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CLINICAL RELEVANCE: Near Vision Impairment (NVI) is common in developing countries. A substantial proportion of NVI can be addressed by providing spectacles. Innovative eye care programmes are needed to address NVI. Population-based epidemiological studies can provide vital data to plan such eye care service delivery models. BACKGROUND: To report the prevalence of NVI and effective Refractive Error Coverage (eREC) for near vision in West Godavari and Krishna districts in Andhra Pradesh, south India. METHODS: A population-based cross-sectional study was carried out using a Rapid Assessment of Visual Impairment methodology. Presenting and pinhole distance visual acuity were assessed followed by near vision assessment using a N notation chart at a fixed distance of 40 cm. If the presenting near vision was worse than N8, the best corrected near visual acuity was recorded with age appropriate near vision correction. NVI was defined as presenting near vision worse than N8 among those without distance vision impairment (6/18 or better in the better eye). Effective Refractive Error Coverage for near was calculated as the proportion of individuals with an adequate correction to the total participants, including those with inadequate, adequate, and no correction for near vision. RESULTS: Data of 2,228 participants aged ≥40 years were analysed. The mean age of these participants was 54.0 ± 10.4 years; 53.8% were women; 44.5% had no formal education. The prevalence of NVI was 27.1% (95% CI: 25.2-29.0%). NVI significantly associated with 70 and above age group (adjusted OR: 1.97; 95% CI: 1.45-3.70). Participants with formal education had lower odds for NVI (adjusted OR: 0.75; 95 % CI: 0.68-0.83). The eREC for near vision was 48.0%. CONCLUSION: NVI affects over a quarter of people aged ≥40 years in the West Godavari and Krishna districts of Andhra Pradesh. However, eREC is under 50% and there is scope for improving this by establishing eye care services to achieve universal eye health for all.

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OBJECTIVES: Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC). DESIGN AND SETTING: Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample. PARTICIPANTS: Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana. MEASUREMENTS: Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision. RESULTS: The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively. CONCLUSION: Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.

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IMPORTANCE: Presbyopia, an essentially universal, age-related loss of the ability to focus un-aided on near objects, is the world's leading cause of visual impairment. BACKGROUND: Smartphone use is widespread in China, but little is known about the prevalence, determinants and correction of difficulties with smartphone use in the setting of presbyopia. DESIGN: Cross-sectional data from a population-based longitudinal cohort study. PARTICIPANTS: A total of 1817 persons aged ≥35 years in Guangzhou, Southern China. METHODS: Participants underwent near visual acuity (NVA) testing and completed questionnaires on smartphone usage detailing knowledge of their own presbyopia status, frequency (hours/day) and subjective difficulties with use of mobile and smartphones. Presbyopia was defined as uncorrected bilateral NVA ≤6/12 with best-corrected bilateral NVA >6/12. MAIN OUTCOME MEASURES: Difficulty in smartphone use associated with uncorrected presbyopia. RESULTS: Among 1427 respondents (78.5%) undergoing examination, 1191 (83.5%) completed questionnaires (mean age 52.3 ± 11.6 years; 54.9% women). Among 451 persons (37.8%) with presbyopia owning smartphones, 290 (64.3%) reported difficulty using them. Multiple ordinal logistic regression modelling showed difficulty in smartphone use due to presbyopia was associated with higher educational level (P = .013), worse NVA (P < .001) and more time spent using smartphones (P = .002 for 1-3 hours/day). Among persons with presbyopia owning smartphones, 353 (78.0%) said they would pay >US$15 (median US$45) for innovations making smartphone use easier. CONCLUSIONS AND RELEVANCE: Difficulty in using smartphones in the presence of presbyopia is common and affected persons are willing to pay for useful solutions to the problem.

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@#AIM: To investigate the incidence and risk factors of near vision impairment(NVI)in patients with asthenopia.<p>METHODS: Totally 51 patients(102 eyes)with visual fatigue in our hospital from May 2017 to May 2018 were enrolled. According to whether the near vision of daily life is damaged, it is divided into daily near vision impairment group(24 cases)and no near vision impairment group(27 cases). General information of all patients were collected, and routine eye examination, subjective optometry and binocular eye movement parameter detection were detected.<p>RESULTS: In the survey, 27 patients(53%)with near vision impairment in naked eye and 24 patients(47%)with impaired near vision in daily life, and all patients had a significant improvement in visual acuity after correct optometry, and there was no one who has best corrected near visual acuity impairment. The age of patients with daily near vision impairment was significantly higher than that of patients without near vision impairment. The proportion of patients aged ≥45 years was significantly higher than that without near vision impairment(<i>P</i><0.01). NRA/PRA, vergence \〖BO(40cm)\〗, and amplitude of vergence(40cm)were significantly different between the two groups(<i>P</i><0.05).<p>CONCLUSION: Nearly half of patients with asthenopia would suffer NVI. The increase of age and imbalance between NRA and PRA as the predominant risk factors for its development.

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OBJECTIVES: To characterize the relationship between diabetes mellitus (DM) and future risk of near vision impairment (VI) in a community-dwelling population of older people. DESIGN: Seven-year population-based longitudinal study. SETTING: Three-Cities Study, a French prospective study designed to assess the risk of cognitive and functional decline attributable to vascular factors. PARTICIPANTS: Community-dwelling individuals aged 65 and older (N = 8,412). MEASUREMENTS: DM was determined at baseline according to self-reported DM, antidiabetic treatment, and fasting blood glucose. Near visual acuity was measured at baseline and 2, 4, and 7 years later. Near VI was defined as a Snellen score greater than 20/30. RESULTS: DM was associated with a higher risk of near VI in an adjusted model (hazard ratio (HR) = 1.24, 95% confidence interval (CI) = 1.02-1.52, P = .03). Because of an interaction between Body Mass Index (BMI) and diagnosed DM, the longitudinal analyses were stratified according to BMI category. DM was associated with greater risk of near VI only in underweight (BMI <21.0 kg/m2 , HR = 2.89, 95% CI = 1.18-7.03) and normal-weight (BMI 21.0-24.9 kg/m2 , HR = 1.60, 95% CI = 1.10-2.32), but not overweight (P = .69) and obese (P = .09) subjects. CONCLUSION: DM is a risk factor for near VI in older people, particularly in those with a low or normal BMI. This risk profile should be taken into account in older adults to support their independence.

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