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The Singapore Malay Eye Study

Elaine W. Chong, MBBS, PhD; Ecosse L. Lamoureux, MSc, PhD; Mark A. Jenkins, PhD; Tin Aung, MBBS, PhD; Seang-Mei Saw, MBBS, PhD; Tien Y. Wong, FRCSE, PhD

Arch Ophthalmol. 2009;127(12):1640-1647.

Objective  To describe the associations between sociodemographic, lifestyle, and medical risk factors and visual impairment in a Southeast Asian population.

Methods  Population-based cross-sectional study of 3280 (78.7% response rate) Malay Singaporeans aged 40 to 80 years. Participants underwent a standardized interview, in which detailed sociodemographic histories were obtained, and clinical assessments for presenting and best-corrected visual acuity. Visual impairment (logMAR > 0.30) was classified as unilateral (1 eye impaired) or bilateral (both eyes impaired). Analyses used multivariate-adjusted multinomial logistic regression.

Results  Older age and lack of formal education was associated with increased odds of both unilateral and bilateral visual impairment based on presenting and best-corrected visual acuity. The odds doubled for each decade older, and lower education increased the odds 1.59- to 2.83-fold. Bilateral visual impairment was associated with being unemployed (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.30-2.60), widowed status (OR, 1.51; 95% CI, 1.13-2.01), and higher systolic blood pressure (OR, 1.96; 95% CI, 1.44-2.66). Diabetes was associated with unilateral (OR, 1.47; 95% CI, 1.10-1.95) and bilateral (OR, 1.69; 95% CI, 1.23-2.32) visual impairment using best-corrected visual acuity.

Conclusions  Older age, lower education, unemployment, being widowed, diabetes, and hypertension were independently associated with bilateral visual impairment. Public health interventions should be targeted to these at-risk populations.

Author Affiliations: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital (Drs Chong, Lamoureux, and Wong), and Centre for Molecular, Environmental, Genetic and Analytic Epidemiology (Dr Jenkins), University of Melbourne, Melbourne; Singapore Eye Research Institute, Singapore National Eye Center, Singapore (Drs Lamoureux, Aung, Saw, and Wong); and Departments of Ophthalmology (Drs Aung, Saw, and Wong) and Community, Occupational and Family Medicine (Dr Saw), Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

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