More than 1 in 3 people in Singapore who are at least 60 years old possess at least 1 undiagnosed age-related eye disease, which puts them at increased risk of visual impairment and reduced quality of life compared with patients without eye diseases or with diagnosed eye conditions, research published in JAMA Ophthalmology suggests.
Researchers analyzed data from 1878 Population Health and Eye Disease Profile in Elderly Singaporeans study (mean age, 72.7) participants and found that 742 people (35.8% overall weighted prevalence) possessed at least 1 type of undiagnosed eye disease (2 diseases, 87; 3 diseases, 5).
People of Malay ethnicity exhibited higher prevalence (46.5%) of undiagnosed eye diseases compared with ethnically Indian (42.9%) and Chinese (33.9%) people. Just under 9 in 10 individuals with age-related macular degeneration (AMD) or diabetic retinopathy (DR) had been undiagnosed. Cataracts were undiagnosed in about 2 in 5 individuals, and glaucoma in nearly 1 in 2.
Odds of undiagnosed eye disease decreased as age increased (odds ratio [OR], 1.08 per year decreased). Wearing multifocal glasses raised odds 75% (95% confidence interval [CI], 1.19-2.59). Malay (OR, 1.71) and Indian (OR, 1.43) people were more likely to have such a disease.
Overall, our results suggest that public health awareness and screening programs involving community optometrists and targeted toward individuals at the lower end of the older-than-60-years age spectrum and those of Malay and Indian ethnicities may be warranted…
Wearing multifocals (OR, 2.64), single-vision distant glasses (OR, 2.2), and single-vision near corrections (OR, 1.82; 95% CI, 1.15-2.90) were at about doubled odds of having diagnosed cataracts. The odds were roughly 4 times greater for blue collar workers (OR, 4.05) and homemakers and retired people (OR, 3.62).
Compared with healthy individuals, patients with undiagnosed eye diseases exhibited poorer patient-centered outcomes (EuroQoL 5-Dimension scores, 1.97% reduction) and Brief Impact of Visual Impairment domains (visual functioning, -4.01%; emotional well-being, -4.57%; overall, -5.67%) and were more likely to possess visual impairment in the less healthy eye (OR, 2.46). The links were absent or less clear in people who were diagnosed and receiving treatment.
The investigators found that people with undiagnosed eye diseases paid 1.73 times (95% CI, 1.06-2.84) more for health care. The rate difference was slightly less (OR, 1.66) for undiagnosed cataracts.
“Overall, our results suggest that public health awareness and screening programs involving community optometrists and targeted toward individuals at the lower end of the older-than-60-years age spectrum and those of Malay and Indian ethnicities may be warranted to mitigate the adverse patient-centered and economic effects of these undiagnosed age-related eye diseases on community-dwelling older adults,” the study authors remark.
Study limitations include the use of self-reported ocular histories.
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