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PubMedDate not supplied

Depression: a comparison study between blind and sighted adolescents.

An exploratory study was conducted to identify whether the incidence of depression was greater among blind adolescents than among a sighted comparison group. A convenience sample of 22 adolescents, legally blind since birth, and 29 sighted adolescents participated in the study. The adolescents in both samples were between the ages of 12 and 18. The Beck Depression Inventory (BDI) was used to measure depression. The findings indicated that the incidence of depression among the blind adolescents was significantly higher than the incidence of depression among the sighted adolescents (t = 2.937, df = 50, p < .005). Mean BDI score was 7.103 for the sighted group and 13.652 for the blind group. There were no significant relationships between demographic variables and depression. This study serves as a pilot for more extensive research that can expand the empirical base for understanding depression and its relationship to visual impairment among adolescents.

Adolescent↗
PubMedDate not supplied

Nutritional assessment and diet quality of visually impaired Spanish children.

BACKGROUND: The visually impaired represents a fairly numerous group in Spain although no data on their nutritional status has previously been published. AIM: This work aims to assess the nutritional state of a sample of visually impaired children and the quality of their diet. SUBJECTS AND METHODS: The sample comprised 229 boys and girls aged between 8 and 18 years (mean = 14, SD = 2.6), all of whom had a visual discapacity and were students of the Centros de Recursos Educativos (CREs; Educational Resources Centres) of the Organización Nacional de Ciegos de España (ONCE; Spanish National Organization for the Blind). RESULTS: This sample featured a high prevalence of overweight (25.8%) and obesity (11.8%) according to the international standard. The mean daily energy consumption and the quantity of carbohydrates, fats, proteins and fibre were greater in boys (2604 kcal day(-1); 290 g of carbohydrates, 126 g of fats and 90 g of proteins) than in girls (2159 kcal day(-1), 232 g of carbohydrates, 107 g of fats and 80 g of proteins). No differences in diet intake according to degree of visual impairment were found. Their diet was unbalanced in comparison with the nutritional objectives for the Spanish population, since consumption of carbohydrates was low and that of fats was very high. The results relating to the quality of the diet reveal quite large deviations from the Mediterranean model. Only 11.9% of the whole sample had a value corresponding to a good quality diet. CONCLUSION: The pattern of dietary consumption was the same as that observed in non visually impaired children in Spain in quantity and quality, nevertheless the prevalence of overweight and obesity is higher than in children without visual handicaps.

Activities of Daily Living↗
PubMed2004

Blindness registrations and socioeconomic factors in Canada: an ecologic study.

PURPOSE: To investigate the socioeconomic factors associated with blindness registration in Canada and its regions using an ecologic approach. METHODS: Canadian National Institute for the Blind (CNIB) blindness registration data for 1996 were divided into units of analysis using postal codes and correlated with demographic and socioeconomic information collected by the 1996 Census of Canada. A total of 1250 units were analyzed representing 28,429,519 persons (98.55% of the population of Canada). Six socioeconomic factors were examined using weighted linear multivariate regression analysis: I) Percentage of the population aged 65 years and over; 2) Median household income; 3) Percentage of the population with university education; 4) Percentage of income derived from government transfer payments; 5) Recent immigrants; and 6) Visible minorities (blacks, Chinese, South Asians). Regression models were created for Canada as well as five geographic regions within Canada. RESULTS: For Canada as a whole, blindness registration prevalence was positively correlated with age distribution and percentage of recent immigrants, and negatively correlated with level of government assistance income and percentage ethnic Chinese population. For five regional regression models, the common predictor variables were age distribution, median household income and percentage of the population who are black. None of the regional models produced an identical set of correlations. CONCLUSIONS: Socioeconomic factors associated with blindness registration prevalence varied across different regions. Median household income was the second most common factor after age distribution, suggesting that areas with lower incomes tend to utilize more blind services. Higher blindness registration rates were associated with areas that had a higher percentage of the population who were black. Differences in blindness registration rates may reflect under-utilization of blind services and/or variations in disease and treatment rates in different populations.

Aged↗
PubMed2004

Coverage of cataract surgery per person and per eye: review of a community-based blindness survey in Oman.

BACKGROUND AND OBJECTIVE: The data from a national survey of blindness and common eye diseases in Oman in 1996 were reviewed. The objective was to compare the calculation of cataract surgery services coverage on a per eye and per person basis. The advantages and limitations of both methods of program management are evaluated. METHODS AND MATERIALS: The information on cataract status, visual status and past history/evidence of cataract surgery was collected for 11,415 Omani subjects. The coverage of existing cataract services was calculated per eye and per person. The rates by gender, age groups, regional groups and type of cataract were also compared. RESULTS: The cataract surgery services could address more than 60% of the reported persons with blinding cataract (vision less than 3/60) and more than half of the eyes with blinding cataract. The services could cover more than one-fourth of the persons with cataract (with any grade of vision defect) and less than one-fourth of the eyes with cataract. If the coverage of cataract services for blinding cataract is calculated using persons as the denominator, it is nearly 10% higher than that calculated using eyes as the denominator. CONCLUSIONS: The two methods of calculating the coverage of cataract services give different results and both are useful for monitoring ophthalmic services. A national program should implement a system for reporting the visual and cataract status of the fellow eye so that coverage rates could be calculated by person and by eye and the impact of the cataract services in relation to time, place, gender and resources could be reviewed.

Adult↗
PubMed2004

Likert and Guttman scaling of visual function rating scale questionnaires.

PURPOSE: To test the assumptions underlying Likert scoring of visual function questionnaires. METHODS: Questionnaires were administered to 284 low-vision subjects by telephone. Each subject was administered two of four questionnaires: ADVS, NEI VFQ-25 plus supplement, expanded VAQ, and VF-14. RESULTS: Z-scores for cumulative frequency of using each rating category across subjects are not linear with rating category rank and items are not the same difficulty for any of the questionnaires. Guttmann coefficients of reproducibility ranged from 57% for the ADVS to 51% for the NEI VFQ-25. Cronbach alphas ranged from 0.92 for the VF-14 to 0.96 for the NEI VFQ; however, inter-item consistency coefficients ranged from 0.24 for the VAQ to 0.45 for the NEI VFQ. Likert scores were significantly correlated between instruments, ranging from 0.66 for NEI VFQ vs ADVS to 0.90 for the VF-14 vs. ADVS. CONCLUSIONS: The rating scales of all four questionnaires fail to satisfy Likert's assumptions. Also, ratings are probabilistic, rather than deterministic, which means that the Likert model is not valid for these questionnaires. However, Likert scores for all four instruments are intercorrelated, suggesting that they are monotonic with the latent subject trait distributed in the low vision sample.

Adult↗
PubMed2005

Visual impairment and morbidity in community-residing adults: the national health interview survey 1986-1996.

PURPOSE: To examine the association between visual impairment (VI) and morbidity. METHODS: Using pooled, annual population-based household interview survey data (n = 140,366) from the 1986-1996 National Health Interview Survey, covariate-adjusted, gender and age group specific logistic regression analyses were used to examine associations between VI and five morbidity indicators: restricted activity days, bed rest days, doctor visits, hospitalizations, and self-rated health. RESULTS: After controlling for educational status, race and the number of reported non-ocular health conditions, fair or poor health status (compared to excellent, very good, or good health status) was generally more strongly associated with severe, bilateral VI (range of odds ratios [OR's]: 2.14-7.24) than with some VI (OR's: 1.45-2.21). Severe, bilateral VI was also associated with more frequent doctor and hospital visits among adults 18-64 years of age (range of OR's: 1.69-3.34), and restricted activity and bed rest days among males 45 years and older (range of OR's: 1.95-3.69). CONCLUSIONS: The present findings, in conjunction with other studies documenting the impact of VI on morbidity outcomes, indicate that an increased focus on the provision of eye care services will be necessary to address the growing burden of VI in aging societies.

Adolescent↗
PubMed2005

Primary open-angle glaucoma presentation at a tertiary unit in Africa: intraocular pressure levels and visual status.

AIM: To investigate the presentation of POAG at a tertiary referral hospital in East Africa, including intraocular pressures, visual status and management decisions. METHODS: Retrospective review of first-time presenters with POAG over a 6-month period. RESULTS: Of the 298 patients identified, mean age 57 years (n = 296, range = 14-88, SD = 14), 213 (72%) male, 122 (41%) had normal vision (using WHO better eye acuity criteria: visual impairment < 6/18, blind < 3/60) at presentation, 87 (30%) had visual impairment and 86 (29%) were blind. The mean presenting IOP was 32 mmHg (SD = 11) and 70% of the patients had a cup:disc ratio of 0.8 or worse in the better eye. Longer disease duration (OR = 1.20, 95% CI 1.04-1.39) and higher mean IOP (OR = 1.06, 95% CI 1.02-1.10) were associated with visual impairment or blindness. Intraocular pressure showed a negative linear correlation with presenting logMAR acuity (R(2) = 0.115, SE = 1.30, p < 0.0005). The mean IOP in eyes that had undergone trabeculectomy (19 mmHg, SD = 8, n = 17) was significantly (p < 0.0005) lower than that in eyes that had not (34 mmHg, SD = 12, n = 274). The referral rate for trabeculectomy was 158/275 (57%). Male sex (OR = 2.17, 95% CI 1.0-4.72), higher mean IOP (OR = 1.09, 95% CI 1.05-1.14) and not being blind (OR = 26.47, 95% CI 9.90-70.78) were associated with surgical referral. Of the 158 patients, 76 (48%) accepted surgery. CONCLUSIONS: A high proportion of patients presenting to our unit with POAG are visually impaired or blind and the higher their presenting IOP the poorer their visual acuity. Previous trabeculectomy was associated with lower IOPs and protection from visual impairment and blindness. Further training of clinic staff towards early surgical referral and investigation of gender barriers is required.

Adolescent↗
PubMed2005

The Pakistan national blindness and visual impairment survey--research design, eye examination methodology and results of the pilot study.

PURPOSE: To establish age- and sex-specific prevalence rates and causes of blindness and low vision in children aged 10 to 15 years and adults aged 30 years and older in Pakistan. METHODS: Multi-stage, stratified (rural/urban), cluster random sampling, with probability proportional-to-size procedures, was utilised to select a cross-sectional, nationally representative sample of adults (16,600 subjects) and children (6,000 subjects). Each subject underwent: interview, visual acuity (logMAR), autorefraction and optic disc examination. Those that saw < 6/12 in either eye underwent corrected visual acuity and dilated posterior segment examination. RESULTS: The results of a pilot survey are reported in this paper. In the two rural pilot sites, 159 subjects (including 47 children) were examined; 50% were male. Thirty seven adults (23.3%) but no children saw worse than 6/12 in either eye. Two subjects were blind (corrected visual acuity) in the better eye, and 11 were visually impaired. Refractive error was the main cause (in 22 eyes (39% of the total of 56 eyes)) of < 6/12 visual acuity, followed by cataract (12 eyes), uncorrected aphakia (6 eyes) and age-related macular disease (3 eyes). CONCLUSIONS: The pilot survey demonstrated that the proposed examination process for the main survey is feasible. Particular strengths of this survey include the use of logMAR visual acuity testing and autorefraction of all subjects, a dilated posterior segment examination, and the use of a 'less than 6/12' threshold for further examination. This lower threshold addresses the burden of refractive error, which, with cataract, are two of the diseases specifically targeted by Vision 2020.

Adolescent↗
PubMed2005

Vision and self-rated health: longitudinal findings from an older Australian population.

PURPOSE: To assess temporal associations between vision and self-rated health. METHODS: We examined 3654 Australian residents (82.4% response) aged 49+ years in the Blue Mountains Eye Study, during 1992 to 1994, and re-examined 2334 in 1997 to 1999. Change in vision was defined if baseline and 5-year visual acuity (VA) changed by > or =10 letters (2 lines). Change in self-rated health was defined if overall health ranking (excellent, good, fair, poor) changed by > or =1 step. RESULTS: Of 2285 participants with data from both examinations, 59.8%, 23.9%, and 16.3% reported unchanged, declined, and improved self-rated health, respectively. Among persons whose self-rated health declined, the proportions with a decline in presenting VA, no change, or improvement were similar (25.2%, 23.8% and 22.5%, respectively, p for trend = 0.5). Among participants with decline, no change, or improvement in self-rated health, a similar magnitude in the age-sex adjusted mean VA decline (-1.0 to -2.7 letters) was observed. After adjusting for age, sex, hospitalizations, and incident chronic conditions, declining VA was not associated with increased decline in 5-year self-rated health (multivariate-adjusted odds ratio 0.99, 95% CI 0.75-1.30). CONCLUSION: There were no parallel 5-year changes in self-rated health and vision in this population.

Aged↗
PubMed2005

Prevalence and outcomes of childhood visual disorders.

PURPOSE: This population-based study examines the prevalence of childhood visual disorders: amblyopia (strabismus, refractive errors) and organic disease. It also assesses treatment outcomes, visual impairment and residual amblyopia. METHODS: 1582 children were retrospectively analysed on treatment completion (age 8-9 years). Significant visual disorders included: esotropia, exotropia, anisometropia (hyperopia > or = 1.50DS, astigmatism > or = 1.00DC, myopia > or = 1.50DS), ametropia (hyperopia > or = 1.50DS, astigmatism > or = 1.0DC, myopia > or = 0.75DS) and organic defects. RESULTS: 198 children (12.5%) had a significant visual disorder: strabismus (3.98%), eso:exo rate 5:1, anisometropia (2.34%), ametropia (5.82%), organic defects (0.38%). Organic disease caused visual handicap (< 6/18 in better eye) in 0.13%. Amblyopic visual impairment (6/18; 6/24-6/60) occurred in 1.13%; 2.02% had residual amblyopia (6/12 or worse). CONCLUSIONS: Childhood visual disorders are a common problem. Unfavourable visual outcomes in esotropia are related to two sub-groups and particularly with poor concordance to treatment. Suggested strategies to improve outcomes include health promotion, an "Amblyopia Nurse" and a "Patch Club".

Amblyopia↗
PubMed2006

Rapid assessment of visual impairment due to cataract and cataract surgical services in urban Argentina.

AIM: To present results of a rapid assessment on visual impairment due to cataract and on cataract surgical services in the Northwestern districts of Buenos Aires, Argentina. These results will enable health managers to plan effective interventions in this area in line with VISION 2020. METHODS: One hundred fifteen clusters of 40 persons of 50 years and older in each cluster (4600 eligible persons) were selected by systematic sampling from the Northwestern districts of Buenos Aires, Argentina. This area consists of 10 districts with a total population of 2,716,573 (2001 census), from whom 4302 persons were examined (coverage 93.5%). The visual acuity was measured with a tumbling E-chart and the lens status with distant direct ophthalmoscopy. RESULTS: Cataract is the major cause of bilateral blindness (54.2%). The age and sex adjusted prevalence of bilateral cataract blindness (presenting VA < 20/400) in people of 50 years and older was 0.5% (95% CI: 0.4-0.8%), an estimated number of 2,985 persons. The cataract surgical coverage at this level was 70% for males and 78% for females. The prevalence of bilateral cataract and VA < 20/200 in persons of 50 years and older was 0.8% (95% CI: 0.6-1.1), an estimated 4,705 persons. In this last group, the surgical coverage was 66% (persons) and 57% (eyes). Of all operated eyes, 10% could not see 20/200. 'Cannot afford' (32%), 'unaware of cataract' (21%) and 'contraindication for surgery' (18%) were mentioned most as reason why surgery had not been done. CONCLUSION: The cataract problem is getting under control in this area. Coverage indicators are fairly high, and the outcome data better than in other studies. The cataract surgical rate could be raised further by awareness campaigns and by making cataract surgery more affordable.

Argentina↗
PubMed2006

Methods for measuring personal costs associated with vision impairment.

PURPOSE: To describe and evaluate the procedures used to collect personal costs associated with vision impairment using diaries. METHODS: Participants with impaired vision (VA < 6/12 or > or = 6/12 with restricted visual fields) were recruited. Twelve-monthly diaries, provided in large print and electronic format (with audio and Braille instruction manuals and personal assistance), were used to record vision-related expenditures grouped under four categories. Two questionnaires were used to collect additional information and to test the validity of the self-reported costs. RESULTS: Of 227 people who consented to participate, 66% (n = 150; 91 females; mean age = 64.8 years) completed > or = 3 monthly diaries. Of the 150 eligible participants, 68% completed the diaries over 12 months, indicating a relatively high completion rate. The median total cost was AUD 2,417 dollars per annum and median values for the four expenditure categories ranged between AUD 206 dollars and AUD 872 dollars per annum. The data were consistent across different months with no significant difference found between any monthly comparison (t-test; p > Bonferroni-adjusted value). Data at 1, 3, and 6 months, extrapolated to annual figures, showed no significant difference from annual total costs, indicating consistency in the data collection periods. A significant association was found between diary data and similar entries in the follow-up questionnaire, confirming the validity of the recorded expenditures (Spearman; p < 0.01). Participants commented that the diary method was useful to obtain personal costs. CONCLUSION: A high response rate was achieved by using diaries and additional assistance methods. The diary provided an accurate and reliable strategy to determine the major personal costs associated with vision impairment.

Aged↗
PubMed2003

Sentinel: towards an ambient mobility network.

PURPOSE: We are concerned with aiding the mobility of visually impaired travellers around often complex and unfamiliar internal and urban environments. To do this we focus on a users interaction with ambient devices because these device types provide an easy entry point for visually impaired individuals to interact with their surroundings. By augmenting the physical environment with mobility focused ambient devices and making existing devices universally accessible our goal of easy, focused, and confident mobility can be achieved. METHOD: We identify, through paper reviews and studies of empirical and anecdotal evidence, the social and technical problems that have so far barred consistent and cohesive development of an ambient mobility-network. RESULTS: We suggest that multi-model sensory-interaction with objects and assistive devices within an environment is the only way to accomplish easy, focused, and confident mobility for visually impaired travellers. We find that universal access to ambient devices does not exist when the user interface and the device functionality are conjoined. And we also suggest that this universal access will not occur if there are only benefits for one small minority user group. CONCLUSIONS: We conclude that to assist mobility we need to provide universal access to objects and devices within the environment. Also, to support the mobility of visually impaired travellers we must first support all travellers regardless of their mobility needs. And to accomplish this we must separate the user interface from the real purpose (the functionality) of the object/device.

Electronics↗
PubMed2004

The effect of cane length on the haptic perception of height.

PURPOSE: The purpose of this investigation was to determine whether the ability to haptically perceive object height is a function of the length of cane being wielded by blindfolded individuals. METHOD: Fifteen sighted females between the ages of 18 and 25 years volunteered to participate in the study. Five different heights of wooden blocks were haptically explored with four different cane lengths (0.92, 1.22, 1.37 and 1.67 m), cane length order being randomized across 2 days of testing. Subjects were asked to report whether the explored block's height was taller, shorter, or equal to that of a previously presented standard block. The percentages of correct judgments for each cane and block height combination were subjected to statistical analysis. RESULTS: The analysis revealed significant main effects for cane length, F (3, 42) = 9.47, p < 0.0001, and block height, F (4, 56) = 17.69, p < 0.0001. The interaction of cane length and block height was not significant, F < 1. The accuracy of haptic perception improved with decreased cane length and increased difference in height from the standard block. CONCLUSIONS: Contrary to previous research on haptic perception in which probe length was found not to affect judgment accuracy, the present study found a marked influence of cane length on perceptual accuracy. This finding indicates that length is an important property that should be taken into account when prescribing canes for the visually impaired.

Adolescent↗