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Purpose: To investigate the association between visual impairment and employment status due to disability, utilizing data from the 2022 National Health Interview Survey (NHIS)., Methods: Adults 18 years of age and older were extracted from the 2022 NHIS dataset. A multivariable logistic regression model was created to evaluate the odds of unemployment ("laid off" and "looking for work"). Persons over the age of 65, as well as persons retired, going to school, self-employed, seasonal, or contract workers were excluded. Independent variables for the model included gender, race, Hispanic ethnicity, urban residency, level of education, citizenship, and self-reported vision. The latter variable was categorized as seeing with "some" difficulty, with "severe" difficulty, "can't see at all," and "a lot of difficulty." Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI)., Results: Associations with unemployment included education less than high school (OR 6.05, 95% CI: 3.98-9.18) and high school (OR 3.80, 95% CI 2.78-5.21); severe vision difficulty (OR 3.68 95% CI 1.73-7.86); Asian race (OR 2.53, 95% CI 1.64-3.89); and Black race (OR 1.78, 95% CI 1.31-2.41). The odds of unemployment were marginally elevated for those living in large metropolitan areas, while being born in the United States had a modest protective effect (OR 0.53, 95% CI 0.42-0.66)., Conclusion: The degree of visual impairment in this post-COVID-19 pandemic survey substantially affects employment, which is consistent with historical studies. Education among those with impaired vision is an important and modifiable variable that can positively influence the chances of employment.

Background: Little was known about the population coverage and causes of sight impairment (SI) registration within the Caribbean, or the extent to which register studies offer insights into population eye health., Methods: We compared causes of SI registration in the Trinidad and Tobago Blind Welfare Association (TTBWA) register with findings from the 2014 National Eye Survey of Trinidad and Tobago (NESTT), and estimated registration coverage. Cross-sectional validation studies of registered clients included interviews, visual function and cause ascertainment in July 2013, and interviews and visual function in July 2016., Results: The TTBWA register included 863 people (all ages, 48.1%(n = 415) male) registered between 1951 and 2015. The NESTT identified 1.1%(75/7158) people aged ≥5years eligible for partial or severe SI registration, of whom 49.3%(n = 37) were male. Registration coverage was approximately 7% of the eligible population of Trinidad. Nevertheless, there was close agreement in the causes of SI comparing the register and population-representative survey. Glaucoma was the leading cause in both the register (26.1%,n = 225) and population-based survey (26.1%, 18/69 adults), followed by cataract and diabetic retinopathy. In the validation studies combined, 62.6%(93/151) clients had severe SI, 28.5%(43/151) had partial SI and 9.9%(15/151) did not meet SI eligibility criteria. SI was potentially avoidable in at least 58%(n = 36/62) adults and 50%(n = 7/14) children., Conclusion: We report very low register coverage of the SI population, but close agreement in causes of SI to a contemporaneous national population-based eye survey, half of which resulted from preventable or treatable eye disease., (© 2024. The Author(s).)

Objectives: To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by diabetic retinopathy and their proportion of the total number of vision-impaired individuals., Methods: Data from population-based studies on eye diseases between 1980 to 2018 were compiled. Meta-regression models were performed to estimate the prevalence of blindness (presenting visual acuity <3/60) and moderate or severe vision impairment (MSVI; <6/18 to ≥3/60) attributed to DR. The estimates, with 95% uncertainty intervals [UIs], were stratified by age, sex, year, and region., Results: In 2020, 1.07 million (95% UI: 0.76, 1.51) people were blind due to DR, with nearly 3.28 million (95% UI: 2.41, 4.34) experiencing MSVI. The GBD super-regions with the highest percentage of all DR-related blindness and MSVI were Latin America and the Caribbean (6.95% [95% UI: 5.08, 9.51]) and North Africa and the Middle East (2.12% [95% UI: 1.55, 2.79]), respectively. Between 2000 and 2020, changes in DR-related blindness and MSVI were greater among females than males, predominantly in the super-regions of South Asia (blindness) and Southeast Asia, East Asia, and Oceania (MSVI)., Conclusions: Given the rapid global rise in diabetes and increased life expectancy, DR is anticipated to persist as a significant public health challenge. The findings emphasise the need for gender-specific interventions and region-specific DR healthcare policies to mitigate disparities and prevent avoidable blindness. This study contributes to the expanding body of literature on the burden of DR, highlighting the need for increased global attention and investment in this research area., (© 2024. The Author(s).)

Background: We aimed to update estimates of global vision loss due to age-related macular degeneration (AMD)., Methods: We did a systematic review and meta-analysis of population-based surveys of eye diseases from January, 1980, to October, 2018. We fitted hierarchical models to estimate the prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness ( < 3/60) caused by AMD, stratified by age, region, and year., Results: In 2020, 1.85 million (95%UI: 1.35 to 2.43 million) people were estimated to be blind due to AMD, and another 6.23 million (95%UI: 5.04 to 7.58) with MSVI globally. High-income countries had the highest number of individuals with AMD-related blindness (0.60 million people; 0.46 to 0.77). The crude prevalence of AMD-related blindness in 2020 (among those aged ≥ 50 years) was 0.10% (0.07 to 0.12) globally, and the region with the highest prevalence of AMD-related blindness was North Africa/Middle East (0.22%; 0.16 to 0.30). Age-standardized prevalence (using the GBD 2019 data) of AMD-related MSVI in people aged ≥ 50 years in 2020 was 0.34% (0.27 to 0.41) globally, and the region with the highest prevalence of AMD-related MSVI was also North Africa/Middle East (0.55%; 0.44 to 0.68). From 2000 to 2020, the estimated crude prevalence of AMD-related blindness decreased globally by 19.29%, while the prevalence of MSVI increased by 10.08%., Conclusions: The estimated increase in the number of individuals with AMD-related blindness and MSVI globally urges the creation of novel treatment modalities and the expansion of rehabilitation services., (© 2024. The Author(s).)

Background/objective: To determine the prevalence of visual impairment (VI), uncorrected refractive errors (URE), and effective refractive error coverage among individuals aged 15-50 years in Koshi Province, Nepal., Methods: A population-based cross-sectional study was conducted in Koshi Province in which 4800 participants were selected from 80 clusters. The study teams visited the selected households and conducted eye examinations. This included monocular unaided (and aided) visual acuity assessment using a Snellen chart with tumbling E optotypes at a distance of 6 meters. Near vision was assessed binocularly using the N notation chart at a fixed distance of 40 cm for each individual. Torchlight examination and distance direct ophthalmoscopy was done. VI was defined as presenting visual acuity worse than 6/12 in the better eye. URE was defined as presenting visual acuity worse than 6/12 and improving to 6/12 or better on using a pinhole. Near Vision Impairment was defined as binocular presenting near vision worse than N8 among those age 35 years and older., Results: In total, 4057 were examined (84.5% response rate). The prevalence of VI was 3.52% (95% CI:2.89-4.13; n = 143). The prevalence of URE in the better eye was 1.95% (95% CI:1.54-2.42; n = 79). The Refractive Error Coverage and Effective Refractive Error Coverage were 34.8% and 31.3% respectively. The prevalence of NVI was 34.24% (95% CI: 32.1-36.40; n = 666)., Conclusion: The prevalence of VI and  URE was low, attributed to the availability and uptake of services in Koshi province in Nepal., (© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Importance: Inconsistent estimates of self-reported vision impairment across survey sources may cause confusion about the true size of the population with vision problems., Objective: To explain why the American Community Survey (ACS) and Behavioral Risk Factor Surveillance System (BRFSS) produce different prevalence estimates for self-reported vision problems in the US, despite using the same question wording., Design, Setting, and Participants: This was a cross-sectional analysis of the 2021 ACS and BRFSS using subgroup analysis and decomposition. Respondents were from 49 states and the District of Columbia. Included in the analysis were a civilian noninstitutionalized population 18 years and older. Data were analyzed from August 2022 to October 2023., Intervention: Aspects of sample design and composition., Main Outcomes and Measures: Self-reported vision problems., Results: This study included a weighted sample of 2.8 million individuals (median [IQR] age, 47.7 [32.8-63.1] years; 51% male). The estimate of self-reported vision problems prevalence from the BRFSS (4.89%; 95% CI, 4.73%-5.04%) was 1.7 times as high as the estimate from the ACS (2.95%; 95% CI, 2.92%-2.97%) for similarly defined populations. If the BRFSS sample were weighted to align with the composition of other disability types in the ACS, the prevalence of vision problems would be 3.67% (95% CI, 3.53%-3.80%), closing about 63% of the gap between survey estimates., Conclusion and Relevance: Results of this survey study suggest that the focus on health may be associated with the higher prevalence in the BRFSS through differential nonresponse or question priming. Differences in other survey operations including frame construction, proxy reporting, and imputation had little impact.

Objective: To evaluate associations between visual impairment, anxiety, and depression during the COVID-19 pandemic in the US., Design: Retrospective cross-sectional METHODS: This study included a cohort of US adults enrolled in the National Institute of Health All of Us Research Program. Individuals who were blind/visually impaired (BVI) were identified via SNONMED codes and compared to a control cohort. Prevalence of baseline, new, and worsened depression and anxiety, as defined by SNONMED codes and medication use were compared between the two groups. Anxiety and depression during the COVID-19 pandemic were evaluated using the Generalized Anxiety Disorder 7 and the Patient Health Questionnaire 9 survey, respectively., Results: 324,915 participants, (7,526 BVI individuals and 317,389 controls) were included. BVI individuals had higher prevalence of baseline anxiety and depression (50.4% vs. 28.7%, p<0.001), new anxiety and depression (0.98% vs. 0.66%, p<0.001), and worsened anxiety and depression throughout the COVID-19 pandemic (0.19% vs. 0.07%, p<0.001) compared to controls. Being BVI was significantly associated with baseline and worsened anxiety and depression, after controlling for age, gender, race, ethnicity, and comorbidity (adjusted odds ratio (aOR)=1.61; 95% CI 1.46-1.78, aOR=2.07; 95% CI 1.03-4.13). Similarly, being BVI was associated with a 2.07-point increase on the GAD-7 survey (adjusted beta=2.07; 95% CI 1.32-3.27) and a 2.96-point increase on the PHQ-9 survey (adjusted beta=2.96; 95% CI 1.64-5.36)., Conclusions: These findings indicate that BVI individuals are disproportionately affected by anxiety and depression at baseline and throughout the pandemic, highlighting an important need to promote access to mental health services among this population., (Copyright © 2022 Canadian Ophthalmological Society. All rights reserved.)

Objectives: To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by glaucoma and their proportion of the total number of vision-impaired individuals., Methods: A systematic review and meta-analysis of published population studies and grey literature from 2000 to 2020 was carried out to estimate global and regional trends in number of people with vision loss due to glaucoma. Moderate or severe vision loss (MSVI) was defined as visual acuity of 6/60 or better but <6/18 (moderate) and visual acuity of 3/60 or better but <6/60 (severe vision loss). Blindness was defined as presenting visual acuity <3/60., Results: Globally, in 2020, 3.61 million people were blind and nearly 4.14 million were visually impaired by glaucoma. Glaucoma accounted for 8.39% (95% uncertainty intervals [UIs]: 6.54, 10.29) of all blindness and 1.41% (95% UI: 1.10, 1.75) of all MSVI. Regionally, the highest proportion of blindness relating to glaucoma was found in high-income countries (26.12% [95% UI: 20.72, 32.09]), while the region with the highest age-standardized prevalence of glaucoma-related blindness and MSVI was Sub-Saharan Africa. Between 2000 and 2020, global age-standardized prevalence of glaucoma-related blindness among adults ≥50 years decreased by 26.06% among males (95% UI: 25.87, 26.24), and by 21.75% among females (95% UI: 21.54, 21.96), while MSVI due to glaucoma increased by 3.7% among males (95% UI: 3.42, 3.98), and by 7.3% in females (95% UI: 7.01, 7.59)., Conclusions: Within the last two decades, glaucoma has remained a major cause of blindness globally and regionally., (© 2024. The Author(s).)

Background: To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by cataract and their proportion of the total number of vision-impaired individuals., Methods: A systematic review and meta-analysis of published population studies and gray literature from 2000 to 2020 was carried out to estimate global and regional trends. We developed prevalence estimates based on modeled distance visual impairment and blindness due to cataract, producing location-, year-, age-, and sex-specific estimates of moderate to severe vision impairment (MSVI presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60). Estimates are age-standardized using the GBD standard population., Results: In 2020, among overall (all ages) 43.3 million blind and 295 million with MSVI, 17.0 million (39.6%) people were blind and 83.5 million (28.3%) had MSVI due to cataract blind 60% female, MSVI 59% female. From 1990 to 2020, the count of persons blind (MSVI) due to cataract increased by 29.7%(93.1%) whereas the age-standardized global prevalence of cataract-related blindness improved by -27.5% and MSVI increased by 7.2%. The contribution of cataract to the age-standardized prevalence of blindness exceeded the global figure only in South Asia (62.9%) and Southeast Asia and Oceania (47.9%)., Conclusions: The number of people blind and with MSVI due to cataract has risen over the past 30 years, despite a decrease in the age-standardized prevalence of cataract. This indicates that cataract treatment programs have been beneficial, but population growth and aging have outpaced their impact. Growing numbers of cataract blind indicate that more, better-directed, resources are needed to increase global capacity for cataract surgery., (© 2024. The Author(s).)

Objective: This study determined the prevalence and aetiology of unilateral visual impairment (VI) and blindness and its associated factors in school children., Methods: We conducted a multistage, cross-sectional study in primary and secondary schools of Saki-East Local Government Area of Oyo State, Nigeria. Unilateral VI was defined as presenting visual acuity (PVA) worse than +0.3 LogMAR (6/12) and unilateral blindness as PVA worse than +1.3 LogMAR (3/60) in the worse eye. Detailed ocular examinations were performed for students with unilateral VI, and Logistic regression analysis was performed to explore associations with independent variables., Results: The mean age of participants was 11 ± 3.2 years. Thirty-six (0.98%) of 3671 children had unilateral VI, and fifteen children had unilateral blindness (0.41%), giving a combined prevalence of 1.39 ± 0.5%. History of ocular trauma was reported by 14 (27.5%) participants with unilateral VI and blindness. In addition, those with a history of ocular trauma were 6.5 times more likely to be blind or have a severe VI (95% CI 1.5-2.8) than those without a history of ocular trauma. Uncorrected refractive error was the major cause of unilateral VI in 26 (51%) participants, while traumatic cataract was the main cause of unilateral blindness seen in 5 (9.8%) participants, none of whom had a previous eye examination., Conclusion: Fourteen per thousand school children had unilateral VI in this study; the major causes were refractive error and cataract, which are treatable. Ocular trauma was a significant risk factor for unilateral VI and blindness., (© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background: Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020 METHODS: Data from population-based eye disease surveys from 1980-2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12)., Results: In 2020, 3.7 million people (95%UI 3.10-4.29) were blind and 157 million (140-176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7-30.3) and 2.4% (2.6-2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26-0.40%)) and MSVI (10.3% (8.82-12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6-76.0) increase from 2000 CONCLUSIONS: The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery., (© 2024. The Author(s).)

Background: Understanding and mitigating the societal economic impact of vision impairment (VI) is important for achieving the Sustainable Development Goals., Aim: To estimate the prevalent societal economic impact of presenting VI in Trinidad and Tobago using bottom-up cost and utilisation data from the 2014 National Eye Survey of Trinidad and Tobago., Methods: We took a societal perspective to combine comprehensive, individual-level cost and utilisation data, with population-based prevalence estimates for VI, and additional data from a contemporaneous national eyecare system survey. We included direct (medical and non-medical) and indirect (productivity loss) costs, and intangible losses in total cost estimates, presented in 2014 Trinidad & Tobago (TT) dollars and UK sterling equivalent. We considered but excluded transfer payments and dead weight losses. Sensitivity analyses explored impact on total cost of parameter uncertainty and assumptions., Results: Individual utilisation and cost data were available for 65.5% (n = 2792/4263) and 59.0% (n = 2516/4263) eligible participants aged ≥40 years, respectively. Participant mean age was 58.4(SD 11.8, range 40-103) years, 56.3% were female. We estimated total societal cost of VI in 2014 at UK£365,650,241 (TT$3,842,324,655), equivalent to £675 per capita (population ≥40 years). Loss of wellbeing accounted for 73.3%. Excluding this, the economic cost was UK£97,547,222 (TT$1,025,045,399), of which indirect costs accounted for 70.5%, followed by direct medical costs (17.9%), and direct non-medical costs (11.6%)., Conclusion: This study provides a comprehensive estimate of the economic impact of vision loss in a Caribbean country, and highlights the extent to which affected individuals and their families bear the societal economic cost of vision impairment., (© 2023. The Author(s).)

Background: It is well established that meeting physical activity (PA) guidelines has a range of physical and mental health benefits. For people who are blind and vision impaired (BVI) there may be additional benefits in terms of social inclusion and the prevention of sight deterioration., Objective: This study aimed to quantify PA levels, barriers to and motivators for PA in adults who are BVI., Methods: PA levels, perceived barriers to, and motivators for PA were measured via questionnaire of 310 self-identifying BVI adults (n = 310 mean age = 29.77 ± 11.37, 55.8% male)., Results: PA levels were low, with 21.7% meeting PA guidelines. Median PA levels were not statistically significantly different between different age groups. There was no significant difference between genders, though mean days of PA for males was 0.382 days lower than for females. There was a significant difference between PA levels between the "no vision" (B1) and "useful vision" (B3) groups (p = 0.027), and the "no vision" (B1) and the "low vision" (B2) groups (p = 0.003). Transport (54.8%) and lack of access to enjoyable activities (47.0%) were the most commonly cited barriers, while "to relax" (36.4%) and "to have fun" (35.6%) were most commonly cited as very important motivators., Conclusions: This study provides a valuable insight into the low levels of PA that persist amongst adults with BVI. Future research should seek to gain a deeper understanding of the PA barriers, motivators and facilitators in this cohort., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: To estimate the magnitude, determinants, and causes of visual impairment (VI) and blindness among people >40 years., Methods: In this cross-sectional survey, 2,968 people >40 years from 34 clusters were examined. A cluster random sampling method with a compact segment sampling technique was used to select the study participants. Prevalence of any VI (presenting visual acuity (PVA) <6/12 in better eye), severe VI (PVA <6/60 - 3/60), and blindness (PVA <3/60 in better eye) were expressed as percentage with 95% confidence interval. Logistic regression was performed to determine the risk factors associated with blindness. A P value of less than 0.05 was considered statistically significant., Results: The mean age of the participants was 54.6 years (Standard deviation ± 11.2 years). The prevalence of mild, moderate, and severe visual impairment was 14.2% (12.95-15.49), 13.7% (12.46-14.97), and 0.7% (0.47-1.12), respectively. The prevalence of blindness was 1.3% (0.94-1.79, n = 39). The overall prevalence of VI (presenting Visual Acuity <6/12) was 12.0% (95% CI: 10.8-13.2%). The major causes of VI were cataract (78.08%), refractive error (12.07%), and optic atrophy (2.22%), and corneal opacity (2.22%) and the major cause of blindness was cataract (77.27%). Blindness was strongly associated with increasing age- OR 17.1 (95% CI: 4.9-59.8) for people >70 years, and OR 7.6 (95% CI: 2.2-26.5) for people aged between 60 and 69 years compared to those aged 41-50 years and people living near coastal regions (Within 50 km of coast) (OR: 3.9, 95% CI: 1.6-7.3)., Conclusion: Blindness and vision impairment are of public health concern in this geographic region. Eye care services need to be augmented to address this challenge., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

This cross-sectional study aimed to develop a hospital and pharmacy services model from the patient's perspective, identifying the gap and domain for services improvement. The study was conducted on 140 persons aged ≥ 18 years with visual impairment or low vision in Bangkok, Thailand. The results demonstrated that patients' perceived services were not inclusively designed for visually impaired persons. The domains with the highest gap analysis score were navigation systems, followed by a detailed explanation, such as dose mismanagement, observed medication expiration dates, and pharmacy self-identification. The patient-centered service model empowered visually impaired persons to achieve medication outcomes and safety.

Purpose: To assess prevalence and incidence of severe visual impairment (VI) and blindness due to uveitis in Northrhine, Germany., Methods:  A random sample of 5088 out of 20 390 cases of the blindness registry in Northrhine was evaluated. The number of cases of severe VI and blindness were projected up to the year 2030., Results: The prevalence of registered severe VI and blindness due to uveitis was 1123.9 (95% CI: 1059.5 to 1191.2) per 100 000 in our study cohort and 550.31 (95% CI: 365.98-794.38) per 100 000 in Northrhine, respectively. The incidence of registered severe VI and blindness due to uveitis was 311.8 per 100 000 PYs (95% CI: 149.6-572.7) in our study cohort and 11.1 per 100 000 (95% CI: 5.6-19.8) in Northrhine, respectively., Conclusions: We report prevalence and incidence of severe VI and blindness due to uveitis in a large German cohort.

Aims/introduction: To conduct a multicenter survey of visually impaired patients with diabetes mellitus (DM) and to identify the physical and ocular characteristics that lead to blindness in Japan., Materials and Methods: Visually impaired patients with diabetes mellitus in Japan were divided into blind and low-vision groups according to the World Health Organization classification. Data on parameters related to diabetes mellitus and ocular complications in the right and left eyes were collected from 19 highly advanced medical facilities and compared between the two groups., Results: Among 408 visually impaired persons (blind group: 257, low-vision group: 151), 72.1% were under 70 years of age. The rates of neovascular glaucoma (NVG) (right eye, P = 0.041; left eye, P = 0.0031) or proliferative diabetic retinopathy (PDR) (right eye: P = 0.014, left eye: P = 0.0047) and the rate of proliferative membrane beyond half of the retinal area (right eye: P = 0.0263, left eye: P = 0.037) were significantly higher in the blind group. The direct cause of visual impairment was retinal atrophy, common in both groups. Neovascular glaucoma and diabetic macular edema were equally prevalent in the blind and low-vision groups, respectively., Conclusions: In Japan, blind patients with diabetes mellitus are characterized by severe conditions such as neovascular glaucoma and progressive proliferative diabetic retinopathy upon their initial visit to an advanced care facility. These results highlight the importance of monitoring retinopathy through regular ophthalmological examinations, internal medicine, and appropriate therapeutic intervention., (© 2024 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Significance: Social media is used by >4.48 billion people worldwide. Despite its popularity, vision-impaired individuals struggle to use social media given visual inaccessibility of content and lack of access to Internet/Wireless-Fidelity-enabled devices. Our study explores visually impaired adult's use of social media in comparison to a control group., Purpose: This study aimed to report the demographic profile and patterns of social media use among adults with vision impairment (VI) aged 18 to 35 years and compare it with an age-matched normally sighted group in India. In addition, we explored barriers to use of social media among adults with VI., Methods: Vision-impaired and normally sighted adults (controls) aged 18 to 35 years at L V Prasad Eye Institute, Hyderabad, India, answered a questionnaire about social media use (e.g., platform used)., Results: Four hundred twenty-two individuals (201 VI, 221 controls) participated. Normally sighted adults (98%) used social media more than the VI group (81%; p<0.001). Vision-impaired users were predominantly male (85%) and unemployed (57%; p<0.00001 for both). There was no significant difference in educational level between groups (p=0.17). Smartphones were the most popular device used (VI, 161 [99%]; control, 206 [95%]), with tablet PC/iPad being the least popular (VI, 5 [3%]; control, 12 [6%]). Adults with VI and controls commonly used WhatsApp as communication platforms, and Facebook and Twitter as networking platforms. Approximately one-third of individuals across both social media user groups reported barriers to use (VI, 48 [30%]; control, 74 [34%]; p<0.001). Vision-impaired individuals cited accessibility issues of having to rely on audio over vision to navigate social media, whereas controls reported having to share a phone., Conclusions: The proportion of social media usage among VI adults is high (81%) and is substantially higher than the 33% reported in the general Indian population. Vision-impaired adults who used social media were male with moderate VI and were less likely to be employed compared with controls., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2024 American Academy of Optometry.)

Purpose: To investigate the characteristics of electronic device users, specifically smartphones and tablets, in the Device & Aids Register (D.A.Re), from several low-vision rehabilitation services in Italy., Methods: We collected general and clinical information about ocular and systemic diseases, visual function, reading speed and Instrumental Activities of Daily Living (IADL) questionnaire score. Technological details of each optical and electronic device, (including screen size, touch-screen and OCR functions, text-to-speech function) were also collected., Results: 1218 patients (752 females and 466 males) were included in our analysis, mean age 71.5 (±18.8) years. Users of electronic aids (n.237) were slightly younger (67 vs 72 years, p < 0.001) than non-users (n.981), had a worse reading speed (38 vs 65 words/minute), critical print size (43 vs 28 print size, p < 0.001), poorer visual acuity (VA)(1.0 logMAR or less: 30% non-users vs 73% users, p < 0.001) and more commonly visual field restriction within 10° (23% vs 14%, p = 0.001). A similar proportion of users and non-users were retired (about 70%) and about 16-17% were employed. The use of portable electronic devices (5″or less, p < 0.001; 6″ to 18″ screen size, p = 0.017) was associated with better IADL scores, and the use of stand devices with worse IADL score (p < 0.001); Furthermore, using smartphones and tablets (193 subjects) was strongly associated with better IADL scores., Conclusion: We found that using electronic devices, and especially smartphone and tablets, were associated with better vision-related quality of life in low-vision people attending rehabilitation services. While this association does not mean causality, these findings seemed robust to confounder adjustment., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Federico Bartolomei, Eliana Costanzo, Ruth E. Hogg, John G. Lawrenson, Elisabetta Falchini, Alessia Di Simone, Valentina Pastore, Chiara Mastrantuono, Giovanni Sato, Filippo Amore, Ilaria Biagini, Giovanni L. Ciaffoni, Mauro Tettamanti, and Gianni Virgili have nothing to disclose.Mariacristina Parravano reports personal fees from Allergan, Novartis, Bayer, Roche, Zeiss outside the submitted work.

Importance: Telehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI)., Objective: To examine the associations between VI and digital technology access measures in US older adults., Design, Setting, and Participants: This was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023., Exposure: VI, measured on categorical (distance and near VI [>0.30 logMAR], contrast sensitivity impairment [CSI; <1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales., Main Outcomes: Self-reported outcomes of digital technology access from the technological environment component of the NHATS., Results: Of the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health- and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97)., Conclusions and Relevance: Results suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health- and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.

Visual stimuli play key roles in influencing men sexual behavior. However, few studies have explored the sexual behavior of blind men. To provide more information about blind men for the study of andrology by surveying the characteristics of their current sexual behavior. A questionnaire-based cross-sectional study design was performed. The questionnaire contained questions regarding demographic characteristics of participants, access to sexual knowledge, perception of the sexual partners' beauty, and sexual arousal. Blind men were interviewed face-to-face by the trained investigator. Complete questionnaires were collected from 54 participants, with an average age of 40.57 ± 9.80 years old. Eye diseases were the most frequent cause of blindness. In terms of sexual orientation, all participants were heterosexual. Notably, 90.7% of the participants reported to have had a sexual experience. Among those who had engaged in sexual behavior, 93.6% experienced sexual pleasure and 69.4% had a normal erectile function. Overall, 16.7% of the participants received sex education. The participants obtained sexual knowledge mainly through sounds from mobile phones, peer-to-peer communication, sounds of television and radio. Voice was the most frequent perception of the sexual partners' beauty, followed by figure, skin, and body fragrance. In terms of stimuli of sexual arousal, tactile sensation and auditory sensation in that order were the most frequent stimuli of sexual arousal. Stimuli of sexual arousal in blind men are mainly mediated by sound and touch. Blind men understand their sexual partners' beauty through auditory, tactile, and olfactory sensations. Blind men in Ganzhou lack formal and systematic sex education., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Importance: Refractive error remains the largest cause of correctable visual impairment in the US. Correction of refractive error will reduce visual impairment and its associated morbidity but also improve quality of life and productivity., Objective: To determine the burden of and risk factors (RFs) associated with any uncorrected refractive error (UCRE) and unmet refractive need (URN) in a population-based sample of African American adults., Design, Setting, and Participants: This cross-sectional study, conducted from April 2014 to April 2018, included a population-based sample of self-identified African American participants 40 years and older from 30 contiguous census tracts in Inglewood, California. Participants underwent a complete ophthalmic examination and an in-home-administered questionnaire to assess sociodemographic, lifestyle, biological, medical, and health care and eye care usage RFs associated with UCRE and URN. Measurements of visual acuity (VA) were performed using a standard Early Treatment Diabetic Retinopathy Study protocol. Noncycloplegic automated refraction with supplemental subjective refraction was performed. UCRE was defined as an improvement of 2 or more lines with refraction in the better-seeing eye. URN was defined as an improvement of 2 or more lines with refraction in the better-seeing eye in those persons who were visually impaired. Sex- and age-specific burden of UCRE and URN were calculated, and multiple regression analyses were used to identify independent RFs. Study data were analyzed from May 2018 to December 2023., Exposures: Presence or absence of correctable refractive error., Main Outcomes and Measures: Self-reported sex- and age-specific prevalence of and risk indicators of UCRE and URN., Results: Of the 7957 eligible participants in the African American Eye Disease Study (AFEDS), 6347 (80%) completed both the in-home interview and the clinical examination. Of these, 6337 participants (mean [SD] age, 61 [11] years; 3997 female [63%]) with complete refractive error data were included in the analysis. Refractive error-related correctable visual impairment was present in over two-thirds of participants with visual impairment (68.7%). The overall prevalence of any UCRE was 14.6% (925 of 6337), and the overall prevalence of any URN was 5.4% (URN1 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve 20/40 or better with correction], 157 of 2893; URN2 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve an improvement of 2 or more lines with refractive correction], 155 of 2891)., Conclusions and Relevance: Results of this cross-sectional study suggest a high burden of refractive error-associated correctable refractive error in African American adults, making it the leading cause of visual impairment in this population. Providing universal coverage for vision care and prescription glasses is an affordable and achievable health care intervention that could reduce the burden of visual impairment in African American adults by over two-thirds and likely raise the quality of life and work productivity, especially in this vulnerable minority population.

Aims: To determine the prevalence and causes of visual impairment and blindness in Vientiane Province, the Lao People's Democratic Republic (Lao PDR)., Methods: We conducted a population-based, cross-sectional study of 1264 participants aged 40 years and older from urban and rural areas of Vientiane Province. The ophthalmic examination included presenting and pinhole Snellen visual acuity (VA) with an illiterate E chart, slit-lamp examination of the anterior segment and dilated stereoscopic fundus examination. Visual impairment and blindness were defined by both presenting and pinhole VA based on the better eye according to WHO criteria: VA worse than 6/12 to 6/18 for mild impairment, VA worse than 6/18 to 6/60 for moderate impairment, VA worse than 6/60 to 3/60 for severe impairment and VA worse than 3/60 for blindness., Results: Comprehensive ophthalmic examinations were performed on 1264 participants (77.8% participation rate). Population-weighted prevalence of presenting bilateral blindness was 1.4% (95% CI 0.8 to 2.0) and bilateral visual impairment was 22.4% (95% CI 14.7 to 30.1). After pinhole correction, the corresponding prevalence of blindness was 1.3% (95% CI 0.8 to 2.0) and that of visual impairment was 12.6% (95% CI 8.2 to 16.9). Cataract was the leading cause of presenting bilateral blindness (52.9%), whereas uncorrected refractive error was the predominant cause of presenting visual impairment (40.3%)., Conclusions: Visual impairment and blindness remain major public health problems in Lao PDR. There is an ongoing need to fund ophthalmic care resources and community education programmes to improve access to healthcare in this region., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Importance: Estimates of the association between visual impairment (VI) and dementia in the US population are based on self-reported survey data or measures of visual function that are at least 15 years old. Older adults are at high risk of VI and dementia so there is a need for up-to-date national estimates based on objective assessments., Objective: To estimate the association between VI and dementia in older US adults based on objective visual and cognitive function testing., Design, Setting, and Participants: This secondary analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study, included 3817 respondents 71 years and older. Data were analyzed from January to March 2023., Intervention: In 2021, NHATS incorporated tablet-based tests of distance and near visual acuity and contrast sensitivity (CS) with habitual correction., Main Outcomes and Measures: VI was defined as distance visual acuity more than 0.30 logMAR, near visual acuity more than 0.30 logMAR, and CS more than 1 SD below the sample mean. Dementia was defined as scoring 1.5 SDs or more below the mean in 1 or more cognitive domains, an AD8 Dementia Screening Interview Score indicating probable dementia, or diagnosed dementia. Poisson regression estimated dementia prevalence ratios adjusted for covariates., Results: Of 2967 included participants, 1707 (weighted percentage, 55.3%) were female, and the median (IQR) age was 76.9 (77-86) years. The weighted prevalence of dementia was 12.3% (95% CI, 10.9-13.7) and increased with near VI (21.5%; 95% CI, 17.7-25.3), distance VI (mild: 19.1%; 95% CI, 13.0-25.2; moderate, severe, or blind: 32.9%; 95% CI, 24.1- 41.8), and CS impairment (25.9%; 95% CI, 20.5-31.3). Dementia prevalence was higher among participants with near VI and CS impairment than those without (near VI prevalence ratio: 1.40; 95% CI, 1.16-1.69; CS impairment prevalence ratio: 1.31; 95% CI, 1.04-1.66) and among participants with moderate to severe distance VI or blindness (prevalence ratio: 1.72; 95% CI, 1.26-2.35) after adjustment for covariates., Conclusions and Relevance: In this survey study, all types of objectively measured VI were associated with a higher dementia prevalence. As most VI is preventable, prioritizing vision health may be important for optimizing cognitive function.

Importance: Existing estimates of the prevalence of vision impairment (VI) in the United States are based on self-reported survey data or measures of visual function that are at least 14 years old. Older adults are at high risk for VI and blindness. There is a need for up-to-date, objectively measured, national epidemiological estimates., Objective: To present updated national epidemiological estimates of VI and blindness in older US adults based on objective visual function testing., Design, Setting, and Participants: This survey study presents a secondary data analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study of Medicare beneficiaries 65 years and older. NHATS includes community-dwelling older adults or their proxies who complete in-person interviews; annual follow-up interviews are conducted regardless of residential status. Round 11 NHATS data were collected from June to November 2021, and data were analyzed in August 2022., Interventions: In 2021, NHATS incorporated tablet-based tests of distance and near visual acuity and contrast sensitivity with habitual correction., Main Outcomes and Measures: National prevalence of impairment in presenting distance visual acuity (>0.30 logMAR, Snellen equivalent worse than 20/40), presenting near visual acuity (>0.30 logMAR, Snellen equivalent worse than 20/40), and contrast sensitivity (>1 SD below the sample mean). Prevalence estimates stratified by age and socioeconomic and demographic data were calculated., Results: In the 2021 round 11 NHATS sample, there were 3817 respondents. After excluding respondents who did not complete the sample person interview (n = 429) and those with missing vision data (n = 362), there were 3026 participants. Of these, 29.5% (95% CI, 27.3%-31.8%) were 71 to 74 years old, and 55.2% (95% CI, 52.8%-57.6%) were female respondents. The prevalence of VI in US adults 71 years and older was 27.8% (95% CI, 25.5%-30.1%). Distance and near visual acuity and contrast sensitivity impairments were prevalent in 10.3% (95% CI, 8.9%-11.7%), 22.3% (95% CI, 20.3%-24.3%), and 10.0% (95% CI, 8.5%-11.4%), respectively. Older age, less education, and lower income were associated with all types of VI. A higher prevalence of near visual acuity and contrast sensitivity impairments was associated with non-White race and Hispanic ethnicity., Conclusions and Relevance: More than 1 in 4 US adults 71 years and older had VI in 2021, higher than prior estimates. Differences in the prevalence of VI by socioeconomic and demographic factors were observed. These data could inform public health planning.

Purpose: Although visual impairment (VI) has been associated with worse cognitive performance among older adults, the temporal relationship between the 2 remains subject to debate. Our objective was to investigate the longitudinal impact of VI on cognitive function and vice versa., Design: Retrospective, time-to-event study., Participants: National Health and Aging Trends Study (NHATS) participants from 2011 to 2018 cycles., Methods: A total of 10 676 participants aged 65 years and older were included. Cox proportional hazards regression models evaluated the impact of baseline VI on subsequent dementia and impact of baseline dementia on subsequent VI. Models were adjusted for potential confounding variables, including demographics, clinical comorbidities, and hearing and physical function limitations., Main Outcome Measures: Hazard ratio (HR) for incident dementia among participants with baseline self-reported VI and HR for incident VI among participants with baseline dementia., Results: Of the 10 676 participants included in the analysis, approximately 40% were aged 65-74 years, 40% were aged 75-84 years, and the remaining 20% were aged 85 years and older. The majority were female (59%), and 68% self-identified as non-Hispanic White. Among participants with normal cognitive status at baseline, subsequent dementia was observed in 1753 (16%), and among participants with normal self-reported vision at baseline, subsequent VI was reported in 2371 (22%). In adjusted regression models, participants with baseline VI had higher likelihood of developing dementia over subsequent follow-up (HR, 2.3; 95% confidence interval [CI], 2.0-2.6; P < 0.001). Likewise, participants with baseline dementia had a higher likelihood of developing self-reported VI over time (HR, 2.5; 95% CI, 2.2-2.8; P < 0.001)., Conclusions: Self-reported VI in the US Medicare population is associated with greater dementia likelihood over time, and dementia is similarly associated with greater VI likelihood over time. Associations are likely multifactorial and bidirectional and could be explained by intervening variables in the path from VI to dementia, or vice versa, or by common risk factors for pathological processes in both eyes and brain. These findings suggest the need for early identification of older adults with visual compromise and consideration of visual disability in the cognitively impaired., (Published by Elsevier Inc.)

Purpose: An attachment theory framework approach may allow insight into how social and psychosocial factors interact to impact vision-related quality of life (QoL). In this pilot study, we investigated potential associations between adult attachment style and visual function QoL of visually impaired individuals., Methods: We recruited 38 visually impaired individuals (15 females, 23 males; 51.8 ± 16.0 years). Visual function measures included distance and near visual acuity (VA) and contrast sensitivity. All participants completed: the 25-item National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ 25) and the Experiences in Close Relationships-Relationships Structures questionnaire., Results: Presenting conditions included inherited retinal dystrophy (n = 10), nystagmus (n = 9), glaucoma (n = 7) and other eye conditions (n = 12). There was a statistically significant negative correlation between the NEI-VFQ-25 composite score (45.5 ± 14.7) and attachment-related anxiety (r = -0.352, p = 0.033). The latter correlation still held when controlling for participants' level of vision (r = -0.352, p = 0.035). Despite the range of conditions and wide age range, these were not significantly correlated with any variable of interest in the current study., Conclusion: Attachment-related anxiety ought to be taken into account when managing a visually impaired individual. Attachment-based approaches could be used to improve access to support services for visually impaired individuals, as well as self-management of their condition.

Purpose: To evaluate the effect of population screening on low vision and blindness from open-angle glaucoma., Design: Retrospective cohort study., Methods: A large population-based screening for glaucoma was conducted in Malmö, Sweden, from 1992 to 1997. A total of 42,497 subjects were invited, of which 32,918 were screened, and 9,579 were non-responders (ie, did not participate). The records of glaucoma patients who had visited the Department of Ophthalmology at Malmö University Hospital from January 1, 1987, to December 31, 2017, were reviewed. Patients diagnosed at or after the screening were assessed for moderate or severe vision impairment, here called low vision, or blindness by the World Health Organization definition. Selection bias was corrected by creating a group of potential screening participants from a comparison group of clinical patients. Main outcome measures were the risk ratios of the cumulative incidence for bilateral low vision or blindness caused by glaucoma in screened patients compared with the potential participants., Results: The cumulative incidence of blindness was 0.17% in the screened population versus 0.32% among the potential participants; and for low vision 0.25% versus 0.53%. The risk ratio (95% confidence interval) between the two was 0.52 (0.32-0.84) for blindness and 0.46 (0.31-0.68) for low vision. There were no differences between the proportions of potential confounders in the comparison group and those in the non-responders., Conclusions: The results suggest that population screening may reduce bilateral low vision and blindness caused by glaucoma by approximately 50%., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Topic: The magnitude and direction of the association between vision impairment and incident dementia and cognitive impairment in prospective cohort studies was estimated by systematic review and meta-analysis. The global burden of dementia associated with vision impairment then was estimated., Clinical Relevance: Because a predominant proportion of vision impairment is preventable or treatable, investigating its association with dementia may help to identify an important modifiable factor for the prevention of dementia., Methods: A literature search was conducted using PubMed, Embase, Web of Science, and Google Scholar on September 15, 2020. Relative risks (RRs) were pooled using random-effects models and stratified analyses for subgroups representing different study characteristics. Publication bias was evaluated with funnel plots and the Egger test. The global burden of dementia associated with vision impairment was estimated based on the Global Burden of Disease Study data on the prevalence of dementia and vision impairment., Results: In the meta-analysis of 14 prospective cohort studies with 6 204 827 participants and 171 888 dementia patients, the pooled RR associated with vision impairment was 1.47 (95% confidence interval [CI], 1.36-1.60). In the meta-analysis of 12 prospective cohort studies with 45 313 participants and 13 350 patients with cognitive impairment, the pooled RR was 1.35 (95% CI, 1.28-1.41). Stratified analyses showed that the associations of vision impairment with incident dementia and cognitive impairment were similar across methods of vision assessment, length of follow-up, and study quality. The global number of people with dementia associated with moderate or severe vision impairment in 2016 was 2.1 million (80% uncertainty interval, 1.0-3.3 million), which accounted for 4.7% (95% CI, 2.3%-7.5%) of the global burden of dementia. Economic inequality was significant for the burden of dementia associated with vision impairment., Discussion: The overall quality of the body evidence was low because of the observational design of the studies included in the analysis. Vision impairment is associated with an increased risk of both dementia and cognitive impairment in older adults. Screening and treating vision impairment, especially in low- and middle-income countries, may help to alleviate the global burden of dementia., (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

The International Paralympic Committee (IPC) and individual sports federations have established the need to develop evidence-based systems of classification for athletes with vision impairment (VI) that may differ depending on the visual demands of each sport. As a consequence, research has been conducted that led to a new classification system for athletes competing in VI shooting. The purpose of this study was to canvas the experiences of key stakeholders (athletes, coaches and classifiers) when the new system of classification was implemented. Twenty-eight participants (17 athletes, 7 coaches and 4 classifiers) completed a questionnaire to rate their experiences of the previous and new classification systems and were interviewed to gain richer insights into their opinions. It was apparent that the changes to the classification system were not adequately communicated to the athletes in particular, and that the classifiers may require a better understanding of the principles of evidence-based classification. The new system was perceived to be significantly more specific for VI shooting and intentional misrepresentation was observed to be significantly less likely than when using the old system. This research provides valuable insights into both the positive and negative experiences of key stakeholders experiencing change in a classification system.

Purpose: TO assess perceptions and implications of COVID-19 infection across the spectrum of individuals with visually impairment (VI) and those with normal sight., Design: Prospective cross-sectional comparative study., Methods: Setting: institutional., Patients: 232 patients and their caregivers. Four groups were created based on better eye characteristics: blind (best-corrected distance visual acuity [BCDVA] <3/60 or visual field <10 central degrees); severe VI (BCDVA ≤3/60 to <6/60; vertical cup-to-disc ratio ≥0.85 or neuroretinal rim width ≤0.1); moderate VI (BCDVA ≤6/60 to <6/18); or no or mild VI (controls: BCDVA ≥6/18) based on International Classification of Diseases-10 criteria and Foster and Quigley's consensus definition of glaucoma., Procedure: telephone questionnaires., Main Outcome Measures: differences in perceptions and implications of COVID-19 infection across various levels of VI. Caregiver perceptions were a secondary outcome measure., Results: Surveys were completed by 232 participants, with 58 participants in each VI group. Mean age was 58.9 ± 13.2 years old. Greater degrees of VI were associated with older age (P = .008) and lower education level (P = .046). Blind participants more commonly perceived vision as a risk factor for contracting COVID-19 (P = .045), were concerned about access to health care (P <.001), obtained news through word of mouth (P <.001), and less commonly wore masks (P = .003). Controls more commonly performed frequent handwashing (P = .001), were aware of telemedicine (P = .029), and had fewer concerns about social interactions (P = .020) than groups with substantial VI. All caregivers reported more frequent patient care since the COVID-19 pandemic began., Conclusions: The pandemic might have had a disproportionate impact on the visually impaired, and evidence-based assessments of COVID-19 health outcomes in this population are warranted., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To explore feasibility of using child/young person patient-reported outcome measures (PROMs) routinely in practice, using vision-specific instruments and paediatric ophthalmology as the exemplar., Methods: Participants comprised patients aged 8-17 years, with visual impairment or low vision (visual acuity of the logarithm of the minimum angle of resolution (logMAR) worse than 0.3 in the better eye), attending the Department of Ophthalmology at Great Ormond Street Hospital, London, UK. All participants completed age-appropriate PROMs before attending their outpatient appointment. Half were randomly assigned to completion at home, with the choice of paper-and-pencil or electronic format. The other half were invited to complete PROMs during their hospital appointment, and randomly assigned to completion format. All participants completed a face-to-face survey exploring their attitudes and preferences. Analysis comprised survival analysis, and direct comparisons of proportions, with complementary qualitative data analysis., Results: 93 patients participated. 48 (98%) completing PROMs at home chose the paper-and-pencil format. Completion at home took longer than at hospital (median=20, vs 14 min, p<0.001). Visual acuity was associated with completion time (p=0.007) and missing data (p=0.03). Overall, 52 (60%) reported a preference for completion at home but there was no clear preference for format (37 (43%) preferred either format)., Conclusion: PROM completion at home ahead of hospital appointments may be preferable for collecting complete, high-quality datasets. Despite equipoise on preference for format, the majority of those completing at home chose the traditional paper-and-pencil format, despite impaired sight. These findings should inform implementation of child/young person PROMs into routine practice., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The purpose of this study was to examine caregiving relationships for older adults with vision impairment (VI)., Design: Cross-sectional study with a nationally representative sample., Methods: Setting: the National Health and Aging Trends Study linked to the National Study of Caregiving, Year 2011., Study Population: 1,776 family or unpaid caregivers to community-dwelling Medicare beneficiaries age ≥65 years old., Outcome Measurement: in the preceding month, 1) the number of hours of care provided; 2) the valued activities affected by caregiving; and 3) the odds of experiencing substantial emotional, financial, and physical difficulty related to providing care., Exposure: VI was defined as a report of blindness or difficulty with distance or near vision., Results: Among 1,776 caregivers, 428 caregivers spent an average ± standard error (SE) of 111 ± 9.1 hours per month assisting older adults with VI, whereas 1,348 spent an average of 72 ± 3.3 hours assisting older adults without VI. In fully adjusted negative binomial regression analyses, caregivers of older adults with VI spent 36% more hours (incident rate ratio [IRR]: 1.36; 95% confidence interval [CI]: 1.15-1.60) providing care and reported having 61% more valued activities affected (IRR: 1.61; 95% CI: 1.23-2.10) than caregivers of older adults without VI. In fully adjusted logistic regression analyses, caregivers of older adults with VI had greater odds of emotional (odds ratio [OR]: 1.46; 95% CI: 1.04-2.03) but not financial (OR: 1.33; 95% CI: 0.87-2.03) or physical (OR: 1.13; 95% CI: 0.74-1.74) difficulty related to providing care than caregivers of older adults without VI., Conclusions: These results suggest that caring for older adults with VI places different demands on time and emotional wellbeing than caring for older adults without VI, but no differences in financial or physical difficulties., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: To reveal the causes of blindness in patients who applied to the medical board of a hospital serving the Southeastern Anatolian region of Turkey., Materials and Methods: We retrospectively reviewed the records of 340 bilaterally blind patients who were among 3,234 patients referred to our hospital's medical board between March 2016 and November 2018 for disability evaluation and rating report., Results: One-hundred sixty (48.8%) were female, 174 (51.2%) were male, and the mean patient age was 64.3±25.4 years. The most common cause of blindness was cataract in 158 eyes (23.2%), followed by corneal opacities in 114 eyes (16.8%), retinal dystrophy in 92 eyes (13.5%), optic atrophy in 73 eyes (10.7%), glaucoma in 65 eyes (9.6%), and phthisis bulbi in 59 eyes (8.7%)., Conclusion: Avoidable causes of blindness such as cataract and corneal opacity (secondary to trachoma) were detected at high rates. Therefore, we believe that more awareness and effort might be required in our region to reduce avoidable blindness due to these causes.

Background: We investigated the incidence and causes of sight-threatening diabetes-related eye disease in children living with diabetes in the UK, to inform the national eye screening programme and enable monitoring of trends., Methods: We undertook a prospective active national surveillance via the British Ophthalmic Surveillance Unit. Eligible cases were children aged 18 years or younger, with type 1 or 2 diabetes, newly diagnosed between January 2015 and February 2017 with sight-threatening diabetic eye disease., Results: Eight children were reported. The annual incidence of all sight-threatening diabetes-related eye disease requiring referral to an ophthalmologist among children living with diabetes (n=8) in the UK was 1.21 per 10 000 person-years (95% CI 0.52 to 2.39) and was largely attributable to cataract (n=5) 0.76 per 10 000 person-years (95% CI 0.25 to 1.77). The incidence of sight-threatening diabetic retinopathy (n=3) among those eligible for screening (12 to 18 year-olds living with diabetes) was 1.18 per 10 000 person-years (95% CI 0.24 to 3.46). No subjects eligible for certification as visually impaired or blind were reported., Conclusions: Secondary prevention of visual disability due to retinopathy is currently the sole purpose of national eye screening programmes globally. However, the rarity of treatment-requiring retinopathy in children/young people living with diabetes, alongside growing concerns about suboptimal screening uptake, merit new consideration of the utility of screening for primary prevention of diabetes-related morbidity by using the screening event and findings as a catalyst for better diabetes self-management., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To assess the risk factors for severe visual impairment (SVI) and corneal complications in primary and secondary Sjögren syndrome (SS)., Design: Retrospective case series., Methods: Ocular data of all consecutive SS patients presenting to an eye-care network and receiving a diagnosis according to 2012 American College of Rheumatology criteria over the past 8 years were reviewed., Main Outcome Measurement: risk factors associated with SVI (best-corrected visual acuity <20/200) and vision-threatening corneal complications (ulceration or perforation) at presentation were evaluated using multivariate analysis and odds ratios (OR)., Results: Of the 919 patients, 285 (31%) had primary and 634 (69%) had secondary SS. The most common cause of secondary SS was rheumatoid arthritis (98.1%), followed by systemic lupus erythematosus (0.79%), psoriasis (0.79%), and scleroderma (0.6%). Among the 1,838 eyes, SVI was noted in 10%, and 2.5% had corneal complications at presentation. The presence of corneal scarring (P < .00001; OR: 3.00), corneal ulceration (P < .00001; OR: 12.96), low Schirmer values (P = .0084; OR: 0.93), cataract (P = .0036; OR: 2.4), glaucoma (P = .04; OR: 4.09), and age at diagnosis (P = .005; OR: 1.02) were independent risk factors for developing SVI. The risk factors for corneal complications were presence of scleritis (P < .0001; OR: 8.9) and a diagnosis of secondary SS (P = .009; OR: 2.94)., Conclusions: In patients with SS, severity of dryness, corneal ulceration and scarring, cataract, and glaucoma are factors associated with poor visual acuity. Eyes with scleritis have a greater risk of developing vision-threatening corneal complications and therefore should be monitored closely., (Copyright © 2020 Elsevier Inc. All rights reserved.)

It is essential for healthcare institutions to accommodate the needs of the growing population of visually impaired patients. Hospital leaders must implement strategies to guarantee these patients' autonomy. We reviewed the literature and identified measures hospitals have implemented to accommodate visually impaired patients. To bridge gaps in the literature, we interviewed healthcare managers from five different hospitals in the United States. These interviews reveal that, while different levels of accommodations are already offered by those institutions, accommodations are generally extremely basic, and leave enormous room for improvement to ensure that the visually impaired receive proper care and dignified treatment.

Purpose: Low Vision Aids (LVAs) can have a transformative impact on people living with sight loss, yet the everyday requirements for developing such devices remain poorly understood and defined. This study systematically explored LVA requirements through a structured de-brief interview following a real-world self-recording study. The purpose of this work was to define the actual needs of those living with sight loss so that low vision services can better address them in future., Methods: Thirty-two visually impaired volunteers with varying levels of previous LVA experience participated in a de-brief interview centred around a structured questionnaire. The de-brief followed a one-week real-world study during which participants used recoding spectacles to capture and narrate all situations in which they would use a 'perfect sight aid'. Content and thematic analyses were used to analyse interviews which had the purpose of contextualising these recordings and exploring requirements around psychological, functional and design factors., Results: Participants reported that 46% of tasks which they had recorded were most important to them. Of these tasks, 82% were encountered frequently. Few tasks emerged as very important across many participants, the remaining tasks reflecting individual lifestyles or circumstances. Every participant used at least one LVA in their everyday life and 72% identified further coping strategies. Current LVAs identified as consistently poor were distance LVAs, with all other devices receiving mixed or only positive feedback. Around two-thirds of participants would prefer LVA use on an ad-hoc / quick access basis rather than over long periods of time, and just over half would prefer to carry it rather than wearing it all day. Lack of consistency in these responses illustrated potentially different user clusters with divergent design needs. Two-thirds of participants emphasised the desire for a discreet LVA that does not attract attention. However, since half of all participants felt self-conscious in public or in front of other people when wearing the small recording spectacles, this may not be technically achievable., Conclusions: There is a substantial opportunity for new LVAs to address visual needs that traditional devices and coping strategies cannot support. Functional, psychological and design factors require careful consideration for future LVAs to be relevant and widely adopted., (© 2021 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Purpose: To estimate the prevalence, causes and risk factors of bilateral visual impairment in rural areas of Tianjin, China., Methods: A large population-based, cross-sectional study. A stratified random cluster sampling method was used to investigate 12 233 participants in all age groups living in rural Tianjin. Participants completed questionnaires and received professional ophthalmology examinations., Results: According to World Health Organization best-corrected visual acuity (BCVA) criteria, the crude prevalence of bilateral visual impairment (BCVA < 20/63), bilateral low vision (BCVA < 20/63 to ≥20/400) and bilateral blindness (BCVA < 20/400) was 2.53%, 2.40% and 0.14% (age- and gender-standardized prevalence was 1.86%, 1.76% and 0.11%). The prevalence increased with age and was higher in women than men. The most common causes of bilateral visual impairment in the total population were cataract (48.39%), refractive error/amblyopia (17.74%), age-related macular degeneration (AMD) (10.00%), diabetic retinopathy (5.81%) and glaucoma (3.87%). For participants younger than 50 years, refractive error/amblyopia was the leading cause of low vision and blindness, while cataract was the major cause in the participants over 50. Female gender, older age and self-reported diabetes were associated with increased risks of visual impairment., Conclusion: The age- and gender-standardized prevalence of low vision, especially in the older group (50+), was higher in this study compared with previous studies in China. Refractive error/amblyopia was the leading cause of bilateral visual impairment in younger group, while cataract was the primary cause in the older group. These findings will provide useful information for planning comprehensive eye healthcare programmes in China., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: Visual impairment (VI) can have a detrimental impact on vision-related quality of life (VRQoL), but it is still unclear how this relationship varies with age across the VI spectrum. We determined the age-stratified, cross-sectional, and longitudinal associations between VI severity and VRQoL., Design: The baseline and follow-up Singapore Chinese Eye Studies (SCES-1/-2; 2009-2011 and 2015-2017)., Participants: A total of 3068 SCES-1 participants (mean age [standard deviation {SD}]: 59.5 [9.8] years; 50.2% female) and 1919 SCES-2 participants (mean age [SD]: 56.8 [8.3] years; 49.9% female)., Methods: Visual impairment was defined as visual acuity (VA) of > 0.3 logarithm of the minimum angle of resolution (logMAR) units; VI severity as mild-moderate (logMAR scores less than the median of all individuals with VI) and severe (logMAR scores median or greater); and VI incidence as VI absence at baseline, but evident at follow-up. Age was stratified into 40 to 49 years, 50 to 64 years, and ≥65 years., Main Outcome Measures: Rasch-transformed scores from the 32-item Impact of Visual Impairment (IVI) questionnaire were used to measure the "Reading," "Mobility," and "Emotional" domains of VRQoL. Multiple linear regression models determined the age-stratified associations of prevalent and incident VI with all 3 VRQoL outcomes, adjusted for potential confounders., Results: Of the 807 persons with prevalent VI, 55.9% had mild-moderate and 44.1% had severe VI. Compared with no VI, age-stratified analyses showed that VRQoL decrements were significant only in the older age groups (mild-moderate VI: 6.2% and 8.1% reduction in Mobility and Reading scores in those aged ≥ 65 years; severe VI: 8.5% to 13.4% reductions in the 3 VRQoL scores in those aged ≥ 50 years). This interaction with older age became more pronounced with incident VI (N = 168), where decrements in all 3 VRQoL domains were evident only in those aged ≥65 years compared with persons without incident VI., Conclusions: Our results suggest that the VI-VRQoL associations are driven mainly by older individuals aged ≥65 years, highlighting the need for effective regular screening and early intervention modalities to prevent the presence and onset of VI, and subsequent VRQoL declines, in these individuals., (Copyright © 2020 American Academy of Ophthalmology. All rights reserved.)

Background: The positive effects of sports participation on health can be an important issue for rehabilitation of visually impaired individuals., Aims: Our aim was to determine the relationship between sports participation and quality of life in individuals with visual impairment., Methods: The study included 100 athletes who participated in national games for people with visual impairment and 100 subjects who did not participate in sports as the control group. The two groups were matched according to age, gender, visual acuity and visual field. The Short-Form Health Survey (SF-36) was applied for assessment of quality of life., Results: All subjects had best corrected visual acuity less than 6/60 and/or visual field less than central 10 degrees in radius in the better eye. The sociodemographic characteristics of the study and control groups were similar except the level of education being higher in the athlete group and level of income higher in the control group. All of the SF-36 scores were higher among athletes compared to controls. Duration of sports activities (years) was positively correlated with Physical Functioning score. There were no significant relations between SF-36 scores and weekly sports participation time (hours). Athletes who had visual loss at an earlier age had better scores in Physical Functioning and Role Limitations due to Physical Problems., Conclusions: Sports activities had positive relationships with all domains of the quality of life in individuals with visual impairment. Thus, appropriate sports activities would increase the success of rehabilitation programs and their quality of life.

Purpose: To assess the influence of distance and near visual impairment on self-reported near visual functioning (VF) in a multinational study., Design: Population-based cross-sectional study., Participants: Participants aged 35 years or older were selected randomly with cluster sampling at 7 sites: rural sites in Nepal (Kaski) and India (Madurai), a semirural site in China (Shunyi), semiurban sites in South Africa (Durban) and Niger (Dosso), and urban sites in the United States (Los Angeles) and China (Guangzhou)., Methods: Binocular presenting distance and near visual acuity (VA) were measured with a logarithm of the minimum angle of resolution tumbling E chart at 4 m and 40 cm, respectively. A 12-item near VF questionnaire interview was administered by trained local interviewers, with responses scored from 100 to 0 as visual disability increased. Multiple linear regression was used to investigate the association of age, gender, education, and VA with overall eyesight, difficulty with activities, and social functioning subscale scores., Main Outcome Measures: Visual functioning subscale scores., Results: The study sample consisted of 6851 questionnaire respondents. The VF subscale scores decreased significantly with worse distance and near VA, and even mildly impaired VA could result in reduced VF. Lower VF subscale scores were associated with older age at 4 sites, female gender at 3 sites, and greater education at 2 sites. The influence of near VA was greater than distance VA at 3 sites, and at 1 site, distance VA was more influential than near VA. With study site included in the regression modeling, lower scores for the overall eyesight subscale (compared with the Shunyi reference site) were found in Guangzhou, Kaski, and Durban; lower difficulty in activities scores were found in Kaski and Durban, but better scores were found in Guangzhou and Madurai; and social functioning scores were lower in Kaski, Durban, and Dosso., Conclusions: Along the entire VA spectrum, lower levels of distance and near VA led to significant reductions in VF subscale scores, with wide variation both within and between study sites. The impact of near vision on VF should receive greater emphasis with further investigation in various socioeconomic and cultural settings., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Background/aim: To investigate the prevalence, causes and risk factors of visual impairment (VI) among the elderly in 'home for the aged' in Hyderabad, India., Methods: Individuals aged ≥60 years were recruited from 41 'homes for the aged'. All participants had complete eye examinations including presenting visual acuity, refraction, slit-lamp examination, intraocular pressure measurement and fundus imaging by trained clinicians. VI was defined as presenting visual acuity worse than 6/18 in the better eye. Multivariate logistic regression was used to determine the risk factors associated with VI., Results: 1512 elderly residents from 41 homes for the aged were enumerated, of whom 1182 (78.1%) were examined. The mean age of examined participants was 75.0 years (SD 8.8 years; range: 60-108 years); 35.4% of those examined were men. The prevalence of VI was 30.1% (95% CI 27.5 to 32.8). The leading cause of VI was cataract (46.3%, n=165), followed by uncorrected refractive error (27.0%, n=96), posterior capsular opacification (14.9%, n=53) and posterior segment disease (6.5%, n=23). Overall, 88.2% of the VI was either treatable or correctable. In multiple logistic regression, those aged 80 years and older (OR: 1.7, p<0.01), living in 'free' homes (OR: 1.5, p<0.01) and who were immobile/bedridden (OR: 3.02, p<0.01) had significantly higher odds of VI. Gender was not associated with VI., Conclusions: VI was common and largely avoidable in residents of 'homes for the aged' in Hyderabad, India. Screening for vision loss in 'homes for aged' and the provision of appropriate services should become routine practice to achieve the goal of healthy ageing in India., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To support survey validation efforts by comparing prevalence rates of self-reported and examination evaluated presenting visual impairment (VI) and blindness measured across national surveys., Design: Cross-sectional comparison., Participants: Participants in the 2016 American Community Survey, the 2016 Behavioral Risk Factor Surveillance System, the 2016 National Health Interview Survey, the 2005-2008 National Health and Nutrition Examination Survey (NHANES), and the 2016 National Survey of Children's Health., Methods: We estimated VI and blindness prevalence rates and confidence intervals for each survey measure and age group using the Clopper-Pearson method. We used inverse variance weighting to estimate the central tendency across measures by age-group, fitted trend lines to age-group estimates, and used the trend-line equations to estimate the number of United States persons with VI and blindness in 2016. We compared self-report estimates with those from NHANES physical evaluations of presenting VI and blindness., Main Outcome Measures: Variability of prevalence estimates of VI and blindness., Results: Self-report estimates of blindness varied between 0.1% and 5.6% for those younger than 65 years and from 0.6% to 16.6% for those 65 or older. Estimates of VI varied between 1.6% and 24.8% for those younger than 65 years and between 2.2% and 26.6% for those 65 years or older. For summarized survey results and NHANES physical evaluation, prevalence rates for VI increased significantly with increasing age group. Blindness prevalence increased significantly with increasing age group for summarized survey responses but not for NHANES physical examination. Based on extrapolations of NHANES physical examination data to all ages, we estimated that in 2016, 23.4 million persons in the United States (7.2%) had VI or blindness, an evaluated presenting visual acuity of 20/40 or worse in the better-seeing eye before correction. Based on weighted self-reported surveys, we estimated that 24.8 million persons (7.7%) had presenting VI or blindness., Conclusions: Prevalence rates of VI and blindness obtained from national survey measures varied widely across surveys and age groups. Additional research is needed to validate the ability of survey self-report measures of VI and blindness to replicate results obtained through examination by an eye health professional., (Copyright © 2020 American Academy of Ophthalmology. All rights reserved.)

Purpose: In this paper we highlight the impact which the disruption of secondary care ophthalmic services, resulting from COVID-19, has had on Sight Impairment (SI) and Severe Sight Impairment (SSI) certification in Northern Ireland., Methods: Regional data on SI and SSI certification in the period after the onset of the lockdown (19 March 2020-18 June 2020) were compared to the period immediately before lockdown (1 January 2020-18 March 2020) and to the same periods in 2019. Change documented was compared to post-lockdown reductions in primary and secondary ophthalmic care activity., Results: In 2019, during the 3-month period (19 March 2019-18 June 2019), 115 individuals were certified as sight impaired (SI 36, SSI 75, unspecified 4). Of those certified, 65 were female, 49 male. Principal causes of certification were: Age-related macular degeneration (AMD) (N = 45), glaucoma (N = 20) and diabetic eye disease (DED) (N = 10). Mean VA, recorded from the better eye of those certified, was 0.96 LogMAR. In the 3 months following the onset of lockdown (19 March 2020-18 June 2020), only 37 individuals were certified (SI 6, SSI 31), 12 female and 25 male. AMD was the most frequent cause of sight impairment (N = 20). There were only two DED certifications and one due to glaucoma. Mean VA in the better eye of those certified was 1.15LogMAR. The numbers of CVI certifications completed following the introduction of COVID-19 lockdown fell by 68%, compared to the 2019 data. There was a significant reduction in the proportion of female certifications (p = 0.01), and in certifications due to glaucoma (p = 0.02). The proportion of those certified as SSI as opposed to SI in the period after the onset of lockdown rose from 68% in 2019 to 84% in 2020. The mean VA of those certified in the period after the onset of lockdown, when compared to those certified in the other three periods, was worse by between 0.21 and 0.19 LogMAR (p = 0.06). Reductions reflected change in overall primary and secondary ophthalmic care activity., Conclusions: It is inconceivable that COVID-19 has reduced the incidence of sight-threatening eye disease. We must therefore assume that a flood of newly presenting sight loss will present once the pandemic has passed. New presentations will include those who would normally have attended during the lockdown period, and patients who, had they accessed ophthalmic care at the appropriate time, would have been saved from severe levels of blindness. The implications of the predicted increase in demand for medical, social and low vision related services are huge., (2020 The Authors Ophthalmic and Physiological Optics © 2020 The College of Optometrists.)

Importance: Perceived everyday discrimination is a psychosocial stressor linked to adverse health outcomes, including mortality., Objective: To assess the association of vision impairment (VI), hearing impairment (HI), and dual sensory impairments (DSI) with everyday discrimination., Design, Setting, and Participants: Cross-sectional analysis of the Health and Retirement Study 2006 and 2008 surveys, a US population-based survey that included noninstitutionalized adults 51 years and older. Analyses were weighted to account for complex sample design and differential nonresponse. Data were analyzed between October 2019 and November 2019., Exposures: Participants rated their vision and hearing, using eyeglasses and/or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, and excellent). Sensory impairment was defined as poor or fair ability in the relevant modality, and sensory impairment was categorized as neither sensory impairment (NSI), VI alone, HI alone, and DSI., Main Outcomes and Measures: Perceived everyday discrimination was measured on the validated 5-question Williams scale (range 0 to 5). Linear regression models estimated differences in discrimination scores by sensory categories, adjusting for age, sex, race, ethnicity, non-US birth, body mass index, relationship status, net household wealth, and number of chronic diseases (among diabetes, hypertension, heart disease, stroke, lung disease, nonskin cancer, and arthritis)., Results: The sample included 13 092 individuals. After weighting the sample to be representative of the US population, 11.7% had VI alone, 13.1% HI alone, and 7.9% DSI. In the fully adjusted model, participants with VI alone (β [change in discrimination score], 0.07; 95% CI, 0.02-0.13), HI alone (β = 0.07; 95% CI, 0.02-0.11), and DSI (β = 0.23; 95% CI, 0.16-0.29) perceived greater discrimination compared with participants with NSI. The DSI group perceived greater discrimination than VI alone or HI alone., Conclusions and Relevance: Older adults with VI or HI in the United States perceive greater everyday discrimination than older adults with NSI, and those with DSI perceive even more discrimination than those with either VI or HI alone. These results provide insight into the social impact of sensory loss and highlight a need to identify and address reasons for discrimination toward older adults with VI and HI.

Background: This study aimed to assess the prevalence and causes of vision loss in sub-Saharan Africa (SSA) in 2015, compared with prior years, and to estimate expected values for 2020., Methods: A systematic review and meta-analysis assessed the prevalence of blindness (presenting distance visual acuity <3/60 in the better eye), moderate and severe vision impairment (MSVI; presenting distance visual acuity <6/18 but ≥3/60) and mild vision impairment (MVI; presenting distance visual acuity <6/12 and ≥6/18), and also near vision impairment (

To assess the prevalence of cataract and cataract surgery in a population from Russia, we conducted the population-based Ural Eye and Medical Study with 5899 participants (80.5% out of 7328 eligible individuals), with an age of 40 + years as the eligibility criterion. In the phakic population, the prevalence of nuclear, cortical, subcapsular cataract and any cataract was 38.0% [95% confidence interval (CI) 36.6, 39.3], 14.5% (95% CI 13.5, 15.5), 0.6% (95% CI 0.4, 0.8) and 44.6% (95% CI 43.2, 46.0), respectively. A higher prevalence of nuclear cataract was associated with older age [odds ratio (OR) 1.10; 95% CI 1.10, 1.11], the female sex (OR 1.27; 95% CI 1.08, 1.50), urban region (OR 2.00; 95% CI 1.71, 2.33), a low educational level (OR 0.93; 95% CI 0.88, 0.98), a high diastolic blood pressure (OR 1.01; 95% CI 1.001, 1.02), a low serum concentration of high-density lipoproteins (OR 0.91; 95% CI 0.84, 0.98), more smoking package years (OR 1.01; 95% CI 1.01, 1.02), chronic kidney disease (OR 1.02; 95% CI 1.10, 1.03), a short axial length (OR 0.93; 95% CI 0.86, 0.99), and a low prevalence of age-related macular degeneration (OR 0.72; 95% CI 0.57, 0.92). The prevalence of previous cataract surgery conducted in 354/5885 individuals (6.0%; 95% CI 5.4, 6.6) increased from 0.4% (95% CI 0.0, 1.0) in the age group of 40-45 years to 37.6% (95% CI 30.9, 44.4) in the age group of 80 + years. Cataract was the cause of moderate-to-severe vision impairment in 109 (1.8%) individuals and of blindness in three (0.05%) individuals. The prevalence of cataract and cataract-related MSVI and blindness were relatively high; subsequently, the prevalence of previous cataract surgery was relatively low in this population from Russia.

Purpose: Despite well-known ocular complications of HIV-related immune suppression, few studies have examined the prevalence and consequences of visual impairment among aging long-term survivors of HIV., Design: Retrospective cohort study., Methods: Aging HIV-infected (HIV+) men who have sex with men (MSM) and HIV-uninfected (HIV-) MSM controls reported their difficulty performing 6 vision-dependent tasks (difficulty defined as: no, a little, moderate, and extreme difficulty). Relationships were examined using logistic regression, regressing each outcome separately on categorical visual function responses, with missing data multiply imputed., Results: There were 634 age-matched pairs for a total sample of 1,268 MSM of 1,700 MSM with available data. The median age was 60 years old (interquartile range [IQR], 54, 66), and 23% were African American. Among HIV+ men, 95% were virally suppressed (viral load <400 copies/mL). HIV+ men were more likely to report moderate or extreme difficulty performing at least 1 task (21% for HIV+ compared to 13% for HIV-; P < .01). Participants reporting extreme vision-related difficulty performing at least 1 task had 11.2 times the odds of frailty (95% confidence interval [CI], 5.2-23.9), 2.6 times the odds of a slow gait speed (95% CI, 1.4-4.8), and 3.2 times the odds of impaired instrumental activities of daily living (95% CI: 1.6-6.3) compared to those reporting no vision-related difficulty on any task., Conclusions: Perceived vision difficulty was more common among older HIV+ MSM than age-matched HIV- MSM controls and was associated with higher risk of depression and physical function loss among MSM., (Copyright © 2020. Published by Elsevier Inc.)

The present study aimed to examine the prevalence of dual sensory impairment, and to identify its risk factors among community-dwelling older adults in Selangor., Methods: Secondary analysis was carried out on data collected by the Grand Challenge Project among older adults aged ≥65 years from Selangor. Data on sociodemographic information, medical history, cognitive function and functional performance were obtained through face-to-face interviews using standardized questionnaires. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while hearing was assessed using pure-tone audiometry. Descriptive analysis was used to measure the prevalence of the impairments, and logistic regression analysis was used to identify the risk factors., Results: The prevalence of dual sensory impairment and hearing impairment were at 10.5% and 76.2% respectively. Multivariate logistic regression analysis revealed that participants with lower cognitive scores were associated with dual sensory impairment (odds ratio, 0.90; 95% confidence interval, 0.83-0.98), while smoking was found associated with hearing impairment (odds ratio, 6.58; 95% confidence interval, 1.51-28.65)., Conclusion: Dual sensory impairment is common among older adults in Selangor. The association between dual sensory impairment and cognitive function suggests the need to have visual and hearing screening on older adults for early detection particularly those at risk of cognitive impairment. The prevalence of hearing impairment was reported high among older adults and smokers appeared to be at higher risk of the impairment. Geriatr Gerontol Int 2020; 20: 911-916., (© 2020 Japan Geriatrics Society.)