Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
Br J Ophthalmol. 2021 Jan;105(1):32-36. doi: 10.1136/bjophthalmol-2019-315678. Epub 2020 Mar 25.
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.
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.
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.
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.
背景/目的：在印度海得拉巴的“养老院”中，调查老年人的视力障碍（VI）的患病率、原因和危险因素。
从 41 家“养老院”中招募年龄≥60 岁的个体。所有参与者均接受了全面的眼科检查，包括视力、屈光度、裂隙灯检查、眼压测量和眼底成像，均由经过培训的临床医生进行。VI 定义为较好眼的视力低于 6/18。采用多变量逻辑回归确定与 VI 相关的危险因素。
从 41 家养老院中统计了 1512 名老年居民，其中 1182 名（78.1%）接受了检查。接受检查的参与者的平均年龄为 75.0 岁（标准差 8.8 岁；范围：60-108 岁）；其中 35.4%为男性。VI 的患病率为 30.1%（95%CI 27.5-32.8）。VI 的主要原因是白内障（46.3%，n=165），其次是未矫正的屈光不正（27.0%，n=96）、后囊混浊（14.9%，n=53）和后节疾病（6.5%，n=23）。总体而言，88.2%的 VI 可治疗或可矫正。在多变量逻辑回归中，80 岁及以上年龄组（OR：1.7，p<0.01）、居住在“免费”养老院（OR：1.5，p<0.01）和无法活动/卧床不起（OR：3.02，p<0.01）的患者发生 VI 的几率显著更高。性别与 VI 无关。
在印度海得拉巴的“养老院”中，VI 较为常见，且在很大程度上是可以预防的。在“养老院”中筛查视力损失并提供适当的服务应成为常规做法，以实现印度健康老龄化的目标。
