scholarly journals Causes of visual impairment and blindness among the middle-aged and elderly in northern Jordan

2002 ◽  
Vol 8 (2-3) ◽  
pp. 404-408
Author(s):  
A. Haddadin ◽  
I. Ereifej ◽  
F. Zawaida ◽  
H. Haddadin
Keyword(s):  
Visual Acuity ◽  
Low Vision ◽  
The Elderly ◽  
Education Programme ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Common Causes ◽  
Northern Jordan ◽  
Population Based Survey

Causes of bilateral low vision [BLLV] and bilateral blindness [BLB] were investigated among 720 outpatients aged > 45 years in Irbid, Jordan, between July 1999 and October 2000. All received full ophthalmic examinations. BLLV was defined as visual acuity < 6/18 but > 3/60 in the better eye; BLB as acuity < 3/60 in the better eye. The leading cause of BLB and BLLV was cataract. Refractive error was the second major cause of BLLV. Other common causes were diabetic retinopathy and glaucoma. Age-related macular degeneration was the single cause of BLB and BLLV for only 1.6% and 2.8% respectively. A population-based survey of BLB and BLLV in the elderly, yearly vision examinations and an ophthalmic education programme are recommended.

Loss of vision

2018 ◽  
Author(s):  
Susan Mollan ◽  
Alastair Denniston
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Low Vision ◽  
Visual Field Loss ◽  
Age Related Macular Degeneration ◽  
World Health ◽  
Clinical Approach ◽  
Loss Of Vision ◽  
P Loss ◽  
Age Related

Loss of vision describes a reduction in vision that cannot be corrected by glasses or contact lenses. Patients who complain of changes in their vision may have loss of visual acuity, distorted vision, or visual field loss. The World Health Organization classifies visual impairment as blindness or low vision. Blindness is defined as visual acuity of less than 3/60 in the better eye. Low vision is present when the visual acuity is less than 6/18 but equal to or better than 3/60, in the better eye. The etiology of permanent visual loss is diverse and depends on the region studied. In the UK, the leading causes are age-related macular degeneration, glaucoma, diabetic retinopathy, optic atrophy, and cataract. This chapter describes the clinical approach to the patient with loss of vision.

Tamoxifen Side Effects, Age-Related Macular Degeneration (AMD) or Cancer Associated Retinopathy (CAR)?

2001 ◽  
Vol 11 (3) ◽  
pp. 309-312 ◽  
Author(s):  
B. Sadowski ◽  
C. Kriegbaum ◽  
E. Apfelstedt-Sylla
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Low Dose ◽  
The Elderly ◽  
Age Related Macular Degeneration ◽  
Visual Field Defects ◽  
Ophthalmological Examination ◽  
Age Related ◽  
Cancer Associated Retinopathy ◽  
Flash Electroretinogram

Purpose Differential diagnosis of maculopathies can be difficult but is important if patients also suffer from other diseases such as breast cancer treated with antiestrogens. The main possible diagnoses, especially in the elderly, are age-related macular degeneration, tamoxifen and cancer-associated retinopathy (CAR). Methods We describe an 84-year-old patient with breast and colon cancer, who complained of a decrease in visual acuity after treatment with low-dose antiestrogens. She underwent a general ophthalmological investigation, perimetry and electroretinographic examination with multifocal (m-ERG) and flash-electroretinogram (flash-ERG). Results Visual acuity was reduced to 1/50 and 0.3. The ophthalmological examination was normal, except for extensive bilateral maculopathy with shining crystalline deposits, central and peripheral visual field defects, slightly affected scotopic and photopic potentials in the flash-ERG, and an abnormal m-ERG. Conclusions The findings are expected with age-related macular degeneration with crystalline drusen, but also with CAR. Even if the single and total dosage of antiestrogens given to the patient is sufficient to cause tamoxifen retinopathy, this diagnosis can be excluded because, in tamoxifen retinopathy unlike in the case presented here, the deposits are not distributed in all retinal layers.

scholarly journals Causes of low vision and use of optical aids in the elderly

2004 ◽  
Vol 59 (4) ◽  
pp. 157-160 ◽  
Author(s):  
Keila Monteiro de Carvalho ◽  
Gelse Beatriz Martins Monteiro ◽  
Cassiano Rodrigues Isaac ◽  
Lineu Oto Shiroma ◽  
Marcela Scabello Amaral
Keyword(s):  
Macular Degeneration ◽  
Elderly Population ◽  
Low Vision ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Rehabilitation Service ◽  
Visual Rehabilitation ◽  
Cross Sectional ◽  
Age Related

PURPOSE: To determine the causes of low vision in an elderly population attended by a university visual rehabilitation service and to check for the use of prescribed optical aids. METHOD: A cross-sectional study was carried out on patients aged 60 years or over attending for the first time a university low vision service in 2001. Ophthalmic reevaluation and interview were performed by means of a structured questionnaire in 2002. RESULTS: The sample comprised 50 subjects aged between 60 and 90 years. Severe low vision (<FONT FACE=Symbol><</FONT>20/200) was present in 68.0% of patients. The main cause of low vision was age-related macular degeneration (44.0%). Regarding literacy, 16.0% were illiterate and 72.0% had completed fundamental schooling. Thirty-one patients (62.0%) had been prescribed optical aids; 54.8% of these patients stated that they use them. A majority (70.6%) held a favorable opinion of these aids. CONCLUSIONS: The main cause of low vision was age-related macular degeneration. Approximately half of those receiving prescriptions reported actually using the aids in their daily activities. Making best use of residual vision in the elderly population with visual impairment is a priority, given the social context, if the independence necessary for enhanced quality of life is to be achieved.

scholarly journals Vision Rehabilitation in Patients with Age-related Macular Degeneration

2014 ◽  
Vol 3 ◽  
pp. RPO.S12364 ◽  
Author(s):  
Filippo M. Amore ◽  
Stefania Fortini ◽  
Valeria Silvestri ◽  
Marco Sulfaro ◽  
Alessia Pacifici ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Visual Stimulation ◽  
Low Vision ◽  
Reading Speed ◽  
Age Related Macular Degeneration ◽  
International Agency ◽  
Visual Rehabilitation ◽  
Age Related ◽  
Fixation Stability

Background The aim of this study was to investigate the rehabilitative process and visual rehabilitation outcomes in patients with central vision loss due to age-related macular degeneration (AMD). Methods Ninety-five subjects with AMD selected from the attendees of the National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients—International Agency for Prevention of Blindness—IAPB Italia Onlus, were evaluated for this retrospective study. Low vision examination included psychological counseling, best corrected visual acuity (BCVA), near visual acuity, Pelli-Robson contrast sensitivity, and fixation stability analysis. Once the clinical assessment was completed, patients attended a low-vision rehabilitative pathway based on visual stimulation, devices training and, if needed, psychological support. Required magnification and reading speed were also evaluated. Results For the whole sample, the mean BCVA of the better eye was 0.7 (±0.2) LogMAR and of the worse eye was 1 (±0.2) LogMAR. Restoring reading ability was the most important focus for the patients examined as it was requested by 85% of the whole sample. Mean power of optical magnifying aids for near activities was 10.6 (±9.1) positive spherical diopters. Mean reading speed for the whole sample was 33.1 (±18.2) words per minute (wpm) before visual rehabilitation sessions and increased to 55.2 (±33.1) wpm after visual rehabilitation path. To cope with distance difficulties, 78 distance refractive correction, 10 Galilean telescopes, and 7 Keplerian telescopes were prescribed. For intermediate distance activities, 22 compensation lenses and 10 Galilean telescopes were suggested. Moreover, PC magnifier softwares were prescribed to nine patients. Sixty-five polarized medical filters were prescribed to reduce glare of sunlight. Because of unstable fixation in their better eye (32.3% (±19.7) within 2° circle and 54.8% (±22.9) within 4° circle) and visual acuity < 1.2 LogMAR in the fellow eye, 38 subjects, before starting the devices training sessions, attended a bio-feedback rehabilitation session with flickering pattern stimulus. In these subjects, fixation stability increased significantly to 75.6 (±14.9) within 2° and 89.4 (±19.5) within 4° ( P < 0.05), respectively. Conclusions Attending a customized low-vision intervention based on a multidisciplinary approach seems to be effective for improving visual functions in AMD. Both optical/electronic magnifiers and specific visual stimulation program can enhance visual performances.

Long term outcomes in dry age-related macular degeneration following low vision rehabilitation interventions

2020 ◽  
pp. 112067212097362
Author(s):  
Yulia Pyatova ◽  
Monica Daibert-Nido ◽  
Samuel N Markowitz
Keyword(s):  
Visual Acuity ◽  
Low Vision ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Low Vision Rehabilitation ◽  
Fixation Stability ◽  
Functional Vision ◽  
Vision Rehabilitation ◽  
Distance Vision

Background: Age-related macular degeneration (AMD) is the leading cause of loss of vision in the older age groups. In the absence of a known therapy, low vision rehabilitation aims at preserving residual functional vision at optimal levels. Long term functional outcomes from Low Vision Rehabilitation (LVR) in AMD cases were never scrutinized in the past. This study brings some clarification in this matter. Methods: This is a retrospective case series study including data up to 2 years following the baseline visit. Low Vision Assessments included microperimetry testing and recommendations for low vision devices for distance vision. Outcomes measures selected for this study were best corrected distance visual acuity, fixation stability and preferred retinal locus (PRL) topography and LVR interventions. Results: Data on 17 patients with an average age of 89.2 ± 4.4 years was collected. In those with better vision than 20/400 loss of vision was about 1.4 letter per year as tested with ETDRS charts compared with losses of four letters per year in a population without LVR interventions. Fixation stability continued to deteriorate while PRL eccentricity seemed to remain the same. In about half of cases there was a change in the topographic location of the PRL to a different retinal quadrant. Conclusion: Long term, as expected, changes were noticed in visual acuity, fixation stability and PRL topography. However, it seems that LVR interventions for distance vision help patients retain significantly better functional vision at the 2 years follow up interval when compared to others.

scholarly journals Fixed Regimen Treatment in Unselected Naïve Patients Cohort with Neovascular Age-Related Macular Degeneration

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ricardo P. Casaroli-Marano ◽  
Carolina Bernal-Morales ◽  
Lillian Chamorro-López ◽  
Marina Dotti-Boada ◽  
Juan P. Figueroa-Vercellino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
The Elderly ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
The Public ◽  
Age Related ◽  
Intravitreal Aflibercept ◽  
One Year

The current treatment of neovascular age-related macular degeneration (nAMD) generates an excessive care pressure in the public health system. The search for a satisfactory treatment regimen, whose anatomical and functional stability may be achieved, is a challenge and a goal to be reached. We analyzed the outcomes in a patient cohort under fixed regimen treatment with intravitreal aflibercept (IVA). A retrospective study, with at least 1-year follow-up, in consecutive treated unselected naïve patients was carried out. Standard protocol was performed and evaluated at baseline, month 4 (after loading dose, LD), and month 12 (after fixed bimonthly regimen). One hundred six patients (123 eyes) aged 80.3 ± 7.7 years were included, receiving 6.8 ± 0.7 IVA. Visual acuity gain after LD was 5.5 ± 12.0 letters ( p < 0.0001 ). At month 12, 23 eyes (18.7%) gained ≥15 letters and 58 (47.1%) had best-corrected visual acuity ≥20/40 (70 letters). The improvement in visual acuity was lower in patients with polypoidal choroidal vasculopathy (+4.9 ± 18.1 letters; p = 0.2544) and somewhat higher in patients with retinal angiomatous proliferation (+5.4 ± 12.3 letters; p = 0.0373 ). Dry macula was present in only 9.8% of cohort at baseline vs. 69.7% at month 12 ( p < 0.0001 ). Atrophy was the most observed complication and related to the elderly patients. The average of follow-up visits was 3 ± 0.5. Functional and anatomical improvement were observed with IVA in a fixed bimonthly regimen treatment after LD, with results maintained up to one year with a good compliance. The fixed bimonthly regimen optimized patient management and logistic issues.

scholarly journals Mortality during 6 years of follow-up in relation to visual impairment and eye disease: results from a population-based cohort study of people aged 50 years and above in Nakuru, Kenya

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029700 ◽  
Author(s):  
Hannah Kuper ◽  
Wanjiku Mathenge ◽  
David Macleod ◽  
Allen Foster ◽  
Michael Gichangi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Mortality Risk ◽  
Cumulative Incidence ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Eye Disease ◽  
Age Related

ObjectiveTo estimate the association between (1) visual impairment (VI) and (2) eye disease and 6-year mortality risk within a cohort of elderly Kenyan people.Design, setting and participantsThe baseline of the Nakuru Posterior Segment Eye Disease Study was formed from a population-based survey of 4318 participants aged ≥50 years, enrolled in 2007–2008. Ophthalmic and anthropometric examinations were undertaken on all participants at baseline, and a questionnaire was administered, including medical and ophthalmic history. Participants were retraced in 2013–2014 for a second examination. Vital status was recorded for all participants through information from community members. Cumulative incidence of mortality, and its relationship with baseline VI and types of eye disease was estimated. Inverse probability weighting was used to adjust for non-participation.Primary outcome measuresCumulative incidence of mortality in relation to VI level at baseline.ResultsOf the baseline sample, 2170 (50%) were re-examined at follow-up and 407 (10%) were known to have died (adjusted risk of 11.9% over 6 years). Compared to those with normal vision (visual acuity (VA) ≥6/12, risk=9.7%), the 6-year mortality risk was higher among people with VI (<6/18 to ≥6/60; risk=28.3%; risk ratio (RR) 1.75, 95% CI 1.28 to 2.40) or severe VI (SVI)/blindness (<6/60; risk=34.9%; RR 1.98, 95% CI 1.04 to 3.80). These associations remained after adjustment for non-communicable disease (NCD) risk factors (mortality: RR 1.56, 95% CI 1.14 to 2.15; SVI/blind: RR 1.46, 95% CI 0.80 to 2.68). Mortality risk was also associated with presence of diabetic retinopathy at baseline (RR 3.18, 95% CI 1.98 to 5.09), cataract (RR 1.26, 95% CI 0.95 to 1.66) and presence of both cataract and VI (RR 1.57, 95% CI 1.24 to 1.98). Mortality risk was higher among people with age-related macular degeneration at baseline (with or without VI), compared with those without (RR 1.42, 95% CI 0.91 to 2.22 and RR 1.34, 95% CI 0.99 to 1.81, respectively).ConclusionsVisual acuity was related to 6-year mortality risk in this cohort of elderly Kenyan people, potentially because both VI and mortality are related to ageing and risk factors for NCD.

The Experience of a Randomized Clinical Trial of Closed-Circuit Television versus Eccentric Viewing Training for People with Age-Related Macular Degeneration

2017 ◽  
Vol 111 (4) ◽  
pp. 354-368 ◽  
Author(s):  
Susan J. Leat ◽  
Francie Fengqin Si ◽  
Deborah Gold ◽  
Dawn Pickering ◽  
Keith Gordon ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Low Vision ◽  
Reading Speed ◽  
Optical Devices ◽  
Reading Performance ◽  
Age Related Macular Degeneration ◽  
Eccentric Viewing ◽  
Age Related

Introduction In addition to optical devices, closed-circuit televisions (CCTVs) and eccentric viewing training are both recognized interventions to improve reading performance in individuals with vision loss secondary to age-related macular degeneration. Both are relatively expensive, however, either in the cost of the device or in the amount of time personnel need to provide training. In this randomized trial, we compared the effectiveness of these two interventions. Methods Participants with age-related macular degeneration and visual acuity between 6/48 (20/160) and 6/120 (20/400) first received basic low vision care, including optical devices. At the subsequent baseline visit, they undertook a battery of measures including logMAR visual acuity; reading speed and accuracy for text in 1.3M and 1M fonts; reading information on medicine bottles, utility bills, and food packages; the NEI-VFQ; the Geriatric Depression Scale; and a reading inventory questionnaire. They were then randomized to either obtaining a CCTV for home use or eccentric viewing training over the following six weeks. Results Recruitment was more difficult than expected for this population. Of 145 patients referred, 29 met the inclusion-exclusion criteria, 14 were willing to enroll, and 10 completed the trial. For the primary outcome (reading speed for 1.3M print), there was a significant improvement between baseline and outcome for the CCTV group (p = 0.005), but not for the eccentric viewing training group (p = 0.28), and the CCTV group showed significantly greater change (p = 0.04). There was a nonsignificant improvement in reading speed for 1M text and a decrease in the amount of time taken to read utility bill information in the CCTV group. There was a significant improvement in near visual acuity with current glasses with eccentric viewing training. The other measures did not reach statistical significance. Discussion Randomized clinical trials for low vision rehabilitation, particularly in the elderly population with vision loss, are challenging, but such trials are important for the allocation of resources. This trial showed early indications of more impact on reading performance from CCTV than eccentric viewing training.

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