Objectives To assess the longitudinal relationship between visual acuity (VA) and depressive symptoms (DS) among older adults. Methods A population-based sample of 2,520 white and black individuals aged 65–84 years in 1993–1995 were assessed at baseline and at two, six, eight years later. Presenting and best-corrected visual acuity were assessed using ETDRS chart. Depressive symptoms were assessed using the Severe Depression subscale of GHQ-28. Latent Growth Curve models estimated visual acuity and depressive symptom trajectories and age-adjusted associations between trajectories. Results Best-corrected logMAR VA worsened over time (slope=0.026, intercept=0.013, both p<0.001). No change in DS over time was observed (slope=−0.001, p=0.762; intercept=1.180, p<0.001). However, a small change in DS was observed in participants who completed all rounds (slope=0.005, p=0.015). Baseline VA levels correlated with baseline DS levels (r=0.14, p<0.001). Baseline DS were associated with best-corrected VA change (r=0.17, p=0.01). Baseline best-corrected VA was not associated with DS change (r=0.017, p=0.8). Best-corrected VA change was not significantly associated with depressive symptom change (r=−0.03, p=0.7). Discussion Depressive symptoms are significantly associated with visual acuity cross-sectionally, and persons with higher baseline DS scores were more likely to experience worsening VA over time. The complex relationship between visual impairment and DS suggests the need for a continued effort to detect and treat both visual decline and severe depressive symptoms in a growing elderly population.

Allostatic load and particularly IADL may function as mediators between VA impairment and mortality. Older adults with VA impairment could potentially benefit from interventions designed to prevent IADL functional status decline to reduce the risk of mortality.

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ObjectiveTo evaluate the presence of clinical signs consistent with suspected glaucoma in Haitian Afro-Caribbean individuals residing in South Florida who do not receive regular eye examinations.DesignRetrospective, cross-sectional study.Methods SETTING: Community health center in the Little Haiti district of Miami, Florida. PATIENT POPULATION: We reviewed medical records and screening forms from five health screenings between October 2011 to October 2013 of 939 Afro-Caribbean individuals older than 18 years, who were never diagnosed with glaucoma or had an eye examination within the last ten years. PROCEDURES: Measurements of distance visual acuity (VA), intraocular eye pressure (IOP), central corneal thickness (CCT), cup-to-disc ratio (CDR), frequency doubling technology (FDT) perimeter visual field (VF).Main Outcome MeasuresProportion of glaucoma suspects, based on IOP greater than or equal to 24 mm Hg or CDR greater than or equal to 0.7 in either eye, and determinants of CDR and IOP.ResultsOne hundred ninety-one (25.5%) of 750 patients were identified as glaucoma suspects. Glaucoma suspects were common in both the youngest and oldest age groups (<40 years, 20.9%; 95% confidence interval [CI], 17.9–23.9; >70 years, 25.0%; 95% CI, 21.8–28.2) and higher in men than women less than 70 years; the reverse was true after 70 years. Among all patients, mean IOP was 19.2±4.5 mmHg, mean CDR was 0.37±0.17, and mean CCT was 532±37.1 µm. In multiple linear stepwise regression analysis, determinates of increased CDR included increasing age (P = 0.004), lack of insurance (P = 0.019), and higher IOP (P<0.001), while increasing CDR (P<0.001) and thicker CCT (P<0.001) were associated with higher IOP.ConclusionsThis first glaucoma survey in a U.S. Haitian Afro-Caribbean population indicates glaucoma suspect status is high across all age groups, and suggests glaucoma monitoring in people less than 40 years of age is indicated in this population.

Endoscopic ethmoidectomy in fresh cadavers reduces impact energy necessary to induce orbital fracture and increases the prevalence of medial wall involvement. Clinicians may wish to counsel patients undergoing endoscopic sinus surgery about these relative risks.