Vision Status and Impact of Refractive Correction on Near Visual Acuity in Older Adults from Parintins City: the Brazilian Amazon Region Eye Survey

Abstract

Purpose : To determine the vision status and the impact of refractive correction and additional lenses on near visual acuity in a population of older adults from the Brazilian Amazon Region.

Methods : A population-based cross sectional study was conducted using cluster random sampling to enumerate subjects ≥45 years of age. Eligible subjects were enumerated through a door-to-door household survey and invited for visual acuity (VA) testing and eye exam. Uncorrected (UCNVA) and presenting (PNVA) near visual acuity were measured from each eye using a logMAR chart at 40 cm. Auto-refraction followed by subjective refraction and additional lenses testing was performed to determine best-corrected near visual acuity (BCNVA). Near vision status was defined by lines of impairment considering UCNVA and PNVA. The impact of refractive correction was defined as lines of improvement from UCNVA to BCNVA and from PNVA to BCNVA. The association of two or more lines of improvement with cause of visual impairment (refractive error or other) and socio-demographic variables was assessed by multiple logistic regression.

Results : A total of 2384 eligible persons was enumerated, and 2041 (85.7%) were examined. Out of these, 2025 individuals who informed VA (4050 eyes) were included. Lines of impairment ranged from 0 (20/20) in 5 (0.12%) eyes to >10 lines (<20/200) in 438 (10.8%) eyes, with an average of 7.2±0.05 lines for UCNVA. For PNVA lines of impairment ranged from 0 in 147 (3.6%) eyes to > 10 lines in 362 (9.0%) eyes, with an average of 6.0±0.06 lines. Average UCNVA to BCNVA improvement was 4.9±0.04 lines, ranging from 0 (no improvement) in 413 (10.2%) eyes to ≥ 10 lines in 167 (4.1%) eyes, with 3447 (85.1%) eyes improving ≥ 2 lines. The average from PNVA to BCNVA improvement was 3.7±0.04 lines, ranging from 0 in 660 (16.3%) eyes to ≥ 10 lines in 63 (1.6%) eyes, with 2982 (73.6%) eyes improving ≥ 2 lines. Two or more lines of improvement from UCNVA to BCNVA was associated with refractive error as cause of visual impairment and with younger age. Similar results for improvement from PNVA to BCNVA were found.

Conclusions : Near visual acuity impairment was found in most participants both for uncorrected and presenting near visual acuity. Adequate reading glasses should be provided for this population to improve their quality of near vision for daily activities.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.