Prevalence and causes of visual impairment among older persons living in low-income old age homes in Durban, South Africa

• Published in: African journal of primary health care & family medicine 2020, Vol.12 (1), p.1-7
• Main Authors: Mashige, Khathutshelo P, Ramklass, Serela S
• Format: Article
• Language: English
• Subjects: Age; Age Distribution; Aged; Aged, 80 and over; Biology; Blindness; Blindness - epidemiology; Blindness - etiology; Cataract - complications; Cataracts; Central business districts; Cornea; Corneal Opacity - complications; Cross-Sectional Studies; Diabetes; Diabetic retinopathy; Disease; Durban; Elder care; Elderly; Eye - pathology; Eye Diseases - complications; Eye examination; Female; Glaucoma; Health care; Health Care Sciences & Services; Homes for the Aged; Humans; Low income groups; Low-income old age home; Macular degeneration; Male; Medicine, General & Internal; Middle Aged; Nursing homes; Older people; Original Research; Population; Poverty; Prevalence; Risk Factors; Sex Distribution; Social change; South Africa - epidemiology; Vision Disorders - epidemiology; Vision Disorders - etiology; Vision Tests; Vision, Low - epidemiology; Vision, Low - etiology; Visual Acuity; Visual impairment; Visually Impaired Persons
• ISSN: 2071-2928; 2071-2936; 2071-2936
• DOI: 10.4102/phcfm.v12i1.2159

Background: Visual impairment (VI) increases with age and has been reported to be more prevalent among older adults living in old age homes than in the general population. Aim: To determine the prevalence and causes of VI among older adults living in low-income old age homes in Durban, South Africa. Setting: This study was conducted at low-income old age homes in Durban. Methods: This cross-sectional study of 118 residents aged 60 years and older, collected sociodemographic data, presenting visual acuities (VAs) for each eye, and binocularly. Anterior segment eye examinations were conducted with a penlight torch and a portable slit-lamp, while posterior segment evaluation was conducted with direct and indirect ophthalmoscopy. Objective and subjective refractions were performed, and the best-corrected distance and near VAs were measured in each eye. VI was defined as presenting VA < 6/18 and included moderate VI (< 6/18−6/60), severe VI (< 6/60 –3/60) and blindness (< 6/120). Results: The mean age of the participants was 73.3 years and included 80.5% females and 19.5% males. The prevalence of VI and blindness was 63.6%. Optical correction significantly reduced the prevalence of VI and blindness by 19.5% (p < 0.05). The main causes of nonrefractive VI and blindness were cataract (54.5%), posterior segment disorders (25.5%) and corneal opacities (20%). Conclusion: The prevalence of VI and blindness is high among residents in low-income old age homes living in Durban. Refractive correction and surgical cataract intervention can significantly reduce the burden of VI and blindness among the elderly residents.