title: The Prevalence and Demographic Associations of Presenting Near-Vision Impairment Among Adults Living in the United States.
abstract: OBJECTIVE
  To estimate prevalence of presenting near-vision impairment (PNVI) among people aged ≥50 years in the United States (US) and examine associations with sociodemographic characteristics.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 11 016 of 12 781 (88.5%) US adults aged ≥50 years participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2008 with recorded near visual acuity. PNVI was defined as presenting near vision worse than 20/40; functional near-vision impairment (FNVI) was defined as at least "moderate difficulty" with either reading newsprint or near work. Prevalence of PNVI and FNVI were estimated accounting for National Health and Nutrition Examination Survey multistage probability sampling design. Multivariable regression models were used to determine sociodemographic characteristics associated with PNVI.
  
  
  RESULTS
  A total of 13.6% of participants had PNVI, with 25.9% reporting concurrent FNVI. Higher odds of PNVI was associated with nonwhite race, older age, male sex, less than high school education, lack of private health insurance, income less than poverty level, lacking/not using near-vision correction at time of examination, and impaired distance vision. Although the majority of participants with PNVI (82.9%) had normal distance vision or uncorrected refractive error, less than half (46.1%) used near-vision correction. Not using near correction was associated with nonwhite race, younger age, male sex, and lack of access to health care.
  
  
  CONCLUSIONS
  Approximately 1 in 8 Americans aged ≥50 years have PNVI, with 1 in 4 reporting concurrent FNVI. Demographic factors shown to be important in access to eye care likely influence PNVI and utilization of near-vision correction in the US. As the majority of PNVI is likely correctable with spectacles, allocation of resources to provide corrective lenses to those in need likely has great public health implications.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland. Electronic address: nzebard1@jhmi.edu.
authors.forename: Nazlee
authors.initials: N
authors.lastname: Zebardast
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.affiliation: Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Susan
authors.initials: S
authors.lastname: Vitale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000208:ethnology* / Q000534:rehabilitation; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*