Visual Acuity and Self-Reported Visual Function among Migrant Farmworkers.
OBJECTIVE
Visual impairment presents significant risks for occupational injuries among farmworkers, a vulnerable population with limited access to vision care. Although previous research has noted farmworkers' low lifetime experience with vision screening and high rates of complaints of eye ailments and poor vision, there have been few screening data collected to evaluate these self-reports. The objectives of this analysis are to (1) describe farmworker visual health using standardized visual acuity screening data and self-reported visual function, and (2) to compare the screening and self-report data.


METHODS
Data are from a cross-sectional study of eye health among Latino migrant farmworkers in North Carolina with uncorrected vision (n = 289). Workers were recruited using methods to achieve a representative sample of a hard-to-reach population. Visual acuity data were collected using Snellen Tumbling E charts for nearsightedness and farsightedness. Binocular data are reported here. Interviews were conducted to obtain personal characteristics and self-assessed visual function.


RESULTS
About 75% of farmworkers reported never having had a vision screening. Based on binocular screening, 1.7% (distance vision) and 6.9% (near vision) had moderate to severe visual impairment (>20/40). Farmworkers self-reported poorer visual function, compared with screening results; only 36.4% reported good or very good vision. Sensitivity of distance and near vision self-reports were 60 and 20%, respectively, but specificity was high.


CONCLUSIONS
This study confirms past reports of little vision screening among farmworkers. Visual impairment for distance is comparable to other studies of Latinos in the US, though these studies have not reported near vision. Self-reports of vision problems are not a sensitive measure of visual acuity among farmworkers. Screening is needed to identify visual impairment that can create occupational safety risks in this health disparate population.
*PhDDepartment of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina (SAQ); Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina (MRS); Department of Biostatistics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina (HC); Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina (TAA); and Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina (SAQ, HC, TAA).
Sara A
SA
Quandt
Mark R
MR
Schulz
Haiying
H
Chen
Thomas A
TA
Arcury
Arch Pediatr Adolesc Med. 1998 Nov;152(11):1119-25
9811291
J Occup Environ Med. 2001 Jul;43(7):601-9
11464390
J Epidemiol Community Health. 2001 Nov;55(11):818-24
11604438
Am J Optom Physiol Opt. 1978 May;55(5):348-51
696798
Arch Environ Occup Health. 2006 Jan-Feb;61(1):27-32
17503618
JAMA. 1997 Dec 24-31;278(24):2163-6
9417010
Annu Rev Public Health. 2003;24:175-93
12359914
J Community Health Nurs. 1994;11(4):219-28
7830094
J Health Care Poor Underserved. 2003 Feb;14(1):52-69
12613068
Am J Public Health. 1996 Sep;86(9):1306-9
8806386
Arch Phys Med Rehabil. 1990 Feb;71(2):144-7
2302048
Ophthalmology. 1998 Jan;105(1):160-4
9442793
Arch Ophthalmol. 2004 Apr;122(4):495-505
15078666
Optom Vis Sci. 2008 Oct;85(10):910-23
18832974
Ann Agric Environ Med. 2005;12(1):27-9
16028862
Invest Ophthalmol Vis Sci. 2014 Sep 23;55(10):6996-7005
25249602
Arch Environ Occup Health. 2008 Spring;63(1):13-6
18479993
Annu Rev Public Health. 2007;28:345-63
17291182
South Med J. 2001 Jun;94(6):603-7
11440328
Inj Prev. 2002 Jun;8(2):155-60
12120837
Prog Community Health Partnersh. 2007 Winter;1(4):359-69
20208215
Ophthalmology. 2004 Jun;111(6):1141-9
15177964
Adv Data. 2004 Jun 24;(344):1-20
15227813
J Agromedicine. 2011 Apr;16(2):143-52
21462026
J Agromedicine. 2012 Jan;17(1):63-9
22191504
Ophthalmology. 2004 Jun;111(6):1132-40
15177963
Invest Ophthalmol Vis Sci. 2002 Jun;43(6):1742-8
12036974
Med Care. 2008 May;46(5):497-506
18438198
J Agric Saf Health. 2007 Nov;13(4):407-18
18075016
J Agric Saf Health. 2007 Jul;13(3):259-74
17892069
JAMA. 2006 May 10;295(18):2158-63
16684986