Causes of blindness and visual impairment in a population-based sample of U.S. Hispanics

Abstract

Objective: To describe the causes of blindness and visual impairment in a population-based sample of Hispanics.

Design: A cross-sectional study.

Participants: A random sample of 4774 Hispanic residents of Santa Cruz and Pima Counties in Southern Arizona aged 40 years and older who participated in Proyecto VER (Vision Evaluation and Research).

Testing: Subjects were interviewed and underwent a thorough ophthalmic examination. Presenting and best-corrected visual acuity was determined using the Early Treatment of Diabetic Retinopathy Study protocol, followed by a standardized ophthalmic examination to determine the causes of visual loss. Anterior and posterior segment specialists in ophthalmology confirmed the causes.

Main outcome measures: Causes of visual loss (best-corrected acuity worse than 20/40).

Results: The response rate of eligible participants was more than 70%. Best-corrected acuity in the better seeing eye worse than 20/40 increased from 0.3% in those aged 40 to 49 to 5.6% in those aged 65 and older. The leading cause was cataract, accounting for 42% of all visual loss, followed by age-related macular degeneration (15%), and diabetic retinopathy (13%). Among 14 people who were bilaterally blind, open-angle glaucoma was the leading cause. Women had higher age-adjusted prevalence of severe cataract compared with men and were more likely to be visually impaired from cataract, diabetic retinopathy, and open-angle glaucoma, although gender differences were not statistically significant.

Conclusions: Causes of visual impairment differ from those reported in Caucasian populations, with open-angle glaucoma being the leading cause of blindness. Further work on gender-based obstacles to eye care in the Hispanic community may be warranted.