Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec 12;308(22):2361-8.
doi: 10.1001/jama.2012.85685.

Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008

Fang Ko  1 , Susan Vitale, Chiu-Fang Chou, Mary Frances Cotch, Jinan Saaddine, David S Friedman
Affiliations

Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008

Fang Ko et al. JAMA. .

Abstract

Context: Over the past decade, chronic illnesses with ophthalmic sequelae such as diabetes and diabetic retinopathy have increased.

Objectives: To estimate prevalence of nonrefractive visual impairment and to describe its relationship with demographic and systemic risk factors including diagnosed diabetes.

Design, setting, and participants: The National Health and Nutrition Examination Survey (NHANES) examined a representative sample of the US noninstitutionalized population. In 1999-2002 and 2005-2008, 9471 and 10,480 participants aged 20 years or older received questionnaires, laboratory tests, and physical examinations. Visual acuity of less than 20/40 aided by autorefractor was classified as nonrefractive visual impairment.

Main outcome measure: Nonrefractive visual impairment.

Results: Weighted prevalence of nonrefractive visual impairment increased 21% among US adults aged 20 years and older from 1.4% in 1999-2002 to 1.7% in 2005-2008 (P = .03); and increased 40% among non-Hispanic whites aged 20-39 years from 0.5% to 0.7% (P = .008). In multivariable analyses, statistically significant risk factors for nonrefractive visual impairment in 1999-2002 included age (per year odds ratio [OR], 1.07; 95% CI, 1.05-1.09), poverty (OR, 2.18; 95% CI, 1.31-3.64), lack of insurance (OR, 1.85; 95% CI, 1.16-2.95), and diabetes with 10 or more years since diagnosis (OR, 1.93; 95% CI, 1.15-3.25). In 2005-2008, risk factors included age (OR, 1.05; 95% CI, 1.04-1.07), poverty (OR, 2.23; 95% CI, 1.55-3.22), education less than high school (OR, 2.11; 95% CI, 1.54-2.90), and diabetes with 10 or more years since diagnosis (OR, 2.67; 95% CI, 1.64-4.37). Prevalence of diabetes with 10 or more years since diagnosis increased 22% overall from 2.8% to 3.6% (P = .02); and 133% among non-Hispanic whites aged 20-39 years from 0.3% to 0.7% (P < .001).

Conclusion: Prevalence of nonrefractive visual impairment was significantly higher in 2005-2008 than in 1999-2002 and may be attributable, in part, to higher prevalence of diabetes, an associated risk factor that increased in prevalence during this time period.

PubMed Disclaimer

Comment in

References

    1. Vitale S, Cotch MF, Sperduto RD. Prevalence of visual impairment in the United States. JAMA. 2006;295(18):2158–2163. - PubMed
    1. Congdon N, O’Colmain B, Klaver CC, et al. Eye Diseases Prevalence Research Group Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122(4):477–485. - PubMed
    1. Zambelli-Weiner A, Crews JE, Friedman DS. Disparities in Adult Vision Health in the United States [published online ahead of print May 23, 2012] Am J Ophthalmol. DOI:10.1016/j.ajo.2012.03.018. - PubMed
    1. Zhang X, Gregg EW, Cheng YJ, et al. Diabetes mellitus and visual impairment: national health and nutrition examination survey, 1999-2004. Arch Ophthalmol. 2008;126(10):1421–1427. - PubMed
    1. Kempen JH, O’Colmain BJ, Leske MC, et al. Eye Diseases Prevalence Research Group The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol. 2004;122(4):552–563. - PubMed

Publication types