Ophthalmology (Eye & Ear Hospital) - Research Publications
Permanent URI for this collection
Search Results
1 - 6 of 6
-
ItemVision impairment and older drivers: who's driving?(BRITISH MED JOURNAL PUBL GROUP, 2002-10)AIM: To establish the association between impaired vision and drivers' decisions to stop driving, voluntarily restrict driving, and motor vehicle accidents. METHODS: Driving related questions were included in a population based study that determined the prevalence and incidence of eye disease. Stratified random cluster samples based on census collector districts were selected from the Melbourne Statistical Division. Eligible participants aged 44 years and over were interviewed and underwent a comprehensive ophthalmic examination. The outcomes of interest were the decision to stop driving, limiting driving in specified conditions, and driving accidents. The associations between these outcomes and the legally prescribed visual acuity (<6/12) for a driver's licence were investigated. RESULTS: The mean age of the 2594/3040 (85%) eligible participants was 62.5 (range 44-101). People with visual acuity less than 6/12 were no more likely to have an accident than those with better vision (chi(2) = 0.175, p>0.9). Older drivers with impaired vision, more so than younger adults, restrict their driving in visually demanding situations (p<0.05). Of the current drivers, 2.6% have vision less than that required to obtain a driver's licence. The risk of having an accident increased with distance driven (OR 2.57, CL 1.63, 4.04 for distance >31 000 km) but not with age. CONCLUSION: There was no greater likelihood of self reported driving accidents for drivers with impaired vision than those with good vision. While many older drivers with impaired vision limit their driving in adverse conditions and some drivers with impaired vision stop driving, there are a significant number of current drivers with impaired vision.
-
ItemUtilisation of eye care services by urban and rural Australians(BMJ PUBLISHING GROUP, 2002-01)AIM: To investigate factors related to the use of eye care services in Australia. METHODS: Health, eye care service use, and sociodemographic data were collected in a structured interview of participants in a population based study. All participants had a standard eye examination. RESULTS: Men (OR 1.3 CL 1.02, 1.7), those who spoke Greek (OR 2.1 CL 1.1, 3.8) or Italian (OR 1.9 CL 1.0, 3.3), and those without private health insurance (OR 1.59 CL 1.22, 2.04) were more likely to have not used eye care services. Ophthalmology services were utilised at lower rates in rural areas (OR 0.14 CL 0.09, 0.2). Approximately 40% of participants with undercorrected refractive error, cataract, and undiagnosed glaucoma had seen either an ophthalmologist, optometrist, or both within the last year. CONCLUSION: Despite the similarity in prevalence of eye disease in urban and rural areas, significant differences exist in the utilisation of eye care services. Sex, private health insurance, urban residence, and the ability to converse in English were significant factors associated with eye healthcare service use. Many participants had undiagnosed eye disease despite having seen an eye care provider in the last year.
-
ItemThe need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern( 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.
-
ItemCorrection of refractive error in the Victorian population: the feasibility of "off the shelf" spectacles(British Medical Association, 2001)Aims - To assess the feasibility of providing a stock of ready made spectacles for correction of refractive error in the general population. Methods - Data were collected in the Visual Impairment Project, a population based survey of Victorian residents aged 40 years or older in randomly selected urban and rural sample areas. This included a refractive eye examination and the proportion of subjects with hypermetropia, emmetropia (defined as -1.0 to +1.0D spherical equivalent), and myopia documented in the 40-60 year age group. Results - 2595 (54.8%) participants were aged between 40 and 60 years. Those with a best corrected visual acuity of less than 6/12, astigmatism of more than 1.25D, and anisometropia of more than 0.5D were excluded. 516 participants had refractive error which was deemed suitable for correction by “off the shelf” spectacles. This represents 19.9% of all participants between 40 and 60 years of age. Provision of spectacles in 0.5D increments would provide suitable stock spectacles for 85.5% of a -3.0 to +3.0D range or 89.2% of a -3.50 to +3.50D range. Conclusions - Ready made “off the shelf” spectacles could significantly alleviate visual morbidity due to refractive error in up to 20% of an urban population in Australia. This approach may also be useful in developing countries with poor access to optometric services.
-
ItemThe importance and state of medical and public health research related to vision in Australia( 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.
-
ItemImpact of unilateral and bilateral vision loss on quality of life(BMJ Publishing Group, 2005-03)Aim: To investigate whether unilateral vision loss reduced any aspects of quality of life in comparison with normal vision and to compare its impact with that of bilateral vision loss. Methods: This study used cluster stratified random sample of 3271 urban participants recruited between 1992 and 1994 for the Melbourne Visual Impairment Project. All predictors and outcomes were from the 5 year follow up examinations conducted in 1997–9. Results: There were 2530 participants who attended the follow up survey and had measurement of presenting visual acuity. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the telephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away from home (OR = 2.86, 95% CI 1.16 to 7.08), getting help with chores (OR = 3.09, 95% CI 1.40 to 6.83), and becoming dependent (getting help with meals and chores) (OR = 7.50, 95% CI 1.97 to 28.6). Non-correctable bilateral visual loss was associated with many activities of daily living except falling. Conclusions: Non-correctable unilateral vision loss was associated with issues of safety and independent living while non-correctable bilateral vision loss was associated with nursing home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and attended to.