Elsevier

Ophthalmology

Volume 111, Issue 1, January 2004, Pages 62-69
Ophthalmology

Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan1: The Shihpai Eye Study☆,

Presented in part at: XXIXth International Congress of Ophthalmology, April, 2002; Sydney.
https://doi.org/10.1016/j.ophtha.2003.05.011Get rights and content

Abstract

Objective

Few population-based data on the prevalence and causes of visual impairment are available from East Asia. The purpose of this study was to determine the prevalence and causes of visual impairment in an elderly Chinese population in Taiwan.

Design

Population-based cross-sectional study.

Participants

The Shihpai Eye Study was a survey of vision and ocular disease among an elderly Chinese population 65 years of age or older residing in Shihpai, Taiwan. A random sample of 2045 elderly residents was identified and selected from the household registration databank. Among them, 1361 (66.6%) underwent a detailed ophthalmic examination.

Methods

The ophthalmic examination included best-corrected visual acuity measurements using standardized protocols. Visual acuity was assessed with a Snellen E chart. The major cause of visual loss was identified for all participants who were visually impaired.

Main outcome measures

Low vision and blindness were defined as a best-corrected visual acuity in the eye with better vision worse than 20/60 to a lower limit of 20/400 and worse than 20/400, respectively, according to World Health Organization categories of visual impairment.

Results

The mean age of the participants was 72.2 (range, 65–91) years old. A total of 40 participants met the World Health Organization criteria of low vision, and 8 were diagnosed as blind. The rate of blindness and low vision was estimated to be 0.59% (95% confidence interval, 0.25%, 1.16%) and 2.94% (95% confidence interval, 2.11%, 3.99%), respectively. There was a significant increase in the rate of low vision (P<0.001) from 0.83% at 65 to 69 years of age to 8.33% at age 80 years or older. There was no gender difference in the prevalence of blindness or low vision. The leading cause of visual impairment was cataract (41.7%), followed by myopic macular degeneration (12.5%) and age-related macular degeneration (10.4%).

Conclusions

The rate of blindness and low vision is close to that reported for other developed countries. The high frequency of myopic macular degeneration as a major cause of visual loss, however, is not observed in European-derived populations. Specific prevention or low-vision rehabilitation programs should be developed for the elderly Chinese population.

Section snippets

Study population

This population-based survey of vision and ocular diseases was conducted among noninstitutionalized residents 65 years of age or older in Shihpai, Taipei, Taiwan, between July 1999 and December 2000. The Shihpai community is located in the Peitou district of Taipei. The Peitou district had a population of approximately 247 100 at the end of 1999,11 making it the second largest district in Taipei. The Shihpai community is the Peitou district's prosperous commercial hub. This area was chosen

Results

Of the 2045 randomly selected individuals, 1361 (66.6%) participated in the ophthalmic examination. Of the 684 nonexamined subjects, 677 (33.1%) cooperated only in the first-step of household interview, and 7 (0.3%) could not be contacted during 3 visits for the household interview (Fig 1). The main reasons for nonexamination were refusal to participate, lack of time, or inability to contact the subjects after the interview. On the basis of available data from the interview, differences in

Discussion

This study provides the first population-based data on the prevalence of blindness and low vision in the elderly Chinese population in Taiwan. To estimate the potential magnitude of visual impairment in the elderly in Taiwan, we applied the observed age- and gender-specific rates to the 2000 year-end population in the Taiwan area. This projection estimated that approximately 13 000 people are blind according WHO criteria (visual acuity <20/400) and more than 63 000 people meet the WHO

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    ☆

    Manuscript no. 220726.

    Supported by Taipei Veterans General Hospital (grant nos.: VGH 89-404, VGH 92-351).

    1

    The authors have no proprietary interest in any aspect of the study.

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    Copyright © 2004 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.