Abstract
Abstract: :
Purpose: To investigate prevalence of visual impairment, blindness and ocular disorders in a defined low income elderly population from a community healthcare reference center for the elderly located in the outskirts of the city of Sao Paulo, Brazil. Methods: A total of 801 residents of a low–income district in the city of Sao Paulo, who were registered in a community reference center for the elderly, aged 60 years and older (range: 60–90 yrs, mean:69±6.1yrs; 207 males and 594 females) underwent a complete ophthalmologic exam, including presenting visual acuity, refratometry, slit lamp exam, tonometry, fundus examination by indirect ophthalmoscope and visual acuity with best optical correction (BCVA). Glasses were prescribed and provided for free when necessary. Visual impairment and blindness were classified according to WHO criteria (blindness BCVA in the better <20/200; visual impairment BCVA from 20/60 to 20/200 in the better eye). Results: Considering presenting VA, the prevalence of blindness was 1.5% (N=12) and the main causes were uncorrected refractive error (41.7%) and cataract (25.0%). Visual impairment prevalence was 12% (N=98): the main causes were cataract (48.0%), uncorrected refractive error (30.6%), glaucoma (5.1%), AMD (3.1%), diabetic retinopathy (3.1%) and corneal scars (3.1%). After glasses prescription, using the BCVA as the final outcome, the prevalence of blindness decreased to 0.87% (N=7) with cataract as the main cause (42.8%). Visual impairment prevalence decreased to 4.5% (N=36); cataract was the major cause (58.3%), followed by uncorrected refractive error (13.9%), diabetic retinopathy (8.3%), AMD (5.6%) and corneal scars (5.6%). The prevalence of ocular disorders in 1602 eyes were: uncorrected refractive error (66.1%); cataract (17.9%), AMD (2.6%), glaucoma (2.2%) and diabetic retinopathy (2.1%). A total of 236 patients (29.5%) were referred to tertiary ophthalmic center for cataract surgery (16.4%), suspicion of glaucoma (6.4%) and retinal diseases (4.0%). Conclusions: Prevalence of blindness and visual impairment in this low income elderly population from a community healthcare reference center were respectively 0.87% and 4.5%. These findings are consistent with previous Brazilian and worldwide studies. Cataract and uncorrected refractive errors were the major causes of visual impairment in this population.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • cataract • aging