Impact of Presbyopia on Quality of Life in a Rural African Setting
Presented at the 64th Wilmer Residents Association Meeting, April 22, 2005, Baltimore, Maryland.
Received 24 June 2005; accepted 11 January 2006.
Purpose
To determine the impact of uncorrected presbyopia on quality of life in rural Tanzania.
Design
Cross-sectional study.
Participants
Population-based sample of 1709 village and town-dwelling adults aged 40 and older in the Kongwa district in rural Tanzania.
Methods
Subjects underwent distance and near visual acuity testing to determine presbyopia. A near vision–related quality of life questionnaire was administered by trained interviewers to determine the degree of self-rated difficulty with tasks appropriate to life in a rural African setting, and how much near vision loss contributed to this difficulty.
Main Outcome Measures
Near vision–related quality of life.
Results
Complete data were available for 1564 (92%) of the subjects. The prevalence rate of presbyopia was 62%. The majority of presbyopes (94%) did not have corrective near vision glasses. Compared with nonpresbyopes, being presbyopic increased the odds of reporting some difficulty with near vision tasks by 2-fold (odds ratio [OR], 2.04; 95% confidence interval [CI]: 1.57–2.66), odds of reporting moderate difficulty by 5-fold (OR 5.01; 95% CI: 3.19–7.89), and odds of reporting high difficulty by >8-fold (OR 8.52; 95% CI 3.13–23.10). The degree of presbyopia was associated with increasing difficulty with daily tasks (P<0.0001).
Conclusions
This is the first study to demonstrate that uncorrected presbyopia has a significant impact on vision-related quality of life in a rural African setting. The high prevalence of presbyopia, and increased aging of the population in developing countries, suggests that the World Health Organization’s Vision 2020 refraction agenda should place greater emphasis on presbyopia.
1Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
ABSTRACT