Impact of Presbyopia on Quality of Life in a Rural African Setting
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, United States; Kongwa Trachoma Project, Kongwa, Tanzania
Purpose: To determine the impact of uncorrected presbyopia on quality of life in rural Tanzania. Design: Cross-sectional study. Participants: Population-based sample of 1709 village and town-dwelling adults aged 40 and older in the Kongwa district in rural Tanzania. Methods: Subjects underwent distance and near visual acuity testing to determine presbyopia. A near vision-related quality of life questionnaire was administered by trained interviewers to determine the degree of self-rated difficulty with tasks appropriate to life in a rural African setting, and how much near vision loss contributed to this difficulty. Main Outcome Measures: Near vision-related quality of life. Results: Complete data were available for 1564 (92%) of the subjects. The prevalence rate of presbyopia was 62%. The majority of presbyopes (94%) did not have corrective near vision glasses. Compared with nonpresbyopes, being presbyopic increased the odds of reporting some difficulty with near vision tasks by 2-fold (odds ratio [OR], 2.04; 95% confidence interval [CI]: 1.57-2.66), odds of reporting moderate difficulty by 5-fold (OR 5.01; 95% CI: 3.19-7.89), and odds of reporting high difficulty by >8-fold (OR 8.52; 95% CI 3.13-23.10). The degree of presbyopia was associated with increasing difficulty with daily tasks (P<0.0001). Conclusions: This is the first study to demonstrate that uncorrected presbyopia has a significant impact on vision-related quality of life in a rural African setting. The high prevalence of presbyopia, and increased aging of the population in developing countries, suggests that the World Health Organization's Vision 2020 refraction agenda should place greater emphasis on presbyopia. © 2006 American Academy of Ophthalmology.
adult; aged; article; confidence interval; controlled study; data analysis; female; human; major clinical study; male; population research; presbyopia; prevalence; priority journal; quality of life; questionnaire; Tanzania; visual acuity; cross-sectional study; daily life activity; health survey; middle aged; pathophysiology; presbyopia; risk; rural population; spectacles; statistics; Tanzania; vision test; Activities of Daily Living; Adult; Aged; Cross-Sectional Studies; Eyeglasses; Female; Health Status Indicators; Humans; Male; Middle Aged; Odds Ratio; Presbyopia; Prevalence; Quality of Life; Questionnaires; Rural Population; Tanzania; Vision Tests; Visual Acuity