Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort

Abstract

Purpose To describe the prevalence of visual impairment and examine its association with demographic, socioeconomic, and health characteristics in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods Visual acuity data was obtained from 6134 participants, aged 46 to 87 years old at time of examination between 2002 and 2004 (mean age 64 years, 47.6% male), from six communities in the United States (U.S.). Visual impairment was defined as a presenting visual acuity of 20/50 or worse in the better-seeing eye. Risk factors were included in multivariable logistic regression models to determine their impact on visual impairment for men and women in each racial/ethnic group. Results Among all participants, 6.6% (N=421) had visual impairment, including 5.6% (N=178) of men and 7.5% (N=243) of women. Prevalence of impairment ranged from 4.2% (N=52) and 6.0% (N=77) in White men and women, respectively, to 7.6% (N=37) and 11.6% (N=44) in Chinese men and women, respectively. Older age was significantly associated with visual impairment in both men and women, particularly in those with lower socioeconomic status, but the effects of increasing age were more pronounced in men. Two-thirds of participants already wore distance correction and not unexpectedly, lower prevalence of visual impairment was seen in this group; however, 2.4% of men and 3.5% of women with current distance correction had correctable visual impairment, most notably among seniors. Conclusion Even in the United States where prevalence of refractive correction is high, both visual impairment and uncorrected refractive error represent current public health challenges.

Prevalence of Visual Acuity Loss or Blindness in the US

“…We identified 5 such studies for inclusion from (1) the Baltimore Pediatric Eye Disease Study (data collection period, 2003-2007; publication date, 2008) ; (2) the Chinese American Eye Study (data collection period, 2010-2013; publication date, 2016) ; (3) the Eye Diseases Prevalence Research Group (EDPRG; a meta-analysis of several earlier PBS; data collection period, 1985-1998; publication date, 2004) ; (4) the Los Angeles Latino Eye Study data collection period, 2000-2003; publication date, 2004) ; and (5) the Multi-Ethnic Study of Atherosclerosis Cohort (data collection period, 2000-2004; publication date, 2015). We abstracted estimated prevalence of dichotomous measures of visual impairment and blindness and sample size information from each study by age group, sex, and race/ethnicity. Of these sources, all but the EDPRG reported primary data on best-corrected visual acuity, as measured by study ophthalmologists.…”

“…For PBS, we searched online sources for studies published after 1991 that were representative of the target population from which the participants were sampled, presented primary results or meta-analysis of primary data, and reported age-specific, race/ethnicity-specific, and/or location-specific prevalence estimates. 11 We identified 5 such studies for inclusion from (1) 16 We abstracted estimated prevalence of dichotomous measures of visual impairment and blindness and sample size information from each study by age group, sex, and race/ethnicity. Of these sources, all but the EDPRG reported primary data on best-corrected visual acuity, as measured by study ophthalmologists.…”

Significant disparities in eyeglass insurance coverage in Canada

“…However, we believe a positive answer is very likely based on studies from the U.S. and Australia that identified URE as the most common cause of visual impairment. [4][5][6] Seniors are the population segment most affected by vision problems. However, eyeglass insurance coverage for seniors (33.8%) is only about half that of other age groups (55.9%−63.3%).…”

“…3 In the United States and Australia, recent data indicate that almost three quarters of individuals with visual impairment had URE as the cause. [4][5][6] URE is an issue in both developing and developed countries. 7,8 The World Health Organization has established a global initiative for eliminating avoidable blindness and has identified URE as one of the 5 working priorities to achieve this goal.…”

Visual impairment and blindness in the Xingu Indigenous Park – Brazil

“…Most estimates, however, do not include data from specific minority populations which are expected to present higher frequencies of visual impairment [ 3 – 5 ]. As a result, the burden of visual impairment and blindness may be underestimated and the public health policies derived from it may insufficiently attend the demand of those minority groups.…”