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Yaping Jin, Yvonne M. Buys, Juan Xiong, Graham E. Trope; Lack Of Government-insured Annual Eye Examinations Increases The Risk Of Vision Problems Amongst Low-income Elderly. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6940.
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In Canada the costs of annual eye examinations provided to the elderly by optometrists and ophthalmologists are not uniformly covered by government-sponsored health insurance plans. We assessed whether lack of government-funded annual eye examinations resulted in reduced vision health status amongst elderly Canadians.
We compared the prevalence of non refractive vision problems (i.e., unable to see close or distance when wearing glasses or contact lenses) between seniors with and without government-insured annual eye examinations. Data was derived from 24,086 respondents aged 65 years or older participating in the Canadian Community Health Survey 2000/2001.
The prevalence of non refractive vision problems was higher in seniors with household incomes under the mid level (7.5%) than in those at mid level or higher (4.3%, p<0.05) and in non-Caucasians (7.5%) compared to Caucasians (4.6%).Amongst Caucasians with a household income under mid level, the prevalence of non refractive vision problems was greater (8.5%, 95% CI 6.8-10.2) in those with no insurance compared to those with insurance (6.4%, 95% CI 5.2-7.6). In Caucasians with household incomes at mid level or higher, the prevalence was similar between those with (4.3%) and without (3.6%) government-insured annual eye examinations (p>0.05). Compared to elderly Caucasians with mid or high income and living in insured provinces, those residing in provinces with no insurance were associated with 50% higher odds of vision problems (adjusted odds ratio (OR) =1.5, 95% CI 1.1-2.0) if their income was under mid level, but with 30% lower likelihood if their income was at mid level or higher (adjusted OR= 0.7, 95% CI 0.6-1.0). The mean age at diagnosis of glaucoma and cataracts was about 2 years older for people with no insurance versus those with insurance: 68.1 years vs 66.6 years for glaucoma and 72.5 years vs 70.8 years for cataracts.
Lack of government funded annual eye examinations is associated with increased levels of non refractive vision problems amongst the low-income elderly. The negative effect of lack of government-insured annual eye examinations on the risk of vision problems is buffered by high household income.
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