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Purpose: To evaluate the association between visual acuity (VA) and 4-year mortality in an older population-based cohort. Methods: Five thousand and fifty-seven persons aged 50 to 96 years (91.0% of the eligible population) residents of the Southern Harbin, Heilongjiang Provence, China participated in the study. At baseline (2006), the main ocular diseases were diagnosed from a basic ocular examination including presenting and best-corrected VA. Of the 5,057 participants in the baseline survey, those who died after the study were identified and the death certificate was checked. The physicians in charge of the health of the village population were asked for the presumed cause of death. The rate of death was determined in the follow-up survey in 2010. We evaluated the association of visual impairment (VI) and mortality using multiple logistic regression. Results: Between the baseline examination and the censoring cutpoint study, a total of 214 subjects (4.2%) were dead. Females with VI were less likely to have died relative to male gender with VI ( P < 0.05). Compared with participants who reported better presenting VA (VA ≥≥ 20/60), the risk of mortality was significantly higher for those reporting moderate VI (20/400 ≤≤ VA < 20/60) (Odds Ratio [OR], 2.1; 95% confidence interval [CI],1--4.1) and those reporting severe VI (VA < 20/400) (OR,3.6; 95% CI, 2.0--6.6). Similar associations were obtained for best-corrected VA in the better eye (OR, 3.1; 95% CI: 1.5--6.4 and 3.9; 95%CI: 2.1--7.2, respectively). Conclusion: In this Chinese population-based cohort we found that visual impairment predicted a significantly elevated mortality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to estimate the prevalence and causes of visual impairment(VI) and blindness by a population-based survey in an elderly rural Chinese population. Methods: Cluster sampling was used to select samples. The protocol consisted of an interview, pilot study, visual acuity (VA) testing and a clinical examination. The definitions of blindness (VA < 20/400) and visual impairment (VA < 20/60 to ≥ 20/400) were based on the presenting VA in the better eye. The major causes of VI and blindness were identified. The associations of bilateral VI and blindness by age, gender and education were calculated through multiple logistic regression. Cataract surgical coverage (CSC) was also calculated. Results: Among the 5559 people entered in the project, 5057 were examined (91.0%), and of these 2383(47.1%) were men. The mean age was 60.5 (range, 50-96) years old. The prevalence of bilateral blindness and VI was 1.9% (95% confidence interval (CI): 1.6 % to 2.3%) and 8.3%(95% CI: 7.5 % to 9.1%), respectively. We found that age, female gender, and illiteracy were associated with bilateral blindness. The leading cause of bilateral blindness was cataract (70.4%), followed by corneal opacity (8.2%) and glaucoma (5.1%). The main causes for bilateral VI were refractive error (35.9%) and cataract (35.7%). The average CSC was 9.3% (95%CI: 6.7% to 11.7%). Conclusions: Cataract is the dominant cause of bilateral blindness and VI in people over 50 years old in rural southern Harbin. Specific prevention and VI rehabilitation programs should be developed for the elderly rural Chinese population. [ABSTRACT FROM AUTHOR]

Purpose: To investigate alcohol drinking status and the association between drinking patterns and visual impairment in an adult population in northern China. Methods: Cluster sampling was used to select samples. The protocol consisted of an interview, pilot study, visual acuity (VA) testing and a clinical examination. Visual impairment was defined as presenting VA worse than 20/60 in any eye. Drinking patterns included drinking quantity (standard drinks per week) and frequency (drinking days in the past week) Results: Information on alcohol consumption was obtained from 8445 subjects, 963 (11.4%) of whom reported consuming alcohol. In multivariate analysis, alcohol consumption was significantly associated with older age ( p < 0.001), male sex ( p < 0.001), and higher education level ( p < 0.01). Heavy intake (>14 drinks/week) was associated with higher odds of visual impairment. However, moderate intake (>1-14 drinks/week) was significantly associated with lower odds (adjusted odds ratio, OR, 0.7, 95% confidence interval, CI, 0.5-1.0) of visual impairment ( p = 0.03). Higher drinking frequency was significantly associated with higher odds of visual impairment. Multivariate analysis showed that older age, male sex, and higher education level were associated with visual impairment among current drinkers. Age- and sex-adjusted ORs for the association of cataract and alcohol intake showed that higher alcohol consumption was not significantly associated with an increased prevalence of cataract (OR 1.2, 95% CI 0.4-3.6), whereas light and moderate alcohol consumption appeared to reduce incidence of cataract. Conclusion: Drinking patterns were associated with visual impairment. Heavy intake had negative effects on distance vision; meanwhile, moderate intake had a positive effect on distance vision. [ABSTRACT FROM AUTHOR]

Purpose: To report visual outcomes and barriers to uptake of cataract surgery among subjects of all ages in Mingshui County, Heilongjiang Province, China. Methods: Cluster sampling was used to select a cross-sectional sample of people living in the Heilongjiang Province. Each subject underwent a participant interview, presenting and best-corrected vision measurements and an ocular examination. Visual outcomes and barriers to uptake of cataract surgery were assessed among subjects undergoing cataract surgery. Individuals who needed cataract surgery were interviewed regarding barriers. Results: Of 11,787 subjects, 10,384 eligible participants underwent visual acuity (VA) testing and a basic eye examination (88.1% response rate). The cross-sectional sub-sample of 21 participants receiving cataract surgery had a median age of 63 years. Six eyes undergoing surgery at the county hospital with conventional intracapsular and extracapsular cataract extraction without an intraocular lens implant were aphakic, and 15 eyes (71.4%) undergoing surgery at tertiary care hospitals were pseudophakic. Seven eyes (33.3%) had corrected VA ≥ 20/60, and nine eyes (42.9%) had presenting VA ≥ 20/60. Approximately 28.6% (6/21) had poor outcomes. The principal causes of presenting blindness after cataract surgery were refractive error/uncorrected aphakia and posterior capsular opacification. Cost was the most common barrier (73.9%) to uptake of cataract surgery. Conclusions: Cataract surgical outcomes in northern China were poor. The principal barrier to uptake of cataract surgery was cost. These findings call for the establishment of cataract surgical services that are of high quality, affordable, and sensitive to high-risk groups. [ABSTRACT FROM AUTHOR]

Purpose: To examine the distribution and causes of corneal blindness in a rural Chinese population. Methods: Cluster sampling of populations age > 50 was used. The protocol consisted of a detailed interview, visual acuity (VA) testing, and clinical examinations. An eye was considered to have cornea blindness if the visual acuity was < 20/400 due to a corneal disease. Results: A total of 5057 eligible subjects agreed to participate, giving an attendance rate of 91.0%. Corneal blindness in at least one eye was present in 48 participants, prevalence of 0.949% (95% CI: 0.682-1.216%) in at least one eye, which included 0.16% prevalence of corneal blindness in both eyes. The most frequent causes of corneal blindness in at least one eye included keratitis during childhood (39.6%), keratitis during adulthood (27.1%), and trauma (20.8%). We found that aging and male gender were associated with prevalence of corneal blindness. Multivariate analysis shows a higher OR of corneal blindness in subjects age 70 and older (1.746) and male gender (1.177). Conclusions: Corneal blindness is a public health problem in southern Harbin, the majority of which is either preventable or treatable. Eye care planning must focus on corneal blindness as well as cataract. [ABSTRACT FROM AUTHOR]