Elsevier

Ophthalmology

Volume 118, Issue 5, May 2011, Pages 805-811
Ophthalmology

Original article
Uncorrected Refractive Error in a Latino Population: Proyecto VER

Presented at: Association for Research in Vision and Ophthalmology Annual Meeting, May 6, 2010, Ft. Lauderdale, Florida; 21st Wilmer Research Meeting, April 23, 2010, Baltimore, Maryland.
https://doi.org/10.1016/j.ophtha.2010.09.015Get rights and content

Purpose

To determine the prevalence of refractive error (RE), the proportion of those with uncorrected RE, and factors associated with uncorrected RE in Latino adults.

Design

Population-based, cross-sectional study.

Participants

A random sample of 4509 Latinos aged ≥40 years from Arizona with both ophthalmic evaluation and questionnaire.

Methods

A case of RE was defined as a subject wearing prescription glasses for distance vision whose presenting visual acuity (PVA) was ≥20/25, or a subject with PVA <20/25 in at least 1 eye who improved ≥2 lines after subjective refraction and whose refractive correction met these cutoffs: sphere < −0.5 diopters (D) or >1.0 D or cylinder ≥ +1.0 D. Among those with RE, those who on refraction achieved ≥2 line improvement in at least 1 eye (definition 1) or in both eyes (definition 2) were classified as uncorrected RE. A questionnaire on access to care, acculturation, and socioeconomic variables was used.

Main Outcome Measures

Prevalence of RE and proportion of uncorrected RE.

Results

The prevalence of RE was 64% in at least 1 eye and 51% in both eyes. Of participants with RE in at least 1 eye, 35% have uncorrected RE. Of those with RE in both eyes, 19% have uncorrected RE. Compared with participants with corrected RE, those with uncorrected RE in at least 1 eye were more likely to have lower levels of acculturation (odds ratio [OR] 1.2; 95% confidence interval [CI], 1.1–1.4 per unit decrease) and education (OR 1.6 for ≤6 years vs. >12 years; 95% CI, 1.2–2.2). Uncorrected RE was also associated with not having insurance (OR 1.4; 95% CI, 1.1–1.6), with a low family income (OR 1.4; 95% CI, 1.1–1.7 for <$20,000/year), and with time since last health care visit (OR 1.4; 95% CI, 1.1–1.7 for >1 year vs. <6 months).

Conclusions

In our sample of Latinos, the proportion of uncorrected RE is high and suggests that one third of those with RE may benefit from new glasses. Indices of marginalization are associated with uncorrected RE and could be targeted for future interventions.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Study Design and Procedure

Detailed descriptions of the study methods have been presented13 and are summarized in this article. Proyecto VER (Spanish for “to see”) is a population-based survey of ocular disease, visual impairment, and legal blindness among non-institutionalized Latinos living in southern Arizona. With the use of the 1990 U.S. Census, block groups from Nogales and Tucson were randomly selected for inclusion in this study with a probability of selection within the strata proportional to the size of the

Population Characteristics

From the 4255 eligible dwelling units, 6659 eligible subjects were identified. Among the eligible subjects, 4769 (72%) completed both the home interview and the ophthalmic examination including visual acuity assessment. As reported previously,9 nonparticipants were more likely to be among the youngest age group (40–49 years) or the oldest age group (≥80 years) and to be male. They were also less likely to report having fair or poor health and less likely to report having problems with their

Refractive Error

The prevalence of RE among our Latino study population of adults in Arizona was found to be as high as 64% in at least 1 eye or as low as 51% in both eyes. Analysis of this population revealed that RE was associated with increasing age and female gender. The increase in RE with age is consistent with Hyman's16 review of RE, in which she notes RE increase among adults is accounted by 2 principle changes: (1) a “hyperopic shift” first seen in the 40- to 50-year age groups and continuing until 60

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    Manuscript no. 2010-725.

    The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Funding: a Senior Scientific Investigator award from Research to Prevent Blindness to Dr. West; National Eye Institute (core grant: EY11283).

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