TY - JOUR
T1 - Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India–The Hyderabad Ocular Morbidity in Elderly Study (HOMES)
AU - Marmamula, Srinivas
AU - Barrenkala, Navya Rekha
AU - Challa, Rajesh
AU - Kumbam, Thirupathi Reddy
AU - Modepalli, Satya Brahmanandam
AU - Yellapragada, Ratnakar
AU - Bhakki, Madhuri
AU - Khanna, Rohit C.
AU - Friedman, David S.
N1 - Funding Information:
The authors thank all the participants for their time, Mr Shashank Yellapragada for his assistance in data collection, and Ms Muni Rajya Lakshmi for her support with data management. The authors thank Professor Jill Keeffe (L V Prasad Eye Institute), Ms Neha Hassija and Dr Shoba Mocherla for their valuable inputs on earlier versions of the manuscript.
Funding Information:
The authors report no conflicts of interest and have no proprietary interest in any of the materials mentioned in this article. This work was supported by Wellcome Trust/DBT India Alliance Fellowship [IA/CPHE/14/1/501506] awarded to Dr Srinivas Marmamula and Hyderabad Eye Research Foundation (HERF), India.
Publisher Copyright:
© 2020 The Authors.Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Purpose: To investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in ‘homes for the aged’ in Hyderabad, India. Methods: Individuals aged ≥60 years and residing in ‘homes for the aged’ in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best-corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE. Results: In total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60–108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5–15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11–2.43) and free homes (OR: 1.67; 95% CI: 1.00–2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07–2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10–2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10–2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self-report of diabetes, and education were not associated with URE. Conclusions: A large burden of URE was found among the residents in the ‘homes for the aged’ in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three years, which indicates poor utilisation of eye care services by the elderly. Regular eye examinations and provision of spectacles are needed to address needless URE for distance among the elderly in residential care in India.
AB - Purpose: To investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in ‘homes for the aged’ in Hyderabad, India. Methods: Individuals aged ≥60 years and residing in ‘homes for the aged’ in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best-corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE. Results: In total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60–108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5–15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11–2.43) and free homes (OR: 1.67; 95% CI: 1.00–2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07–2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10–2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10–2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self-report of diabetes, and education were not associated with URE. Conclusions: A large burden of URE was found among the residents in the ‘homes for the aged’ in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three years, which indicates poor utilisation of eye care services by the elderly. Regular eye examinations and provision of spectacles are needed to address needless URE for distance among the elderly in residential care in India.
KW - India
KW - elderly
KW - refractive errors
KW - residential care
KW - spectacle use
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U2 - 10.1111/opo.12684
DO - 10.1111/opo.12684
M3 - Article
C2 - 32207179
AN - SCOPUS:85082104117
SN - 0275-5408
VL - 40
SP - 343
EP - 349
JO - Ophthalmic and Physiological Optics
JF - Ophthalmic and Physiological Optics
IS - 3
ER -