Search PubMed⌕ Search

Biomedical subjects

Paul Mitchell

Publications and source records attributed to Paul Mitchell.

At least 55 records · Page 3Linked to original sources
PubMed2006

Homocysteine and retinal emboli: the Blue Mountains Eye Study.

PURPOSE: To examine the association between serum homocysteine and retinal emboli in a general older population. DESIGN: Cross-sectional population-based study. METHODS: Homocysteine level was determined from fasting venous blood collection at the second Blue Mountains Eye Study (BMES) (n = 3509, age > or =49 years, 1997 to 2000). Retinal emboli were graded from retinal photographs. Using logistic regression, we analyzed associations between serum homocysteine and retinal emboli adjusting for age, gender, hypertension, body mass index, and lipid levels. RESULTS: After multivariable adjustment, serum homocysteine was associated with presence of retinal emboli (odds ratio (OR) 1.2; 95% confidence interval (CI), 1.0 to 1.6 per standard deviation [4.8 micromol/l] increase in serum homocysteine). CONCLUSION: Elevated serum homocysteine is weakly associated with increased odds of retinal emboli in this older population-based study.

Aged↗
PubMed2006

Prevalence of eye disorders in young children with eyestrain complaints.

PURPOSE: To determine whether eyestrain symptoms predict eye conditions in 6-year-old children. DESIGN: Cross-sectional population-based study. METHODS: Reports of eyestrain symptoms were sought in parental questionnaires; 1740 children (79% response) underwent eye examinations (visual acuity, cover testing, cycloplegic autorefraction, and fundus examination). RESULTS: Eyestrain information was available for 1448 children; 220 (15.2%) reported eyestrain symptoms, including 60 (3.4%) who reported near work-associated headaches. Most children (82.3%) had a normal eye examination, while refractive errors, amblyopia, and strabismus were found in 15.0%, 3.6%, and 7.3%, respectively. Corresponding rates for children without eyestrain were 9.9%, 1.4%, and 1.8%, respectively. Moreover, 78.7% of children with refractive errors, 68% with amblyopia, and 58% with strabismus reported no eyestrain. CONCLUSIONS: Most children complaining of eyestrain had a normal eye examination; whereas most children with refractive error, amblyopia, or strabismus were free of eyestrain, making this complaint a poor marker of eye conditions in young children.

Asthenopia↗
PubMed2006

Influence of birth parameters on peripapillary nerve fiber layer and macular thickness in six-year-old children.

PURPOSE: To examine influences of gestational age and birth parameters on peripapillary nerve fiber layer (NFL) and macular thickness at age six. DESIGN: Cross-sectional study. METHODS: The Sydney Childhood Eye Study examined a random-cluster sample of 1765 six-year-old Sydney school children. Peripapillary NFL and macular thickness were measured (StratusOCT, Zeiss, Dublin, California, USA). Birth parameters were extracted from health records. Multivariate analyses were performed. RESULTS: Higher birth weight children had greater peripapillary NFL, inner and outer (all P(trend) < 0.03), but not central or average macular thickness (both P(trend) > 0.1). Peripapillary NFL (P(trend) = 0.001), inner (P(trend) = 0.01), outer (P(trend) = 0.002), and average macular thickness (P(trend) = 0.02), but not central macular thickness (P(trend) = 0.5) was greater in children with larger head circumference at birth. The central macula was thicker in prematurely (<37 weeks) born children (195.0 microm) than those born at term (191.2 microm), P = 0.04. CONCLUSION: Birth weight and head circumference predicted peripapillary NFL and macular thickness. Prematurity was weakly associated with central macular thickness.

Birth Weight↗
PubMed2006

Cardiovascular risk factors and retinal microvascular signs in an adult Japanese population: the Funagata Study.

OBJECTIVE: To describe the prevalence of retinal vascular signs and their association with cardiovascular risk factors in a Japanese population. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Adult persons aged 35 years or older from Funagata, Yamagata Prefecture, Japan (n = 1481). METHODS: The Funagata Study is a Japanese population-based study of persons aged 35 years or older, and included 1961 nondiabetic participants (53.3% of 3676 eligible subjects). A nonmydriatic retinal photograph was taken of 1 eye to assess retinal microvascular signs. Retinal arteriolar wall signs (focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex) and retinopathy were assessed in 1481 participants without diabetes (40.3% of eligible persons) using a standardized protocol. Using a computer-assisted method, retinal vessel diameters were measured in 921 participants with gradable retinal image (25.1% of eligible persons). MAIN OUTCOME MEASURES: Prevalence of retinal microvascular signs and their association with cardiovascular risk factors. RESULTS: Moderate or severe focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex, and retinopathy were found in 8.3%, 15.2%, 18.7%, and 9.0%, respectively, of the study population. Mean (+/-standard error) values for retinal arteriolar diameter were 178.6+/-21.0 mum, and mean values (+/-standard error) for venular diameter were 214.9+/-20.6 mum. Older persons were more likely to have retinal arteriolar wall signs, retinopathy, and narrower retinal vessel diameters. After adjusting for multiple factors, each 10-mmHg increase in mean arterial blood pressure was associated with a 20% to 40% increased likelihood of retinal arteriolar signs and a 2.8-mum reduction in arteriolar diameter. Retinopathy was associated with higher body mass index and both impaired glucose tolerance and impaired fasting glucose. CONCLUSIONS: In nondiabetic Japanese adults, retinal arteriolar wall signs were associated with older age and increased blood pressure, whereas retinopathy was associated with older age, higher body mass index, impaired glucose tolerance, and impaired fasting glucose. These findings are comparable with data from white populations.

Adult↗
PubMed2006

Open-angle glaucoma and cardiovascular mortality: the Blue Mountains Eye Study.

PURPOSE: To evaluate the association between open-angle glaucoma (termed glaucoma) and 9-year mortality in an older population-based cohort. DESIGN: Population-based cohort. PARTICIPANTS: Three thousand six hundred fifty-four persons aged 49 to 97 years (82.4% of the eligible population), residents of the Blue Mountains, west of Sydney, Australia. METHODS: At baseline (1992-1994), glaucoma was diagnosed from congruous typical glaucomatous visual field changes (full-threshold fields) and optic disc cupping (stereo-optic disc photography). Demographic information from baseline participants was matched with the Australian National Death Index data (December 2001) to obtain the number and causes of deaths. Cox proportional hazards regression analysis, controlling for age, male gender, diabetes, hypertension, heart disease, stroke, use of oral beta-blockers, current smoking history, alcohol use, myopia, and nuclear cataract were performed to assess hazard ratios for cardiovascular mortality. Adjustments for all-cause mortality also included history of cancer. MAIN OUTCOME MEASURES: Cardiovascular and all-cause mortality. RESULTS: At baseline, glaucoma was diagnosed in 108 participants (3.0%). Of 873 deaths (23.9%) before January, 2002, 312 people (8.5%) died of cardiovascular events. The age-standardized all-cause mortality was 24.3% in persons with and 23.8% in those without glaucoma, whereas cardiovascular mortality was 14.6% in persons with and 8.4% in those without glaucoma. After multivariate adjustment, those with glaucoma had a nonsignificant increased risk of cardiovascular death (relative risk [RR], 1.46; 95% confidence interval [CI], 0.95-2.23). Increased cardiovascular mortality was observed mainly in glaucoma patients aged <75 years (RR, 2.78; 95% CI, 1.20-6.47). Further stratified analyses showed that cardiovascular mortality was higher among those with previously diagnosed glaucoma (RR, 1.85; 95% CI, 1.12-3.04), particularly in those also treated with topical timolol (RR, 2.14; 95% CI, 1.18-3.89). CONCLUSIONS: Findings from the Blue Mountains Eye Study demonstrate an increased cardiovascular mortality in persons with previously diagnosed glaucoma. There was a suggestion of higher cardiovascular mortality in glaucoma patients using topical timolol that merits further study.

Administration, Topical↗
PubMed2006

Peripapillary retinal nerve fiber layer thickness in a population of 6-year-old children: findings by optical coherence tomography.

PURPOSE: To study the distribution of retinal nerve fiber layer (RNFL) thickness by ocular and demographic variables in a population-based study of young children. DESIGN: Population-based cross-sectional study. PARTICIPANTS: One thousand seven hundred sixty-five of 2238 (78.9%) eligible 6-year-old children participated in the Sydney Childhood Eye Study between 2003 and 2004. Mean age was 6.7 years (50.9% boys). METHODS: Detailed examination included cycloplegic autorefraction and measurement of axial length. Retinal nerve fiber layer scans using an optical coherence tomographer were performed with a circular scan pattern of 3.4-mm diameter. Multivariate analyses were performed to examine the distribution of RNFL parameters with gender, ethnicity, axial length, and refraction. MAIN OUTCOME MEASURES: Peripapillary RNFL thickness and RNFL(estimated integral) (RNFL(EI)), which measures the total cross-sectional area of ganglion cell axons converging onto the optic nerve head. RESULTS: Peripapillary RNFL thickness and RNFL(EI) were normally distributed. The mean+/-standard deviation RNFL average thickness was 103.7+/-11.4 microm and RNFL(EI) was 1.05+/-0.12 mm2. Retinal nerve fiber layer thickness was least for the temporal quadrant (75.7+/-14.7 microm), followed by the nasal (81.7+/-19.6 microm), inferior (127.8+/-20.5 microm), and superior (129.5+/-20.6 microm) quadrants. Multivariate adjusted RNFL average thickness was marginally greater in boys than in girls (104.7 microm vs. 103.2 microm; P = 0.007) and in East Asian than in white children (107.7 microm vs. 102.7 microm; P<0.0001). The RNFL was thinner with greater axial length (P(trend)<0.0001) and less positive spherical equivalent refractions (P(trend) = 0.004). CONCLUSIONS: Retinal nerve fiber layer average thickness and RNFL(EI) followed a normal distribution. Retinal nerve fiber layer thickness varied marginally with gender, but differences were more marked between white and East Asian children. Retinal nerve fiber layer thinning was associated with increasing axial length and less positive refractions.

Anthropometry↗
PubMed2006

The effect of cataract surgery on neuropsychological test performance: a randomized controlled trial.

Recent cross-sectional studies have reported strong associations between visual and cognitive function, and longitudinal studies have shown relationships between visual and cognitive decline in late life. Improvement in cognitive performance after cataract surgery has been reported in patients with Mild Cognitive Impairment. We investigated whether improving visual function with cataract surgery would improve neuropsychological performance in healthy older adults. A randomized clinical trial of cataract surgery performed at acute hospitals was conducted on 56 patients (mean age 73) with bilateral cataract, after excluding a total of 54 patients at the screening stage, of whom 53 did not meet visual acuity criteria and one did not have cataract. In-home assessments included visual and neuropsychological function, computerized cognitive testing and health questionnaires. Results showed no cognitive benefits of cataract surgery in cognitively normal adults. We conclude that visual improvement following cataract surgery is not strongly associated with an improvement in neuropsychological test performance in otherwise healthy adults. Joint associations between visual and cognitive function in late life are likely to be due to central factors, and unlikely to be strongly related to eye disease. Short-term increased neural stimulation from improved visual function does not appear to affect cognitive performance.

Aged↗
PubMed2006

Retinal vessel diameters and obesity: a population-based study in older persons.

OBJECTIVE: Obesity is linked with large vessel atherosclerosis and diabetes. Its association with microvascular changes is less clear. We investigated the associations among retinal vessel diameters, vessel wall signs, and BMI in an older population. RESEARCH METHODS AND PROCEDURES: Retinal photographs were taken on 3654 persons aged 49+ years at baseline of the Blue Mountains Eye Study in Australia. Arteriolar and venular diameters were measured from digitized retinal photographs of the right eyes. BMI was calculated as weight (kilograms)/height (meters2). Incident obesity was defined in persons with BMI < or = 30 at baseline but > 30 after 5 years. A significant weight gain was defined as an increase in BMI of 2+ SDs (4 or more units) over the 5-year period. RESULTS: At baseline, mean BMI was 26.1 (+/-4.6) in this population. At 5-year examinations, 177 (10.0% of 1773 at risk) developed incident obesity, and 136 (6.4% of 2143 at risk) had significant weight gain. After adjusting for age, sex, smoking, triglyceride levels, and mean arterial blood pressure, persons with wider retinal venular diameters had a higher risk of incident obesity (odds ratio, 1.8; 95% confidence interval, 1.0 to 3.1, comparing the highest with lowest venular diameter quintiles) and significant weight gain (odds ratio, 1.7; 95% confidence interval, 0.9 to 3.2). These associations were attenuated with further adjustment for baseline BMI. Arteriolar diameter was unrelated with baseline or change in BMI. DISCUSSION: Wider retinal venular diameter is associated with risk of obesity, independent of hypertension, diabetes, lipids, and cigarette smoking. These data may support a role for impaired microvascular function in the course of weight gain.

Aged↗
PubMed2006

Macronutrient intake, glycaemic index and glycaemic load of older Australian subjects with and without diabetes: baseline data from the Blue Mountains Eye study.

Individuals with diabetes receive more nutrition advice than other population segments yet little is known about how well they comply or differ in nutrient intake from the rest of the population. The present study determined the mean macronutrient intake, glycaemic index (GI), and glycaemic load (GL) of a cohort of 3654 older Australians, with and without diabetes. Fasting pathology tests, including plasma glucose, were obtained for 88 % of the 3654 residents, and a 145-item semi-quantitative food-frequency questionnaire was completed by 2900 residents (89 %) between 1992 and 1994. In total, 6 % of participants had diagnosed diabetes. Valid food-frequency data were available for 2736 without and 164 individuals with diabetes. The GI and GL were calculated from a customised database of Australian foods. Individuals with diabetes consumed significantly more protein (P = 0.001) and less sugars (P < or = 0.001) than the general population. Only seven individuals with diabetes (4.3 %) met all macronutrient recommendations and only four (2.4 %) met fibre recommendations as well. Those with diabetes had a lower mean GI (55 (sd 5) v. 57 (sd 4); P = 0.007, respectively) and GL (122 (sd 26) v. 134 (sd 24); P < 0.001, respectively) than the general population. In conclusion, older individuals with diabetes living in Australia in the 1990s chose a diet that had significantly more protein and less sugars than those without diabetes. This difference had little impact on the average GI, but it led to a moderate reduction in the average GL. Only a small percentage, however, was able to meet nutritional recommendations for optimal diabetes management.

Aged↗
PubMed2006

Patterns of eyecare utilization by young Australian children: findings from a population-based study.

OBJECTIVES: To report factors associated with childhood eyecare utilization in a random sample of 1740 Sydney schoolchildren aged 6, examined during 2003-4. METHODS: Information on use of eyecare services, defined as any previous consultation with an ophthalmologist or optometrist, was sought from parents. Children had comprehensive eye examinations, including visual acuity (VA), cover testing, cycloplegic refraction and dilated fundus examination. RESULTS: Prior ophthalmic or optometric assessment was reported by 465 children (29.2%), and was not associated with gender (p = 0.9), parental employment (p = 0.4) or home ownership (p = 0.9). Children of East Asian (odds ratio, OR, 0.7, 95% confidence interval, CI, 0.5-0.9) or other ethnicities (OR 0.7, CI 0.6-1.0) were less likely than European Caucasian children to have been examined. Parent-expressed concern about their child's vision was associated with a 10-fold increased likelihood of previous eye examination (OR 10.2, CI 7.3-14.5). Complaints of eyestrain were associated with a 4-fold increase (OR 4.4, CI 3.2-5.9). Most children with VA < 20/40 in at least one eye (63.1%), amblyopia (80.0%) or strabismus (86.4%) had been assessed. CONCLUSIONS: One third of this childhood sample reported prior examination by an eyecare professional. Given that most children needing vision assessment had been examined and likely effects of parental motivation, this rate seems reasonable and appropriate.

Australia↗
PubMed2006

Assessment of vision-related quality of life in an older population subsample: The Blue Mountains Eye Study.

PURPOSE: To assess visual functioning and vision-specific health-related quality of life (HRQOL) in an older, community-dwelling-based population subsample, using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). METHODS: Three-quarters (76%, n = 892) of Extension Blue Mountains Eye Study participants (aged > or = 50 years, mean 60.8 years) completed the self-administered NEI-VFQ-25, an instrument consisting of 12 dimensions and one summary composite score, and comprehensive eye examinations, including monocular distance visual acuity. Visual impairment was defined as visual acuity < 6/12. Unilateral and bilateral visual impairment was defined by the worse eye and better eye, respectively. Correctable visual impairment was defined as that which improved, and non-correctable visual impairment as that which persisted after subjective refraction. Mild visual impairment was defined as visual acuity < 6/12 but > or = 6/24, moderate as < 6/24 but > or = 6/60, and severe as < 6/60. RESULTS: There were no significant differences in age, sex, or vision status between NEI-VFQ-25 responders and non-responders. Men had significantly better scores in three subscales than women but there were no significant differences in their overall composite scores (men 88.5+/- 0.5; women 88.1+/- 0.4). Persons aged 60-69 years had the best NEI-VFQ-25 profiles (mean composite score +/- standard error, 90.2 +/- 0.5; 50-59 years, 88.5 +/- 0.4; > or =70 years, 86.2 +/- 0.8). Presenting bilateral visual impairment (77.1 +/- 1.4) was associated with significantly poorer functioning than unilateral (87.5 +/- 0.8) or no visual impairment (89.4 +/- 0.3). Increasing levels of impairment were associated with poorer levels of visual functioning. The impact of impairment was principally from non-correctable (49.2 +/- 2.6) rather than refractive impairments (85.3 +/- 1.4), although the latter accounted for over three-quarters (77.5%) of presenting bilateral impairment. Non-correctable unilateral impairment (85.3 +/- 1.1) was associated with poorer functioning than no impairment. CONCLUSIONS: The findings from this community-dwelling older population show that the NEI-VFQ-25 differentiates well between various levels of visual impairment with regard to the magnitude of their impact on vision-specific quality of life. Greater impacts were noted among persons with bilateral compared to unilateral impairment, with increasing impacts at greater severities of visual impairment. Visual impairment from refractive errors is more frequent than from underlying pathologic disorders, but the impact of correctable visual impairment was considerably milder than the impact of non-correctable visual impairment.

Aged↗
PubMed2006

Odds of demonstrating auditory processing abnormality in the average older adult: the Blue Mountains Hearing Study.

OBJECTIVE: To determine, for the average older adult, the odds of demonstrating an auditory processing abnormality for each of seven speech-based measures of auditory processing and how these odds vary based on a number of independent subject variables. DESIGN: Using a cross-sectional design, 1576 adults aged 55 years and older were assessed with speech measures of central auditory processing and questionnaires pertaining to health status, cognitive and perceived auditory function. The speech-based measures from which abnormal/normal outcomes were derived were (a) right ear Macquarie Synthetic Sentence Identification (MSSI) test maximum performance score (Rt MSSImax), (b) left ear MSSI test maximum performance score (Lt MSSImax), (c) right ear Macquarie Dichotic Sentence Identification (MDSI) test score (Rt MDSI), (d) left ear MDSI test score (Lt MDSI), (e) difference score for the right and left ear MDSI test (MDSI Diff score), (f) right ear MSSI test maximum performance score subtracted from the maximum performance score for monosyllabic word list materials in the same ear (Rt PB-MSSImax), and (g) left ear MSSI test maximum performance score subtracted from the maximum performance score for monosyllabic word list materials in the same ear (Lt PB-MSSImax). RESULTS: The odds of demonstrating auditory processing abnormality for average older participants, increased by 4 to 9% per year of age. Men were approximately twice as likely as women to demonstrate this abnormality, but the gender difference was only evident with dichotic measures. With increasing hearing handicap, the odds of demonstrating auditory processing abnormality increased, but this was only evident for speech-in-noise measures. With subtle cognitive decline, the odds of demonstrating auditory processing abnormality also increased. CONCLUSIONS: This population-based study provides evidence of a link between perceived hearing handicap and outcomes on speech-in-noise measures as well as evidence of a gender difference that became apparent using dichotic tests. The contribution of central auditory processing abnormality to hearing health should therefore not be overlooked in the provision of auditory rehabilitation programs to older adults.

Aged↗
PubMed2006

Regular aspirin use and retinal microvascular signs: the Blue Mountains Eye Study.

OBJECTIVE: Hypertension is closely related to microvascular abnormalities and there is increasing interest in agents that target the microvasculature. The effect of aspirin on the microvasculature has not been well studied. We examined the cross-sectional and longitudinal associations between regular aspirin use and retinal microvascular signs. DESIGN AND METHODS: We digitized retinal photographs from participants of the Blue Mountains Eye Study cohort (1992-1994, n = 3654, aged over 49 years, and 1997-1999, n = 2335) and used a computer-assisted method to measure average retinal arteriolar and venular diameters. Information on the frequency of aspirin use was collected, with regular aspirin use defined as weekly or daily. RESULTS: Regular aspirin users comprised 21.2% (n = 775) of the baseline population. At baseline and in individuals who were on one or more antihypertensive medication, regular aspirin use was found to be associated with retinal arterioles on average 3.6 mum (95% confidence interval 1.0, 6.2) wider than those of non-users or occasional aspirin users, after adjusting for age, blood pressure, smoking, diabetes, non-steroidal anti-inflammatory drug use and other variables. Increasing frequency of aspirin use was associated with increasing retinal arteriolar diameter (Ptrend < 0.01). At 5-year follow-up, regular users of aspirin and antihypertensive medication(s) had wider retinal arterioles than those who used aspirin less regularly. Neither antihypertensive medication use alone nor aspirin use alone was associated with wider retinal vessels. CONCLUSION: Our finding of a possible association between the combined use of aspirin and antihypertensive agent(s) and wider retinal arteriolar diameter warrants further investigation into the effects of aspirin on the microvasculature.

Aged↗
PubMed2006

An evaluation of keratometry in 6-year-old children.

PURPOSE: To evaluate the repeatability and comparability of keratometry measured by both the IOLMaster and RK-F1 AutoRef-Keratometer in children. METHODS: Keratometry results from a sample (n = 447) of 6-year-old children who were examined in the Sydney Myopia Study were analyzed. Corneal power was analyzed along the flattest and steepest meridians to determine if there were any systematic differences between repeat measurements or between the two instruments. The 95% limits of repeatability (LR) and 95% limits of agreement (LA) (mean difference +/- 1.96 x standard deviation of differences) were calculated. RESULTS: There were no systematic differences in repeat measurements for each instrument. For the IOLMaster, mean difference of the flattest corneal meridian was -0.01 (D) (P = 0.3, 95% LR, -0.22, 0.21 D) and of the steepest corneal meridian, 0.01 D (P = 0.3, 95% LR, -0.35, 0.38 D). For the RK-F1, mean difference of the flattest corneal meridian was -0.02 D (P = 0.3, 95% LR, -0.25, 0.21 D); and of the steepest corneal meridian, 0.00 D (P = 0.9, 95% LR, -0.39, 0.39 D). Systematic differences, however, were found between the two instruments. The IOLMaster gave significantly (P < 0.0001) steeper readings than the RK-F1 for both the flattest corneal meridian, 0.29 D (95% LA, -0.08, 0.66 D), and the steepest corneal meridian, 0.18 D (95% LA, -0.29, 0.65 D). CONCLUSIONS: Keratometry was highly repeatable for both the IOLMaster and RK-F1 instruments when used in young children. These instruments would be suitable for use in monitoring changes of corneal curvature over time. Small significant systematic differences in keratometry between the two instruments were also found.

Anthropometry↗
PubMed2006

Comparison of aberrometer and autorefractor measures of refractive error in children.

PURPOSE: The purpose of this study was to evaluate and compare the Complete Ophthalmic Analysis System (COAS) G200 Aberrometer (Wavefront Sciences Inc., Albuquerque, NM) and Canon RK-F1 Autorefractor (Canon Inc., Tokyo, Japan) for measuring refractive errors in young children. METHODS: The Sydney Myopia Study is a population-based study of refractive error and eye health in young Australian children. Cycloplegic refractions were performed on 1504 school year 1 students (mostly 6 years old) and 890 school year 7 (mostly 12 years old) students using both the COAS G200 Aberrometer and Canon RK-F1 autorefractor. Refractive data were analyzed using power vectors. Mean differences and 95% limits of agreement were determined for refractive components between the two instruments. RESULTS: The mean age +/- standard deviation was 6.7 +/- 0.4 years (range, 5.5-9.1 years) and 12.6 +/- 0.5 years (range, 11.1-14.4 years) for the year 1 and year 7 students, respectively. Mean paired differences for the M component (spherical equivalent) between the COAS G200 and Canon RK-F1 were <0.25 D in both age groups and were statistically significant in the year 1 group only (p < 0.001). Small significant differences were found in the astigmatic components (J0 and J45) in both groups. A smaller coefficient of agreement for the M component was found in the older group (0.54 D), whereas the coefficients of agreement of the astigmatic components (J0 and J45) were similar for both groups. CONCLUSIONS: The COAS G200 aberrometer was an easy-to-use instrument for the measurement of refractive error in children. In addition to being able to measure higher and lower order aberrations, the COAS G200 provides refractive error measurements comparable to those of an autorefractor.

Adolescent↗
PubMed2006

Eye care service utilization in older people seeking aged care.

BACKGROUND: To assess the need for, and the use of eye care services in older people seeking aged care. METHODS: In total, 188 people (69.1% of those eligible) aged 65+ years who were assessed for aged care provision at Westmead Hospital, Sydney, were recruited in 2003 and re-examined a year later. At baseline, presenting visual acuity (VA) was randomly assessed in half the participants. People with under-corrected refractive error (pinhole VA improved at least 10 letters in those with presenting VA <6/6), bilateral visual impairment (better eye VA <6/12), or self-reported visual problems, were recommended to have further assessment by eye care professionals. At follow up, information on utilization of eye care services in the past 12 months was collected and VA was assessed in all returned participants. RESULTS: Of the 188 baseline participants, 121 (70% of survivors) were revisited a year later. Overall, 90/121 participants (74%) had seen an eye care professional in the previous year. Of the 66 participants who were recommended to see an eye care professional, 42 (64%) were revisited and 37/42 (88%) complied with the recommendation. At revisit, bilateral visual impairment was found in 49/120 (41%). The proportion with bilateral visual impairment was lower in participants whose vision was assessed at baseline (35%) than in those whose vision was not assessed (47%, P = 0.17), and also lower among people who had visited an eye care professional during the previous 12 months (39%) than those who had not (45%, P = 0.57). CONCLUSIONS: This pilot study indicates a relatively high need for, and high utilization of eye care services in the subgroup of older people seeking aged care services.

Aged↗