Prevalence of Visual Impairment and Eye Diseases in Arkansas

1
Prevalence of Visual Impairment and Eye Diseases
in Arkansas

• Inci Irak-Dersu MD 1, Appathurai Balamurugan, MD
  MPH2
• 1 College of Medicine,
  University of Arkansas Medical Sciences
  2 Fay W. Boozman College of Public
  Health, University of Arkansas Medical Sciences
  and Arkansas Department of Health

Authors have no financial interest in the subject
matter of this poster.
2
Introduction

• Visual impairment is one of the major public
  health problems in the United States.
• In 2000, there were approximately 937,000 people
  who were blind in the United States.
• It is estimated that this number will reach to
  1.6 million by 2020.
• Visual impairment, regardless of its cause, is
  known to have impact on health-related quality of
  life.
• The extent and nature of visual impairment and
  eye diseases in Arkansas has not been well
  described previously.

3
Methods

• The Behavioral Risk Factor Surveillance System
  (BRFSS) is an annual survey conducted by 50
  states and the District of Columbia to obtain
  state-specific information on health risk
  behaviors.
• The survey uses a random digit dial telephone
  methodology designed and developed by the Centers
  for Disease Control and Prevention.
• Disproportionate stratified random sampling is
  used to identify eligible participants.
• Participants are non-institutionalized adults gt18
  years of age, and only one adult is interviewed
  per household.
• In 2005, the BRFSS added Visual Impairment and
  Access to the Eye Care module to the survey to
  better understand visual impairment for
  individuals aged 40 years and older.

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Visual Impairment and Access to the Eye Care
module

• In this module, there are a total of 10
  questions.
• Participants were asked if they had been told by
  a health care professional that they have any eye
  diseases including glaucoma, cataract and
  age-related macular degeneration.
• Participants were also asked the frequency of
  their visits to the eye doctor, the reasons for
  infrequent visits, and eye insurance status.

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Visual Impairment and Access to the Eye Care
module-2

• In addition, there were two questions about
  vision specific health related quality. 1) How
  much difficulty, if any, do you have in
  recognizing a friend across the street? 2) How
  much difficulty, if any, do you have reading
  print in newspaper, magazine, recipe, menu, or
  numbers on the telephone?
• Response options were no difficulty, a little
  difficulty, moderate difficulty, extreme
  difficulty, unable to do because of eyesight,
  unable to do for other reasons.
• BRFSS data obtained from Arkansas Department of
  Health were analyzed to determine prevalence of
  glaucoma, age-related macular degeneration, and
  cataract by bivariate analysis and t-test was
  used to compare vision related quality of life
  between no eye disease and eye disease group.

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Results

• The analytic sample consisted of 893 respondents
  who had one or more of the following eye
  diseases glaucoma, age-related macular
  degeneration and cataract, and 3102 respondents
  who did not have any of 3 eye diseases.
• The prevalence of glaucoma, age-related macular
  degeneration, and cataract among Arkansas survey
  respondents gt 40 years was found to be 5.5 (95
  CI, 4.7 6.3), 5.3 (95 CI, 4.5 - 6.0), and
  13.7 (95 CI, 12.6 14.8), respectively.
• The prevalence of glaucoma, age-related macular
  degeneration and, cataract was higher among the
  females and those who had an annual income under
  25,000 compared to those who had an annual
  income more than 25,000. (Table 1)
• A higher proportion of people with age-related
  macular degeneration could not recognize a friend
  across the street, and had more difficulty in
  reading prints (52.6 vs. 30.1 respectively)
  than no eye disease group. (Table 2)

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Table 1. Weighted prevalence of eye diseases
among Arkansans age 40 and older by select
demographic characteristics
Variable Glaucoma Macular Degeneration Cataract
95 CI 95 CI 95 CI
Age 40-64 years 65-84 years gt 85 years 3.9 3.0-4.8 8.1 6.5-9.8 17.9 10.1-25.6 3.2 2.4-4.0 9.0 7.2-10.8 13.1 6.1-20.2 6.9 5.9-7.9 29.0 26.4-31.6 22.0 13.1-30.9
Gender Male Female 4.3 3.1-5.4 6.6 5.5-7.6 4.1 3.0-5.2 5.9 4.9-7.0 10.8 9.2-12.4 15.6 14.1-17.0
Education Non-high school graduate High school graduate Some college College graduate and more 7.6 5.0-10.2 5.7 4.4-7.0 4.0 2.8-5.2 5.6 3.9-7.2 6.5 3.9-9.1 5.2 3.9-6.4 5.7 4.1-7.2 4.3 2.9-5.7 15.4 12.1-18.7 14.1 12.3-16.0 13.4 11.2-15.6 12.7 10.6-14.8
Prevalence increased by age for all 3 eye
diseases.(p lt0.05) Prevalence of all 3 eye
diseases was higher among females than males. (p
lt0.05) Prevalence of all 3 eye disease was
higher among respondents with annual income lower
than 25,000 than other income groups. (p lt0.05)
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Table 2. Comparison of vision related quality of
life among survey participants with eye diseases
and no eye disease
No eye disease 95 CI No eye disease 95 CI Glaucoma 95 CI Glaucoma 95 CI Macular degeneration 95 CI Macular degeneration 95 CI Cataract 95 CI Cataract 95 CI
Difficulty in recognizing friend across the street 16.2 14.8-17.6 20.4 12.5-28.4 30.1 21.3-38.9 18.1 14.4-17.6
Difficulty in reading 33.1 31.3-34.8 29.7 20.2-39.1 52.6 42.6-62.6 33.4 28.8-37.9

More respondents with macular degeneration had
difficulty in seeing at distance and near than
other groups. (Plt0.05)
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Discussion

• The prevalence of glaucoma and, age-related
  macular degeneration increased with age among
  Arkansas residents. This was consistent with the
  literature.
• Vision related quality of life (VRQL) is an
  important indicator of overall vision health.
  VRQL was assessed among the survey respondents by
  their ability to recognize a friend across the
  street and read print materials. A higher
  proportion of Arkansans with age-related macular
  degeneration reported having a poor VRQL compared
  to those with other eye diseases and those with
  no eye disease.
• Females and individuals with low-income were
  found to be at higher risk for having eye
  diseases. The National Health Interview Study has
  also showed prevalence of blindness was inversely
  related to education and income.

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Limitations

• One of the limitations, BRFSS only interviews
  residents with home telephones, those Arkansas
  residents who use their cellular telephone as
  their main phone were not interviewed.
• In addition, the prevalence of the eye diseases
  reported here was an estimate based on
  self-reported information from survey
  respondents.

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Conclusion

• Prevalence of glaucoma, age-related macular
  degeneration, and cataract increased with age.
• Age-related macular degeneration had the most
  impact on vision-related quality of life.
• Females and individuals with low-income were at
  higher risk for having eye diseases.

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References

• The Eye Disease Prevalence Research Group. Causes
  and Prevalence of Visual Impairment among Adults
  in the United States. Arch Ophtahlmol.2004122
  477-485.
• BRFSS-CDCs Behavioral Risk Factor Surveillance
  System. www.cdc.gov/BRFSS/
• Ryskulova A, Turczyn K, Makuc DM et al.
  Self-Reported Age-Related Eye Diseases and Visual
  Impairment in the United States Results of the
  2002 National Health Interview Survey. Am J
  Public Health 2008 98454-61.