Prevalence, Correlates and Impact of Uncorrected Presbyopia in a Multi-ethnic Asian Population

Abstract

Purpose : The prevalence of presbyopia, an age-related inability to focus up-close, is increasing owing to a rapidly aging global population. This cross-sectional study examined the prevalence, correlates and impact of uncorrected presbyopia on vision-specific functioning (VF) in a multi-ethnic population of Singaporean adults.

Methods : We included 7890 subjects with presbyopia of Malay, Indian and Chinese ethnicities (3909 females, age range 40–86 years) from the Singapore Epidemiology of Eye Disease cohort study. Presbyopia was defined as needing a near correction of ≥ +1.00 diopters added to best corrected distance visual acuity (VA) to achieve a near VA ≤ 0.2 logarithm of the minimum angle of resolution in either eye, and further classified as corrected and uncorrected based on participant self-reported use of near correction. VF was assessed with the VF-11 validated using Rasch analysis. The overall and individual items scores were used as outcomes. Multivariable logistic and linear regression models were used to investigate the associations of sociodemographic and clinical parameters with uncorrected presbyopia, and the impact of uncorrected presbyopia on VF, respectively. As myopia may mitigate the impact of uncorrected presbyopia, we repeated the same analyses on myopic subjects only (n=2742).

Results : A total of 2678 (33.9%) of 7890 subjects had uncorrected presbyopia, of which 1522 (57.9%) were myopic. In multivariable models, younger age, male gender, Malays, presenting visual impairment (VI) in at least one eye and lower education and income levels were associated with higher odds of having uncorrected presbyopia (all P<0.05). Except for gender and income which were non-significant, these associations were similar for myopic subjects. Compared to corrected presbyopia, uncorrected presbyopia was correlated with worse overall VF and lower ability to perform individual vision-specific tasks including cooking, reading newspapers, phonebooks and street signs, recognizing faces, seeing stairs, filling in lottery tickets and watching TV even after adjusting for distance VA and other confounders (all P<0.05). Associations were similar for myopic individuals.

Conclusions : Uncorrected presbyopia is highly prevalent in Singaporean adults, and poses a significant public health problem as a result of its adverse impact on both near and distance vision-specific tasks.

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