Refractive errors in an elderly Japanese population: the Tajimi study.
OBJECTIVE
To evaluate the prevalence of refractive errors associated with age, gender, and central corneal thickness and to evaluate astigmatism in the refraction and keratometry in a randomly sampled elderly Japanese population.


METHODS
Population-based epidemiologic survey.


METHODS
A random sampling of residents of Tajimi, Japan, aged 40 years or older. A total of 3021 residents (participation rate, 78.1%) participated.


METHODS
Each subject underwent screening examinations including autokeratorefractometry, subjective refraction, best-corrected visual acuity, central corneal thickness measurement, intraocular pressure measurement, slit-lamp examination, fundus photography, and visual field testing.


METHODS
The prevalence of myopia (spherical equivalent [SE], <-0.5 diopters [D]), high myopia (SE, <-5 D), hyperopia (SE, >0.5 D), refractive astigmatism (cylinder, >0.5 D), and anisometropia (difference in SE between eyes, >1.0 D), and the correlation of refractive errors with age, gender, and central corneal thickness. Astigmatism in the refraction and keratometry was analyzed using polar value analysis and the vector calculation method.


RESULTS
The crude prevalence of myopia, high myopia, hyperopia, refractive astigmatism in the refraction, and anisometropia was 41.8% (95% confidence interval [CI], 40.0%-43.6%), 8.2% (95% CI, 7.2%-9.2%), 27.9% (95% CI, 26.3%-29.6%), 54.0% (95% CI, 52.1%-55.8%), and 15.1% (95% CI, 13.7%-16.4%), respectively. The prevalence of myopia decreased with age up to 70 to 79 years but increased slightly in patients 80 years and older; the prevalence of hyperopia showed the opposite trend. The prevalence of astigmatism and anisometropia was higher in the older age groups. No significant gender difference was found associated with the refractive status except for keratometric readings. Polar value analysis and the vector calculation method showed a trend toward against-the-rule astigmatism with increasing age in both refractive and keratometric astigmatism, with a discrepancy between the two.


CONCLUSIONS
The overall prevalence of myopia (SE, <-0.5 diopters) was 41.8% in the study population, which is higher than that in population-based studies previously reported.
Sawada
Akira
A
Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
Tomidokoro
Atsuo
A
Araie
Makoto
M
Iwase
Aiko
A
Yamamoto
Tetsuya
T
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007429:Intraocular Pressure; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011897:Random Allocation; D012030:Refractive Errors / Q000453:epidemiology*; D017678:Sex Distribution; D014792:Visual Acuity; D014794:Visual Fields