Abstract
Purpose: :
Presbyopia is both common and easy to treat; however, many communities lack access to basic eye care. The purpose of the present project was to assess the burden of uncorrected presbyopia in a rural Filipino population and pilot an intervention aimed at increasing access to reading glasses in the community.
Methods: :
Patients over age 40 who presented to a rural outreach in Nueva Vizcaya, Philippines were invited to undergo a near vision exam to assess functional presbyopia (impairment in near visual acuity that could be improved at least one line of acuity by placing a plus lens in front of the eye) and be fitted with reading glasses. The change in stereoacuity was used as a surrogate measure of functional improvement upon application of reading glasses. Trained interviewers administered a survey to assess this population’s perceived barriers and benefits to correcting near vision with the model intervention.
Results: :
The average age of patients who took part in the survey was 57 ± 11 years with an uncorrected near vision worse than 20/70 (n=142). Fitting patients with reading glasses improved near vision to greater than 20/40 in more than 80% of patients. More than three quarters of patients also showed improvement in tests of stereoacuity upon the application of readers. The average stereoacuity of patients prior to the application of readers was less than 400 arc-seconds versus 111 ± 110 arc-seconds following correction of near vision (p<0.0001). Over 95% of the study population reported the ability to read, and improved reading ability was cited as the most important benefit of reading glasses. Participants perceived that cost greatly prevented them from obtaining glasses more than availability. 69% of the population had previously owned a pair of reading glasses. Those who did not have experience with reading glasses cited lack of money (86%) as the main reason. 84% of the population perceived the reading glasses received would greatly improve their ability to earn a living.
Conclusions: :
Uncorrected presbyopia is a significant cause of age-related visual impairment in this indigenous Filipino community. Dispensing reading glasses is a simple and cost-effective intervention to improve near vision and enhance depth perception. The significant amount of uncorrected presbyopia in this population is associated with difficulties with daily activities, decreased satisfaction with vision, and quality of life, all of which are perceived to improve following the application of reading glasses. Understanding of the barriers and benefits to correcting near visual acuity will help in the design and execution of a sustainable program to improve near vision in developing countries.
Keywords: presbyopia • quality of life • aging