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Prevalence and incidence of presbyopia in urban Southern China
  1. Xiaotong Han1,2,
  2. Pei Ying Lee2,
  3. Stuart Keel2,
  4. Mingguang He1,2
  1. 1 Department of Preventive Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong, China
  2. 2 Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
  1. Correspondence to Dr Mingguang He, Zhongshan Ophthalmic Center, Guangzhou 510620, People’s Republic of China; mingguanghe{at}


Aims To investigate the prevalence and incidence of presbyopia in an urban Chinese population.

Methods 1817 subjects aged ≥35 years were identified by random cluster sampling in Yuexiu District, Guangzhou, China, at baseline in 2008, and all were invited for the follow-up examination in 2014. Distance and near visual acuity (VA) tests, as well as non-cycloplegic automated refraction were performed at each examination as per standardised protocol. Participants with presenting near VA ≤20/40 were further tested with add power at a standard distance of 40 cm to obtain their best-corrected near VA. Functional presbyopia was defined as near VA under presenting distance refraction correction of <20/50 and could be improved by at least one line with add power.

Results A total of 1191 (83.5% of the 2014 follow-up) participants were included in the current analysis with a mean (SD) age of 50.4 (9.7) years, and 52.9% were female. Prevalence of functional presbyopia at baseline was 25.2% (95% CI 21.5 to 28.9) and the 6-year incidence was 42.8% (95% CI 39.4 to 50.1). Older and more hyperopic subjects had both higher prevalence and incidence of presbyopia (P<0.001). Average presbyopic correction coverage (PCC) was 87.7% at baseline and was significantly lower in myopic participants (P=0.006).

Conclusions Prevalence of functional presbyopia in urban China is relatively lower along with a higher PCC compared with previous population-based rural cohorts. We identified a high presbyopia incidence, and further studies are needed to understand longitudinal presbyopia progression as well as the urban–rural gap in presbyopia to throw light on future strategic planning.

  • epidemiology
  • vision
  • public health

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  • Contributors XH was responsible for the manuscript writing, data collection and data analysis. PYL, SK and MH did the major revision to the manuscript. MH was responsible for the concept of the study and study supervision.

  • Funding This study was supported by the WHO, Geneva, Switzerland (under National Institutes of Health, Bethesda, Maryland, USA, contract No. N01-EY-2103) and the by Fundamental Research Funds of the State Key Laboratory of Ophthalmology at the Zhongshan Ophthalmic Center. Professor He receives support from the University of Melbourne at Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government. The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Ethics approval WHO Secretariat Committee on Research involving human subjects and Institutional Review Board at ZOC in Guangzhou, China.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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