Presbyopia and Near Vision Impairment in Older Adults from Parintins: The Brazilian Amazon Region Eye Survey (BARES)

Abstract

Purpose : To estimate the prevalence of near vision impairment and presbyopia in older adults from urban and rural areas of Parintins, Brazilian Amazon Region.

Methods : A population-based cross sectional study was conducted using cluster random sampling to enumerate subjects 45 years of age and older from 20 clusters (14 urban and 6 rural). Eligible subjects were enumerated through a door-to-door household survey and invited to an examination site. 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 2383 eligible persons was enumerated, and 2042 (85.7%) were 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%], 81.2% [95% CI: 77.7% - 84.3%] with best correction. Presbyopia was found in 76.0% [95% CI: 73.8% - 78.1%]. For each of uncorrected VA less than 20/32, presenting VA less than 20/32 and presbyopia a multiple logistic regression model was adjusted using age, gender, education and geographic area of residence as predictors. Higher educational level was significantly associated with less near vision impairment both uncorrected (p<0.05) and presenting (p<0.01). Presbyopia was associated with higher schooling (p<0.05). Older age was associated with uncorrected near vision impairment and presenting near vision impairment (p<0.05), whereas presbyopia was associated with younger age (p<0.01). Principal causes of near vision impairment besides presbyopia were: cataract, pterygium, other retinal disorders and glaucoma.

Conclusions : A high prevalence of near vision impairment, most of it optically correctable, was found in this older Brazilian population living in the Amazon. Other ocular conditions such as cataract and pterygium were principal causes of near vision impairment mainly in the older participants. Health authorities should consider initiatives to improve the access to near glasses and eye care campaigns to minimize the effects of near vision impairment in this population.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.