the U.S. The association
between clinical measurements of age-related eye diseases and visual impairment in
data from a national survey has not been reported.
Purpose
To examine common eye conditions and other correlates associated with visual impairment
in the U.S.
Methods
Data from the 2005–2008 National Health and Nutrition Examination Survey of 5222 Americans
aged ≥40 years were analyzed in 2012 for visual impairment (presenting distance visual
acuity worse than 20/40 in the better-seeing eye), and visual impairment not due to
refractive error (distance visual acuity worse than 20/40 after refraction). Diabetic
retinopathy (DR) and age-related macular degeneration (AMD) were assessed from retinal
fundus images; glaucoma was assessed from two successive frequency-doubling tests
and a cup-to-disc ratio measurement.
Results
Prevalence of visual impairment and of visual impairment not due to refractive error
was 7.5% (95% CI=6.9%, 8.1%) and 2.0% (1.7%, 2.3%), respectively. The prevalence of
visual impairment not due to refractive error was significantly higher among people
with AMD (2.2%) compared to those without AMD (0.8%), or with DR (3.5%) compared to
those without DR (1.2%). Independent predictive factors of visual impairment not due
to refractive error were AMD (OR=4.52, 95% CI=2.50, 8.17); increasing age (OR=1.09
per year, 95% CI=1.06, 1.13); and less than a high school education (OR=2.99, 95%
CI=1.18, 7.55).
Conclusions
Visual impairment is a public health problem in the U.S. Visual impairment in two
thirds of adults could be eliminated with refractive correction. Screening of the
older population may identify adults at increased risk of visual impairment due to
eye diseases.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Severity of visual field loss and health-related quality of life.Am J Ophthalmol. 2007; 143: 1013-1023
- Impact of visual field loss on health-related quality of life in glaucoma: the Los Angeles Latino Eye Study.Ophthalmology. 2008; 115: 941-948
- Preventing and managing visual disability in primary care: clinical applications.JAMA. 2004; 291: 1497-1502
- Impact of unilateral and bilateral vision loss on quality of life.Br J Ophthalmol. 2005; 89: 360-363
- Vision impairment and hearing loss among community-dwelling older Americans: implications for health and functioning.Am J Public Health. 2004; 94: 823-829
- Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration.Invest Ophthalmol Vis Sci. 2011; 52: 5088-5092
Prevent Blindness America. The economic impact of vision problems. www.preventblindness.org/sites/default/files/national/documents/EI_introduction.pdf.
- The economic burden of major adult visual disorders in the U.S.Arch Ophthalmol. 2006; 124: 1754-1760
- Economic impact of visual impairment and blindness in the U.S.Arch Ophthalmol. 2007; 125: 544-550
- Causes and prevalence of visual impairment among adults in the U.S.Arch Ophthalmol. 2004; 122: 477-485
- Prevalence of visual impairment in the U.S.JAMA. 2006; 295: 2158-2163
- The prevalence and consequences of vision impairment in later life.Top Geriatr Rehabil. 2004; 20: 185-195
- Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dame Eye Study.Ophthalmology. 2007; 114: 253-262
- Are individuals with diabetes seeing better? A long-term epidemiological perspective.Diabetes. 2010; 59: 1853-1860
- Computer vision syndrome: a review. 2005; 50: 253-262
- Racial differences in the cause-specific prevalence of blindness in East Baltimore.N Engl J Med. 1991; 325: 1412-1417
CDC, National Center for Health Statistics (NCHS). NHANES—survey questionnaire and exam components, 2007–2008. www.cdc.gov/nchs/nhanes/nhanes2007-2008/nhanes07_08.htm.
- Prevalence of open-angle glaucoma among adults in the U.S.Arch Ophthalmol. 2004; 122: 532-538
- The methodology of visual field testing with frequency doubling technology in the National Health and Nutrition Examination Survey, 2005-2006.Ophthalmic Epidemiol. 2010; 17: 411-421
CDC; National Center for Health Statistics. National Health and Nutrition Examination Surveys: response rates and CPS population totals. www.cdc.gov/nchs/nhanes/response_rates_CPS.htm.
National Center for Health Statistics. National Health and Nutrition and Examination Survey (NHANES) Ophthalmology Procedures Manual. September 2005. www.cdc.gov/nchs/data/nhanes/nhanes_05_06/OP.pdf.
National Center for Health Statistics. National Health and Nutrition and Examination Survey (NHANES) Digital Grading Protocol. January 15, 2005. www.cdc.gov/nchs/data/nhanes/nhanes_05_06/NHANES_ophthamology_digital_grading_protocol.pdf.
- Prevalence of age-related macular degeneration in the U.S. population.Arch Ophthalmol. 2011; 129: 75-80
- The effect of optic disc diameter on vertical cup to disc ratio percentiles in a population based cohort: the Blue Mountains Eye Study.Br J Ophthalmol. 2004; 88: 766-770
CDC, National Center for Health Statistics (NCHS). Analytic note regarding 2007-2010 survey design changes and combing data across other survey cycles. www.cdc.gov/nchs/data/nhanes/analyticnote_2007-2010.pdf.
- Prevalence of diabetic retinopathy in the U.S., 2005–2008.JAMA. 2010; 304: 649-656
- Criteria for definition of overweight in transition: background and recommendations for the U.S.Am J Clin Nutr. 2000; 72: 1074-1081
- Causes of visual impairment.JAMA. 2003; 290: 2088
- Causes of blindness and visual impairment in a population of older Americans: the Salisbury Eye Elevation Study.Arch Ophthalmol. 2000; 118: 819-825
- Reasons for not seeking eye care among adults aged ≥40 years with moderate-to-severe visual impairment—21 states, 2006-2009.MMWR Morb Mortal Wkly Rep. 2011; 60: 610-613
- Prevalence of usual-corrected binocular distance visual acuity impairment in Hispanic and non-Hispanic adults.Ophthalmic Epidemiol. 2000; 7: 73-83
- Global magnitude of visual impairment caused by uncorrected refractive errors in 2004.Bull WHO. 2008; 86: 63-70
- Visual impairment and socioeconomic factors.Br J Ophthalmol. 1997; 81: 574-577
- Four-year incidence and progression of visual impairment in Latinos: the Los Angeles Latino Eye Study.Am J Ophthalmol. 2010; 149: 713-727
- Prevalence and risk indicators of visual impairment and blindness in Latinos: the Los Angeles Latino Eye Study.Ophthalmology. 2004; 111: 1132-1140
- Cause of visual impairment in two older population cross-sections: the Blue Mountains Eye Study.Ophthalmic Epidemiol. 2003; 10: 215-225
- The prevalence and risk indicators of uncorrected refractive error and unmet refractive need in Latinos: the Los Angeles Latino Eye Study.Invest Ophthalmol Vis Sci. 2008; 49: 5264-5273
- Factors associated with undercorrected refractive errors in an older population: the Blue Mountains Eye Study.Br J Ophthalmol. 2002; 86: 1041-1045
- Prevalence and predictors of undercorrected refractive errors in the Victorian population.Am J Ophthalmol. 1999; 127: 590-596
- Socioeconomic status and visual impairment among urban Americans.Arch Ophthalmol. 1991; 109: 637-641
- Socioeconomic status and blindness.Br J Ophthalmol. 2001; 85: 1484-1488
- The relation of socioeconomic factors to age-related cataract, maculopathy, and impaired vision: the Beaver Dam Eye Disease Study.Ophthalmology. 1994; 101: 1969-1979
Article info
Identification
Copyright
© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
