presbyopia
Report assess presbyopia in low- and middle-income countries

A recent report in the Community Eye Health Journal reviewed presbyopia’s prevalence and effects in low- and middle-income countries and what interventions are available to the populace.
Ilesh Patel, M.D., M.P.H., research fellow, and Sheila K West, Ph.D., El-Maghraby Professor of Preventive Ophthalmology, both of Wilmer Eye Institute, Johns Hopkins University, Baltimore, reported on their research in Tanzania as well as the available literature.
For the report, they defined people as presbyopic if both of the following were true: they were unable to read the N8 optotype (1M or 20/50 Snellen acuity) with distance correction in place, if needed; and they were able to read at least one more line with the addition of a plus lens.
Additionally, the degree of presbyopia was determined as the minimum amount of plus lens needed to achieve the maximum improvement in lines read to the end point (N8).
Summarizing the studies to date of presbyopia in low- and middle-income countries suggests the following: more than half of adults over the age of 30 have presbyopia; women have both a higher prevalence of, and more severe, presbyopia; the majority of those with presbyopia do not have corrective spectacles.
While new treatments are being developed for presbyopia, spectacles represent an effective, economic option for low- and middle-income countries. However, there is little research on the determinants of, and barriers to, the use of near-vision spectacles. The researchers said they still are awaiting data on the availability and affordability of near-vision refractive error services, including a system for efficient dispensing of high-quality, affordable spectacles.
But in general, assessment and correction of presbyopia require modest expertise and can be undertaken independently of fixed optical services. The Scojo Foundation (New York), which works in Africa, Latin America and Asia, has demonstrated a sustainable model to distribute high-quality, low-cost reading spectacles in rural areas.
The research team stated that further research should be conducted to determine why women and persons who live in urban environments have more presbyopia. As low- and middle-income countries undergo the demographic transition towards an aging population, the number of people with presbyopia will increase.
The effect on quality of life for older persons is now clear and presbyopia should be part of the World Health Organization (WHO) refractive error agenda. Clearly, presbyopia poses an important public health challenge, because it affects older people’s ability to maintain their economic independence.

Source: EyeWorld News Service