Abstract
Abstract: :
Purpose:To determine the prevalence of uncorrected refractive error and unmet refractive need and their risk indicators among a population–based sample of Latino adults aged 40 years and older. Methods:The Los Angeles Latino Eye Study (LALES) is a population–based study of eye disease in Latinos aged 40 years and older. Study participants underwent an interview and a clinical examination that included self–reported data on education, insurance coverage, income, acculturation, and other potential risk indicators and measurement of distance presenting visual acuity (PVA), subjective refraction and measurement of best corrected visual acuity (BCVA) using the ETDRS protocol. Uncorrected refractive error was defined as an improvement in PVA of >2 lines following refraction. Definition 1 of unmet need included those persons with worse than 20/40 PVA in the better eye and a BCVA of 20/40 or better in that same eye. Definition 2 of unmet need included participants who had worse than 20/40 PVA in the better eye and a > 2 line improvement following refraction. Age– and gender–specific prevalence of uncorrected refractive error and unmet need were calculated. Univariate and multivariate stepwise logistic regression procedures were used to identify significant socio–demographic and clinical risk indicators. Results: The overall prevalence of uncorrected refractive error and unmet need (definition 1 and 2) were 15.1%, 8.9%, and 9.6%, respectively. The prevalence of uncorrected refractive error and unmet need (for both definitions) was higher in older Latinos compared to younger Latinos (p<0.05). No gender–related differences were noted. Independent risk indicators for uncorrected refractive error were: older age [OR=2.19, 95% CI (1.25, 3.84) for > 80 years], unemployed work status [OR=1.29 (1.06, 1.57)], < high school education [OR=1.35 (1.12, 1.64)], and lack of health insurance [OR=1.34 (1.12, 1.61)]. Independent risk indicators for unmet refractive need (definition 1) were: older age [OR=2.98 (1.38, 6.44) for > 80 years], < high school education [OR=2.47 (1.57, 3.86)], < $20,000 annual income [OR=2.62 (1.22, 5.62)], and current smoking [OR=1.82 (1.14, 2.91)]. The risk indicators and odds ratios for definition 2 were similar to definition 1. Conclusions: The prevalence of uncorrected refractive error and unmet need is high in Latinos. Better education and obtaining health insurance may decrease the burden of uncorrected refractive error and unmet need in this minority population.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment