A Population-Based Assessment of Presbyopia in the State of Andhra Pradesh, South India: The Andhra Pradesh Eye Disease Study

Nirmalan, Praveen K; Krishnaiah, Sannapaneni; Shamanna, B R; Rao, Gullapalli N; Thomas, Ravi

doi:10.1167/iovs.05-1192

Cited by 127 publications

(161 citation statements)

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“…8 The discovery that residing in a rural location is associated with the development of presbyopia has been replicated elsewhere. 9 In the same way, our study was undertaken exclusively in rurally located clusters, and our mean prevalence of presbyopia was higher in females. Female gender is consistently regarded as a risk factor for presbyopia, 7,10 which is an important revelation, because females are often less likely to receive ophthalmic treatment in low-income settings.…”

Section: U S O P H T H a L M I C R E V I E Wmentioning

confidence: 77%

Presbyopia, Related Functional Impairment, and Spectacle Use in Rural Kenya

Sherwin¹,

Mathenge²

2012

US Ophthalmic Review

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Presbyopia is the age-related loss of accommodation and is often associated with a progressive inability to read fine print and to write. Worldwide, it is estimated that 45 million people are blind, but this figure does not take into account the number with uncorrected presbyopia, the estimate of which is unknown. 1 The International Centre for Eyecare Education (ICEE) states that presbyopia affects 170 million people in sub-Saharan Africa, with over 7 million presbyopes in Kenya from a population of approximately 30 million, 2 of whom the majority will be uncorrected.The last few years have seen a discernible rise in research investigating the epidemiology, impact on quality of life, and management of presbyopia in low-and middle-income regions. Burke et al., authors of a large populationbased study of presbyopia in Tanzania, concluded that the 'VISION2020:The Right to Sight' refractive error agenda should place increased emphasis on targeting presbyopia. MethodsNakuru District is situated in the Rift Valley in Kenya, where a large percentage of the rural population are subsistence farmers earning less than $2 per day. For the purposes of our study, we selected clusters of people over 50 years of age through probability proportionate to size, and individuals were selected within clusters through compact segment sampling. Of those enumerated, 134 (93.1%) were willing to participate.Four were excluded because they did not see at least 3/60 (best corrected visual acuity [BCVA]) in either eye.Participants were given a short questionnaire evaluating their near-visionrelated functional impairment and history of spectacle use. Patients were also examined for presbyopia using a near-vision chart in English and local languages, but were not corrected for distance vision. Patients were excluded if they were bilaterally blind (BCVA <3/60 with a Logmar 'E' chart at 6m). All participants were given free spectacles for near vision if they required them and if they wanted them. We only assessed functional presbyopia, which we defined as 'requiring at least +1.00 diopter (D) in order to read the N8 optotype at a distance of 40cm in the participant's usual visual state.' Subsequently, subjects included myopes who were able to see N8 despite having lost the ability to accommodate. Subjects who were not functionally presbyopic but who had presbyopia following distance correction (objective presbyopes) were not included. Participants were also tested for near vision with reading glasses if they owned them and had them present at the time of the examination. PrevalenceWe examined 130 subjects, and found that the prevalence of presbyopia in the >50 years of age population was 85.4%. Of the participants with presbyopia, the mean age was 61.5 years and 39.6% were male. Due to differences in the age range of the subjects (see Table 1) and in the definition of presbyopia, 5 it is difficult to compare our estimated prevalence of presbyopia with the few reported findings of other population-based studies from low-or middle-income regions...

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Section: U S O P H T H a L M I C R E V I E Wmentioning

confidence: 77%

Presbyopia, Related Functional Impairment, and Spectacle Use in Rural Kenya

Sherwin¹,

Mathenge²

2012

US Ophthalmic Review

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“…Duarte et al, in Brazil estimated the prevalence of presbyopia in 3,000 adults of 30 years and older at 54.7 percent [22]. In southern India, Nirmalan et al, found a prevalence of 55 percent in subjects aged 30 years and older [23].…”

Section: Discussionmentioning

confidence: 99%

“…Testing both habitual distance visual acuity (uncorrected or with current correction) and corrected near visual acuity identifies refractive error or ocular disease and enables assessment of the patient's ability to function during near tasks. Patients underwent an ophthalmic examination that included Snellen Visual acuity, color vision, slit lamp biomicroscopy of the anterior segment as well as examination of the fundus [9]. Near vision was tested and corrected to the nearest +0.75 diopter.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence of presbyopia among smoking population

Khalaj¹,

Gasemi²,

Barikani³

et al. 2014

J Eye Ophthalmol

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Background: Presbyopia is a natural part of the aging process of the eye in which the loss of flexibility of the crystalline lens takes place over a number of years. This study aimed to determine differences in age of onset and progression of presbyopia between smoking and non smoking patients in Qazvin-Iran. Material and methods: A comparative cross-sectional study was carried out in Boali Hospital in Qazvin-Iran between 2011 and 2012. Within the context of this survey, 304 eligible participants over 30 years age were randomly selected for interview and underwent nearvision testing. Of these, 152 participants were smokers and formed the case group and 152 non-smoking people were considered control participants. Functional presbyopia was defined as requiring at least +0.75 diopter in order to read the N8 optotype at a distance of 35 cm in the participant's usual visual state. Optometric and ophthalmologic examinations were performed on all participants. presbyopic correction coverage were calculated and the results were analyzed using SPSS Program with P<0.05. Resuts: A total of 304 participants' records were evaluated. Of those, 152 cigarette smokers were categorized as samples and 152 normal patients as control group. Eighty-five patients with ages between 39-40 year among smoking group needed to use glasses for near tasks, but nobody in normal group needed presbyopic glasses. There were significant differences in the age of onset and or progression of presbyopia were detected between smoking and normal patients (p<0.05). Conclusions: Our study is the first population-based investigation of presbyopia in Iran, with the aim of determining age of onset and progression of presbyopia among smoking people related to normal population. The results of this study indicate that the onset of presbyopia among smoking group was earlier than normal group. Statistically significant difference in the age of onset and progression of presbyopia was found between smoking and non-smoking patients.

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“…Reduction in the cost of glasses and treatment of complications due to government, insurance, or other external subsidies or by other means, such as the use of ready-made spectacles, 28 would likely improve acceptance and thus the effect on VA and costeffectiveness. However, other barriers besides cost, such as discomfort and lack of perceived need, 29 have been shown to reduce adult use of spectacles in LMICs. Approximately one-third (27.9% in Africa) to almost two-thirds (64.8% in Latin America) of patients could benefit from glasses for residual postoperative refractive error.…”

Section: Discussionmentioning

confidence: 99%

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery

Meltzer

Congdon

Kymes³

et al. 2017

JAMA Ophthalmol

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IMPORTANCE Some experts recommend increasing low rates of follow-up after cataract surgery in low-and middle-income countries using various interventions. However, little is known about the cost and effect of such interventions.OBJECTIVE To examine whether promoting follow-up after cataract surgery creates economic value. DESIGN, SETTING, AND PARTICIPANTSThe Prospective Review of Early Cataract Outcomes and Grading (PRECOG) is a cohort study with data from patients undergoing cataract surgery from January 19, 2010, to April 18, 2012. Final follow-up was completed on August 10, 2012. Data were collected before surgery, at discharge, and at follow-up at least 40 days after surgery from 27 centers in 8 countries in Asia, Africa, and Latin America. Each center enrolled 40 to 120 consecutive patients undergoing cataract surgery. If patients did not return to the hospital for the follow-up visit, hospitals could use telephone calls or transportation subsidies to increase follow-up rate. Data were analyzed from December 2013 to January 2016. MAIN OUTCOMES AND MEASURES Cost of interventions (telephone calls and transportationsubsidies) to increase follow-up at least 40 days after surgery, visual acuity (VA) in the eye undergoing cataract surgery, presence of complications, patient and facility costs per visit, and willingness to pay for treatment or glasses if needed. The maximum incremental cost of improving VA in 1 patient (incremental cost-effect ratio [ICER]) was calculated for spontaneous follow-up (compared with no follow-up) and follow-up with the telephone and transportation interventions. Expected ICERs were estimated including only those patients willing to pay. RESULTS Among 2487 patients (1068 men [42.9%]; 1405 women [56.5%]; 14 missing [0.6%]; mean [SD] age, 68.4 [11.3] years), 2316 (93.1%) received follow-up, of whom 369 (16.0%) were seen in an outside facility or home and were in the cost-effectiveness analysis as unable to follow up. A grand mean (a mean of means of the different countries) of 56.3% of patients needed glasses, of whom 56.9% were willing to pay, and 1.6% had treatable complications, of whom 39.4% were willing to pay. Maximum proportions with improved VA (and corresponding ICERs) were 0.08 for no follow-up, 0.45 ($151.56) for spontaneous follow-up, 0.53 ($164.46) for a telephone intervention, and 0.53 ($133.07) for a transportation intervention. These results were most sensitive to the cost of follow-up. Expected proportions (ICERs) were 0.08, 0.27

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A Population-Based Assessment of Presbyopia in the State of Andhra Pradesh, South India: The Andhra Pradesh Eye Disease Study

Abstract: The high prevalence of presbyopia and the stated effect on performing activities related to near vision needs to be translated into programs and strategies that specifically target presbyopia.

Cited by 127 publications

References 26 publications

Presbyopia, Related Functional Impairment, and Spectacle Use in Rural Kenya

Presbyopia, Related Functional Impairment, and Spectacle Use in Rural Kenya

Prevalence of presbyopia among smoking population

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery

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