Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0170804
Title: Prevalence, risk factors, and impact of undiagnosed visually significant cataract: The Singapore epidemiology of eye diseases study
Authors: Chua J. 
Lim B.
Fenwick E.K.
Gan A.T.L.
Tan A.G.
Lamoureux E. 
Mitchell P.
Wang J.J. 
Wong T.Y. 
Cheng C.-Y. 
Keywords: adult
age
aged
Article
best corrected visual acuity
cataract
Chinese
controlled study
educational status
employment
ethnic difference
female
human
Indian
major clinical study
Malay (people)
male
prevalence
risk factor
Singapore
visual impairment
visually significant cataract
cataract
Diabetes Complications
ethnic group
eye
Eye Diseases
middle aged
pathophysiology
physiology
quality of life
very elderly
vision
Vision Disorders
Adult
Aged
Aged, 80 and over
Cataract
Diabetes Complications
Ethnic Groups
Eye
Eye Diseases
Female
Humans
Male
Middle Aged
Quality of Life
Risk Factors
Vision Disorders
Vision, Ocular
Issue Date: 2017
Publisher: Public Library of Science
Citation: Chua J., Lim B., Fenwick E.K., Gan A.T.L., Tan A.G., Lamoureux E., Mitchell P., Wang J.J., Wong T.Y., Cheng C.-Y. (2017). Prevalence, risk factors, and impact of undiagnosed visually significant cataract: The Singapore epidemiology of eye diseases study. PLoS ONE 12 (1) : e0170804. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0170804
Abstract: Objective To determine the prevalence, risk factors, and impact of undiagnosed visually significant cataract in an Asian population. Methods The Singapore Epidemiology of Eye Diseases is a population-based study where 8,697 adults of Malay, Indian, and Chinese ethnicities aged > 40 years were invited for an eye examination, including lens photograph, to establish cataract diagnosis. Visually significant cataract was defined by Wisconsin Cataract Grading System and a best-corrected visual acuity <20/40 with cataract as the primary cause of vision impairment. Participants were deemed 'undiagnosed' if they had visually significant cataract and reported no prior physician diagnosis of cataract. Visual functioning (VF) was assessed with the VF-11 questionnaire validated using Rasch analysis. Results Among the 925 participants with visually significant cataract, 636 (68.8%) were unaware of their cataract status. Age-standardized prevalence varied according to ethnicity, with Malays having higher rates than Chinese and Indians. Factors independently associated with having undiagnosed visually significant cataract were: Malay ethnicity, lower educational attainment, in employment, and without a history of diabetes (all P<0.05). In those with undiagnosed visually significant cataract, half had bilateral visual impairment, which was significantly associated with 24.8% poorer visual functioning compared to those with unilateral visual impairment (P<0.001).Conclusions Two-thirds of Singaporean adults with visually significant cataract were previously undiagnosed. Half of these cases had bilateral visual impairment and substantially reduced quality of life. Public health strategies targeting elderly patients, such as regular screening for visual impairment and timely referral to ophthalmologists in order to prevent progression to bilateral visual impairment when visual function is compromised are warranted. © 2017 Chua et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/166023
ISSN: 19326203
DOI: 10.1371/journal.pone.0170804
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