Ophthalmology (Eye & Ear Hospital) - Research Publications

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Author: Keeffe, Jill × End date: 1999 × Start date: 1994 × Subject: CERA ×

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    The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern
    McCarty, C. A. ; Keeffe, J. E. ; Taylor, H. R. ( 1999)
    Aim - To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern. Methods - Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual acuity, visual fields, intraocular pressure, satisfaction with current vision, personal health history and habits, and a standardised eye examination and photography of the lens and fundus. Lens photographs were graded twice and adjudicated to document lens opacities. Cataract was defined as nuclear greater than or equal to standard 2, 4/16 or greater cortical opacity, or any posterior subscapsular opacities. Results: 3271 (83% response) people living in their own homes were examined. The participants ranged in age from 40 to 98 years and 1511 (46.2%) were men. Previous cataract surgery had been performed in 107 (3.4%) of the participants. The overall prevalence of any type of cataract that had not been surgically corrected was 18%. If the presence of cataract as defined was considered the sole criterion for cataract surgery with no reference to visual acuity, There would be 309 cataract operations per 1000 people aged 40 and over (96 eyes of people who were not satisfied with their vision, 210 eyes of people who were satisfied with their vision, and three previous cataract operations). At a visual acuity criterion of less than 6/12 (the vision required to legally drive a car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision. Conclusions - Estimates of the need for cataract surgery vary dramatically by level of lens opacity, visual acuity, and patient concern. These data should be useful for the planning of health services.
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    The importance and state of medical and public health research related to vision in Australia
    McCarty, Catherine A. ; Keeffe, Jill E. ; Livingston, Patricia M. ; Taylor, Hugh R. ( 1996)
    It has been shown that health research is fundamental to maintaining a high-quality, cost-effective health care system, and that biomedical research can ultimately realise huge cost savings to the national health care budget. Priorities for illness prevention and health promotion should be based on research-based information about the public health significance of health problems, the theoretical preventability of the health problems and the relative cost-effectiveness of individual preventive measure. Diabetic retinopathy is one eye condition that has been comprehensively studied in these three areas. Results from research conducted in the United States have shown that diabetic retionopathy is the leading cause of blindness in working-age adults, that early screening and treatment is highly efficacious in preventing vision loss, and that primary and secondary prevention are cost effective. The significant research resources required to understand diabetic retinopathy to this extent will be returned in the form of improved vision and heatlh care savings. Further resources are needed to better understand the other major contributors to vision loss in the community - cataract, glaucoma, age-related macular degeneration and ocular trauma.