PURPOSE: To describe the age-specific and gender-specific rates of blindness and visual impairment in urban adults aged 40 years and older. METHODS: A population-based sample of residents was recruited. Presenting and best-corrected distance visual acuities were assessed. Functional near vision was measured at each participant's preferred distance. Visual field examination was performed with a Humphrey Field Analyzer (HFA); those unable to perform the field analyzer test attempted a Bjerrum screen or confrontation field. RESULTS: The study population comprised 3,271 residents (83% of eligible) from ages 40 to 98 years; 54% were women. Overall, 56% of the study population wore distance correction; this was significantly lower in men but higher in the older age groups. Age-adjusted rates of blindness were 0.066% in men and 0.170% in women. Vision with current correction improved after refraction by gender and age. Direct age-standardized rates of functional near vision did not vary significantly by gender. Forty-six people had significant visual field loss in their better eye. The proportion of participants with constriction of the visual field to within 20 degrees of fixation was similar for men and women when controlled for age (odds ratio, 0.81; 95% confidence interval, 0.44 to 1.49) but increased significantly with age controlled for gender. Visual field abnormalities were detected in 548 right eyes (17%) and 533 left eyes (16%). CONCLUSIONS: Although overall rates of blindness because of visual acuity loss were relatively low, nearly three times more people had visual impairment because of visual field loss than visual acuity loss. These results highlight the need to target blindness prevention programs to the aging population, with a special emphasis on women.
Bibliographical noteFunding Information:
Accepted for publication Oct 10, 1996. From the Department of Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. The Melbourne Visual Impairment Project is supported in part by the Victorian Health Promotion Foundation, Melbourne, Australia; the Ansell Ophthalmology Foundation, Melbourne, Australia; and the National Health and Medical Research Council, Canberra, Australia, including the Sir John Eccles Award (to Prof Taylor). Reprint requests to Hugh R. Taylor, MD, FRACO, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, 3002 Victoria, Australia; fax: (613) 9662 3859; e-mail: firstname.lastname@example.org