Prevalence, associations and characteristics of severe uncorrected refractive error in the Australian National Eye Health Survey

Abstract

Importance: In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. Background: To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. Design: Population-based cross-sectional study. Participants: A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. Methods: Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. Main Outcome Measure: Severe uncorrected refractive error Results: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between −2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. Conclusions and Relevance: Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error. K E Y W O R D Suncorrected refractive error, epidemiology, vision loss

Risk factors for uncorrected refractive error: Persian cohort eye study - Rafsanjan center

“… 15 16 17 While, female patients were more susceptible to URE in some studies, 15 18 others have reported the opposite. 19 20 21 Lower education, lack of insurance, and low income have also been related to URE. 17 18 21 Type of refractive error and diabetes are among the diseases that have been associated with URE.…”

Uncorrected refractive error in the Australian National Eye Health Survey

“…Associated risk factors were older age (OR 3.59), habitation in outer regional areas (OR 1.78) and lack of an eye examination in the previous 2 years (OR 1.5) for the Indigenous group. In the non‐Indigenous group, these risk factors were older age (OR 1.51), habitation in outer regional areas (OR 0.68 for inner regional) and male gender (OR 1.30) . The comparison of risk factors alerts us to several interesting findings involving demographics, age and modifiable risk factors.…”

“…In the current issue of the journal, Keel et al have extended their analysis to establish risk factors associated with severe uncorrected refractive error that may underpin the previously reported vision loss and blindness . In the included paper, they examined 1738 Indigenous Australians aged 40 to 92 years and 3098 non‐Indigenous Australians aged 50 to 98.…”

“…In the included paper, they examined 1738 Indigenous Australians aged 40 to 92 years and 3098 non‐Indigenous Australians aged 50 to 98. They reported the prevalence of severe uncorrected refractive error in the NEHS at 11.0% in the non‐Indigenous group and 14.5% in the Indigenous study group . Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity of <6/12.…”

“…The majority of these are likely individuals who present with some level of nuclear cataract. Confidence in this assertion arises from the reported prevalence of any cataract at 24% in non‐Indigenous and 33% in Indigenous participants . It would be interesting to undertake a longitudinal study as part of the NEHS to investigate the slow progression of nuclear cataracts over time in the older age group.…”