Refractive error and visual function difficulty in a Latino population.
OBJECTIVE
To assess the association of correction of myopia, hyperopia, and astigmatism with self-reported near and distance visual function.


METHODS
Population based, cross-sectional study.


METHODS
A random sample of 4272 Latinos older than 40 years of age from Arizona with both ophthalmic examination and questionnaire data, including answers to the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25).


METHODS
Cases of refractive error (RE) were defined as subjects who met at least 1 of the following criteria in both eyes: myopia, sphere -0.5 diopters (D) or less; hyperopia, sphere 1.0 D or more; or astigmatism, cylinder 0.75 D or more. Uncorrected refractive error (URE) was defined as having RE and achieving 2 lines or more of improvement in visual acuity in both eyes after refraction. The association between RE category and near and distance vision difficulty (as measured by the NEI VFQ-25 near and distance vision subscores) was modeled with ordinal logistic regression, adjusting for age, gender, diabetes, hypertension, income, education, and acculturation.


METHODS
Association between RE correction and near and distance vision difficulty by type of RE (myopia, hyperopia, and astigmatism).


RESULTS
Of 4272 participants, 54% had RE. Forty-eight percent of these had myopia, 41% had hyperopia, and 11% had astigmatism. Fourteen percent of myopes, 21% of hyperopes, and 22% of astigmatics had URE. Subjects with myopia, astigmatism, and hyperopia were significantly more likely to report more distance vision difficulty than subjects without RE, regardless of whether they had correction (odds ratios [ORs], 1.7-3.7; P<0.005 for all). Subjects with corrected myopia reported less near vision difficulty than subjects without RE (OR, 0.8; 95% confidence interval [CI], 0.7-0.9). Subjects with uncorrected hyperopia and uncorrected astigmatism reported more near vision difficulty than those without RE (OR, 1.6; 95% CI, 1.2-2.2; and OR, 1.7; 95% CI, 1.0-3.0, respectively). Self-reported distance and near visual function scores were sensitive to nonvision variables, namely, age, gender, diabetes, high blood pressure, acculturation score, income, and education.


CONCLUSIONS
In this population, correction of any type of RE is not entirely sufficient to restore distance visual function to the level of those without RE. More research is necessary to determine the reasons for this shortcoming.
School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. rasnasandhu@gmail.com
Rasanamar K
RK
Sandhu
Beatriz E
BE
Munoz
Bonnielin K
BK
Swenor
Sheila K
SK
West
D001130:Arizona / Q000453:epidemiology; D001251:Astigmatism / Q000175:diagnosis / Q000208:ethnology*; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006306:Health Surveys; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000175:diagnosis / Q000208:ethnology*; D057566:Self Report; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis / Q000208:ethnology*; D014792:Visual Acuity / Q000502:physiology*
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human