PREVALENCE OF NEAR VISION IMPAIRMENT IN MIDDLE-AGED AND OLDER ADULTS IN AN URBAN CENSUS SECTOR OF PARINTINS, BRAZILIAN AMAZON REGION

Abstract

Purpose: To estimate the prevalence of near vision impairment and use of correctable spectacles in older adults in an urban census sector of Parintins, Brazil.

Methods: An urban census sector was conveniently chosen for its proximity to the eye clinic for ophthalmic assessment. Subjects were enumerated through a door-to-door survey and those with ages 45 years and older were invited for ophthalmic assessment. Uncorrected, presenting and best-corrected near visual acuity was measured in each eye at 40 cm using a logMAR near vision tumbling E chart followed by an ocular examination. Additional lenses were tested for near in those with uncorrected near visual acuity <20/40. Presbyopia was considered as the main cause of near vision impairment when uncorrected near vision was <20/40 improving to best-corrected near vision of >20/32.

Results: A total of 178 eligible persons in 136 households were enumerated, and 144 (80.9%) examined. The prevalence of uncorrected near visual acuity impairment (<20/40 in the better eye) was 88.1% (95% confidence interval [CI]: 82.7% - 93.5%), and 18.2% (95% CI: 11.8% - 24.6%) with best correction. Uncorrected near vision impairment was statistically independent of age, gender and educational level. Presbyopia as main cause of near vision impairment was found in 79.37% (95% CI: 72.2% - 86.5%) and it was reduced in those aged 70 years and older, when other ocular pathologies become more prevalent (p<0.001). The odds of having presbyopia as main cause of near vision impairment in subjects with superior educational level was 18 times greater than those having less than complete primary education (p<0.001). For those in need of near refractive correction 48% did not have the necessary spectacles and 9% were wearing inadequate correction.

Conclusions: In a small urban area of the Brazilian Amazon region, the prevalence of near vision impairment in middle-aged and older adults was almost 90% with most of it correctable optically. Higher educational level seems to be a risk factor for presbyopia in this population. More than half of those in need of near glasses were not wearing them, reinforcing the need of access to refractive services in that region.

Keywords: 653 presbyopia • 463 clinical (human) or epidemiologic studies: prevalence/incidence • 754 visual acuity