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.
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© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
