This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (107)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Alert me on articles by topic

The Salisbury Eye Evaluation Study

Beatriz Muñoz, MSc; Sheila K. West, PhD; Gary S. Rubin, PhD; Oliver D. Schein, MD; Harry A. Quigley, MD; Susan B. Bressler, MD; Karen Bandeen-Roche, PhD; and the SEE Study Team

Arch Ophthalmol. 2000;118:819-825.

Objective  To determine the causes of blindness and visual impairment in a population-based sample of older Americans.

Methods  A random sample of 3821 residents of Salisbury, Md, between the ages of 65 and 84 years was identified from Medicare records. Sixty-six percent (2520 persons) agreed to undergo an eye examination; 26% of the participants were African American. The clinical examination included acuity testing with an Early Treatment Diabetic Retinopathy Study chart and standardized refraction testing for those with a visual acuity worse than 20/30, slitlamp and dilated retinal examination by an ophthalmologist, tonometry, lens and fundus photography, and a suprathreshold visual field test. Visual impairment was defined as a best-corrected acuity in the better-seeing eye worse than 20/40 and better than 20/200, while blindness was acuity in the better-seeing eye of 20/200 or worse. For those with a visual acuity worse than 20/40 in either eye, one or more causes were assigned by an ophthalmologist and a final cause for each eye was confirmed by a panel of 3 subspecialty ophthalmologists (O.D.S., H.A.Q., and S.B.B.) based on all available evidence.

Results  Bilateral presenting acuity worse than 20/40 increased from 4% in the 65- to 74-year age group to 16% in the 80- to 84-year age group. One third of those with presenting acuity worse than 20/40 improved to 20/40 or better with refraction. Overall, 4.5% had a best-corrected acuity worse than 20/40. African Americans were more likely to remain visually impaired than were whites despite refraction (odds ratio [95% confidence interval], 1.7 [1.1-2.6]). Whites were most often impaired or blind from age-related macular degeneration (1.2% vs 0.5%; P=.09). African Americans had higher rates of impairment and blindness from cataract or posterior capsular opacification (2.7% vs 1.1%; P=.006), glaucoma (0.9% vs 0.1%; P=.006), and diabetic retinopathy (1.2% vs 0.2%; P=.004).

Conclusions  More than half of those with visual impairment or blindness had conditions that were either surgically treatable or potentially preventable. African Americans had a disproportionate number of blinding diseases, particularly those amenable to eye care intervention. Targeted interventions for specific populations to increase appropriate eye care use would greatly improve vision and function in older Americans.

From the Dana Center for Preventive Ophthalmology (Ms Muñoz and Drs West, Schein, and Quigley), the Lions Vision Research Center (Dr Rubin), and the Retinal Vascular Center (Dr Bressler), The Johns Hopkins School of Medicine, and Department of Biostatistics, School of Hygiene and Public Health (Dr Bandeen-Roche), The Johns Hopkins University, Baltimore, Md.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Association between Complement Factor H Gene Polymorphisms and Neovascular Age-Related Macular Degeneration in Koreans
Kim et al.
IOVS 2008;49:2071-2076.
ABSTRACT | FULL TEXT  

Impact of posterior subcapsular opacification on vision and visual function among subjects undergoing cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring is Hip Project, Report 5
Congdon et al.
Br. J. Ophthalmol. 2008;92:598-603.
ABSTRACT | FULL TEXT  

Self-Reported Age-Related Eye Diseases and Visual Impairment in the United States: Results of the 2002 National Health Interview Survey
Ryskulova et al.
Am. J. Public Health 2008;98:454-461.
ABSTRACT | FULL TEXT  

The Variability and Quality of Medication Container Labels
Shrank et al.
Arch Intern Med 2007;167:1760-1765.
ABSTRACT | FULL TEXT  

Mitochondrial DNA Haplogroups and Age-Related Maculopathy
Jones et al.
Arch Ophthalmol 2007;125:1235-1240.
ABSTRACT | FULL TEXT  

Geriatric Conditions and Disability: The Health and Retirement Study
Cigolle et al.
ANN INTERN MED 2007;147:156-164.
ABSTRACT | FULL TEXT  

Causal inference for non-mortality outcomes in the presence of death
Egleston et al.
Biostatistics 2007;8:526-545.
ABSTRACT | FULL TEXT  

The Visual Status of Older Persons Residing in Nursing Homes
Owsley et al.
Arch Ophthalmol 2007;125:925-930.
ABSTRACT | FULL TEXT  

Effect of the Isoflavone Genistein Against Galactose-Induced Cataracts in Rats
Huang et al.
Exp. Biol. Med. 2007;232:118-125.
ABSTRACT | FULL TEXT  

Dynamic Measures of Visual Function and Their Relationship to Self-Report of Visual Functioning
Freeman et al.
IOVS 2006;47:4762-4766.
ABSTRACT | FULL TEXT  

Associated factors for age related maculopathy in the adult population in China: the Beijing eye study
Xu et al.
Br. J. Ophthalmol. 2006;90:1087-1090.
ABSTRACT | FULL TEXT  

Prevalence of visual impairment in the United States.
Vitale et al.
JAMA 2006;295:2158-2163.
ABSTRACT | FULL TEXT  

Racial Differences in Glaucoma Care: The Longitudinal Pattern of Care
Ostermann et al.
Arch Ophthalmol 2005;123:1693-1698.
ABSTRACT | FULL TEXT  

Visual Acuity Change and Mortality in Older Adults
Freeman et al.
IOVS 2005;46:4040-4045.
ABSTRACT | FULL TEXT  

Differences in Visual Function and Optic Nerve Structure Between Healthy Eyes of Blacks and Whites
Racette et al.
Arch Ophthalmol 2005;123:1547-1553.
ABSTRACT | FULL TEXT  

Poor Uptake of Cataract Surgery in Nursing Home Residents: The Salisbury Eye Evaluation in Nursing Home Groups Study
Friedman et al.
Arch Ophthalmol 2005;123:1581-1587.
ABSTRACT | FULL TEXT  

Visual acuity in northern China in an urban and rural population: the Beijing Eye Study
Xu et al.
Br. J. Ophthalmol. 2005;89:1089-1093.
ABSTRACT | FULL TEXT  

Glaucoma: Macrocosm to Microcosm The Friedenwald Lecture
Quigley
IOVS 2005;46:2663-2670.
FULL TEXT  

The 5-Year Incidence and Risk Factors for Age-Related Maculopathy in a General Japanese Population: The Hisayama Study
Miyazaki et al.
IOVS 2005;46:1907-1910.
ABSTRACT | FULL TEXT  

Heritability of Refractive Error and Familial Aggregation of Myopia in an Elderly American Population
Wojciechowski et al.
IOVS 2005;46:1588-1592.
ABSTRACT | FULL TEXT  

Prevalence and Risk Factors for Self-Reported Visual Impairment Among Middle-Aged and Older Adults
Horowitz et al.
Research on Aging 2005;27:307-326.
ABSTRACT  

Cataract surgery and subtype in a defined, older population: the SEECAT Project
Lewis et al.
Br. J. Ophthalmol. 2004;88:1512-1517.
ABSTRACT | FULL TEXT  

Racial Variations in Causes of Vision Loss in Nursing Homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study
Friedman et al.
Arch Ophthalmol 2004;122:1019-1024.
ABSTRACT | FULL TEXT  

Causes and Prevalence of Visual Impairment Among Adults in the United States
The Eye Diseases Prevalence Research Group
Arch Ophthalmol 2004;122:477-485.
ABSTRACT | FULL TEXT  

The Prevalence of Refractive Errors Among Adults in the United States, Western Europe, and Australia
The Eye Diseases Prevalence Research Group
Arch Ophthalmol 2004;122:495-505.
ABSTRACT | FULL TEXT  

Prevalence of Age-Related Macular Degeneration in the United States
The Eye Diseases Prevalence Research Group
Arch Ophthalmol 2004;122:564-572.
ABSTRACT | FULL TEXT  

The risk of complications of uveitis in a district hospital cohort
Maini et al.
Br. J. Ophthalmol. 2004;88:512-517.
ABSTRACT | FULL TEXT  

Lack of Association of Mutations in Optineurin With Disease in Patients With Adult-onset Primary Open-angle Glaucoma
Wiggs et al.
Arch Ophthalmol 2003;121:1181-1183.
ABSTRACT | FULL TEXT  

Recent Advances and Future Frontiers in Treating Age-Related Cataracts
Solomon and Donnenfeld
JAMA 2003;290:248-251.
FULL TEXT  

Incidence of Blindness in Southern Germany Due to Glaucoma and Degenerative Conditions
Trautner et al.
IOVS 2003;44:1031-1034.
ABSTRACT | FULL TEXT  

How big is the burden of visual loss caused by age related macular degeneration in the United Kingdom?
Owen et al.
Br. J. Ophthalmol. 2003;87:312-317.
ABSTRACT | FULL TEXT  

Sleep Complaints and Visual Impairment Among Older Americans: A Community-Based Study
Zizi et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2002;57:M691-694.
ABSTRACT | FULL TEXT  

Causes of Incident Visual Impairment: The Blue Mountains Eye Study
Foran et al.
Arch Ophthalmol 2002;120:613-619.
ABSTRACT | FULL TEXT  

Blindness and visual impairment in the Americas and the Caribbean
Munoz and West
Br. J. Ophthalmol. 2002;86:498-504.
ABSTRACT | FULL TEXT  

Blindness, Visual Impairment and the Problem of Uncorrected Refractive Error in a Mexican-American Population: Proyecto VER
Munoz et al.
IOVS 2002;43:608-614.
ABSTRACT | FULL TEXT  

Sensory Impairments and Subjective Well-Being Among Aged African American Persons
Bazargan et al.
J. Gerontol. B Psychol. Sci. Soc. Sci. 2001;56:P268-278.
ABSTRACT | FULL TEXT  

The Association of Multiple Visual Impairments with Self-Reported Visual Disability: SEE Project
Rubin et al.
IOVS 2001;42:64-72.
ABSTRACT | FULL TEXT