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Prevalence and causes of visual impairment in The Barbados Eye Study.
Ophthalmology 2001; 108(10):1751-6O

Abstract

OBJECTIVE

To determine the prevalence and causes of low vision and blindness in a predominantly black population.

DESIGN

Population-based prevalence study of a simple random sample of Barbados-born citizens aged 40 to 84 years.

PARTICIPANTS

Four thousand seven hundred nine persons (84% participation).

METHODS

The standardized protocol included best-corrected visual acuity (with a Ferris-Bailey chart), automated perimetry, lens gradings (LOCS II), and an interview. Participants with visual acuity of worse than 20/30, other positive findings, and a 10% sample also had an ophthalmologic examination that evaluated the cause and extent of vision loss (resulting from that cause), if any.

MAIN OUTCOME MEASURES

Low vision and blindness were defined as visual acuity in the better eye between 6/18 and 6/120 and visual acuity worse than 6/120, respectively (World Health Organization [WHO] criteria).

RESULTS

Of the 4631 participants with complete examinations, 4314 (93%) reported their race as black, 184 (4%) reported their race as mixed (black and white), and 133 (3%) reported their race as white or other. Low vision was found in 5.9% of the black, 2.7% of the mixed, and 3.0% of white or other participants. Bilateral blindness was similar for black and mixed race participants (1.7% and 1.6%, respectively) and was not found in whites. Among black and mixed participants, the prevalence of low vision increased with age (from 0.3% at 40-49 years to 26.8% at 80 years or older). The prevalence of blindness was higher (P < 0.001) for men than women at each age group (0.5% versus 0.3% at ages 40-49 and 10.9% versus 7.3% at 80 years or more). Sixty percent of blindness was due to open-angle glaucoma and age-related cataract, each accounting for more than one fourth of cases. Other major causes were optic atrophy or neuropathy and macular and other retinal diseases. Few cases of blindness were due to diabetic retinopathy (1.4%), and none were due to age-related macular degeneration.

CONCLUSIONS

Using the WHO criteria, prevalence of visual impairment was high in this African-origin population, particularly at older ages. Most blindness was due to open-angle glaucoma and cataract, with open-angle glaucoma causing a higher proportion of blindness than previously reported. The increased prevalence of blindness in men may be due to the increased male prevalence of glaucoma in this population and warrants further investigation. Results underline the need for blindness prevention programs, with emphasis on effective treatment of age-related cataract and enhancing strategies for early detection and treatment of open-angle glaucoma.

Authors+Show Affiliations

Department of Preventive Medicine, University Medical Center at Stony Brook, Stony Brook, New York, USA. lhyman@uhmc.sunysb.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11581045

Citation

Hyman, L, et al. "Prevalence and Causes of Visual Impairment in the Barbados Eye Study." Ophthalmology, vol. 108, no. 10, 2001, pp. 1751-6.
Hyman L, Wu SY, Connell AM, et al. Prevalence and causes of visual impairment in The Barbados Eye Study. Ophthalmology. 2001;108(10):1751-6.
Hyman, L., Wu, S. Y., Connell, A. M., Schachat, A., Nemesure, B., Hennis, A., & Leske, M. C. (2001). Prevalence and causes of visual impairment in The Barbados Eye Study. Ophthalmology, 108(10), pp. 1751-6.
Hyman L, et al. Prevalence and Causes of Visual Impairment in the Barbados Eye Study. Ophthalmology. 2001;108(10):1751-6. PubMed PMID: 11581045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and causes of visual impairment in The Barbados Eye Study. AU - Hyman,L, AU - Wu,S Y, AU - Connell,A M, AU - Schachat,A, AU - Nemesure,B, AU - Hennis,A, AU - Leske,M C, PY - 2001/10/3/pubmed PY - 2001/10/19/medline PY - 2001/10/3/entrez SP - 1751 EP - 6 JF - Ophthalmology JO - Ophthalmology VL - 108 IS - 10 N2 - OBJECTIVE: To determine the prevalence and causes of low vision and blindness in a predominantly black population. DESIGN: Population-based prevalence study of a simple random sample of Barbados-born citizens aged 40 to 84 years. PARTICIPANTS: Four thousand seven hundred nine persons (84% participation). METHODS: The standardized protocol included best-corrected visual acuity (with a Ferris-Bailey chart), automated perimetry, lens gradings (LOCS II), and an interview. Participants with visual acuity of worse than 20/30, other positive findings, and a 10% sample also had an ophthalmologic examination that evaluated the cause and extent of vision loss (resulting from that cause), if any. MAIN OUTCOME MEASURES: Low vision and blindness were defined as visual acuity in the better eye between 6/18 and 6/120 and visual acuity worse than 6/120, respectively (World Health Organization [WHO] criteria). RESULTS: Of the 4631 participants with complete examinations, 4314 (93%) reported their race as black, 184 (4%) reported their race as mixed (black and white), and 133 (3%) reported their race as white or other. Low vision was found in 5.9% of the black, 2.7% of the mixed, and 3.0% of white or other participants. Bilateral blindness was similar for black and mixed race participants (1.7% and 1.6%, respectively) and was not found in whites. Among black and mixed participants, the prevalence of low vision increased with age (from 0.3% at 40-49 years to 26.8% at 80 years or older). The prevalence of blindness was higher (P < 0.001) for men than women at each age group (0.5% versus 0.3% at ages 40-49 and 10.9% versus 7.3% at 80 years or more). Sixty percent of blindness was due to open-angle glaucoma and age-related cataract, each accounting for more than one fourth of cases. Other major causes were optic atrophy or neuropathy and macular and other retinal diseases. Few cases of blindness were due to diabetic retinopathy (1.4%), and none were due to age-related macular degeneration. CONCLUSIONS: Using the WHO criteria, prevalence of visual impairment was high in this African-origin population, particularly at older ages. Most blindness was due to open-angle glaucoma and cataract, with open-angle glaucoma causing a higher proportion of blindness than previously reported. The increased prevalence of blindness in men may be due to the increased male prevalence of glaucoma in this population and warrants further investigation. Results underline the need for blindness prevention programs, with emphasis on effective treatment of age-related cataract and enhancing strategies for early detection and treatment of open-angle glaucoma. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11581045/Prevalence_and_causes_of_visual_impairment_in_The_Barbados_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(01)00590-5 DB - PRIME DP - Unbound Medicine ER -