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Beatriz Muñoz, Sheila K. West, Jorge Rodriguez, Rosario Sanchez, Aimee T. Broman, Robert Snyder, Ronald Klein; Blindness, Visual Impairment and the Problem of Uncorrected Refractive Error in a Mexican-American Population: Proyecto VER. Invest. Ophthalmol. Vis. Sci. 2002;43(3):608-614.
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purpose. To report the prevalence of blindness and visual impairment and
the contribution of uncorrected refractive error to visual loss, in a
population-based sample of Mexican Americans aged 40 and older.
methods. Proyecto VER is a population-based study of blindness and
visual impairment in Mexican Americans in Arizona. Block groups in
Tucson and Nogales were randomly selected with probability proportional
to the size of the Mexican-American population aged 40 and older.
Participants had a complete ophthalmic evaluation, including assessment
of presenting and best corrected visual acuity using standardized
procedures. Those with presenting visual acuity worse than 20/30 had
refraction to determine best corrected vision. A home questionnaire and
a clinic examination provided data on education, perception of visual
impairment, income, and acculturation.
results. The prevalence of presenting visual acuity worse than 20/40 was 8.2%,
with uncorrected refractive error accounting for 73% of the impaired
acuity. In multivariate models comparing those who improved two or more
lines on the acuity chart with proper refraction with those who had
adequate optical correction, uncorrected refractive error showed a
strong association with age, less than 13 years of education (odds
ratio [OR] 1.6, 95% confidence interval [CI] 1.5–2.0), low
acculturation index (OR 1.3, CI 1.1–1.3), lack of insurance coverage
(OR 1.4, CI 1.1–1.7), and not having seen an eye-care provider in the
past 2 years (OR 2.5, CI 2.1–3.0). Prevalence of best corrected acuity
worse than 20/40 increased from 0.3% in those aged 40 to 49 years to
18% in those aged 80 years or more.
conclusions. Visual loss in this Mexican-American population is higher than has been
reported in whites and is comparable to that in African Americans.
Almost three quarters of those with visual acuity impairment would
improve with optical correction. Socioeconomic factors that are
probable markers of limited access to health care services were
associated with uncorrected refractive error. These data suggest that
education programs and interventions to improve access to eye care
could significantly decrease the burden of visual loss among Mexican
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