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. 2013 Jul;45(1):29-35.
doi: 10.1016/j.amepre.2013.02.018.

Age-related eye diseases and visual impairment among U.S. adults

Chiu-Fang Chou  1 , Mary Frances Cotch  2 , Susan Vitale  2 , Xinzhi Zhang  3 , Ronald Klein  4 , David S Friedman  5 , Barbara E K Klein  4 , Jinan B Saaddine  3
Affiliations

Age-related eye diseases and visual impairment among U.S. adults

Chiu-Fang Chou et al. Am J Prev Med. 2013 Jul.

Abstract

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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Figures

Figure 1
Figure 1
Flow diagram of participants aged ≥40 years in National Health and Nutrition Examination Survey, 2005–2008, included in analysis FDT, frequency-doubling technology; MEC, Mobile Examination Center
Figure 2
Figure 2
Prevalence of presenting visual impairment, and visual impairment that is not due to refractive error, by age group among those aged ≥40 years Note: p < 0.001 for association of increasing age with visual impairment and with visual impairment that is not due to refractive error. Error bars indicate 95% CI. Data source: National Health and Nutrition Examination Survey, 2005–2008
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