Su-Ying Tsai

Prevalence of dry eye among an elderly Chinese population in Taiwan: The Shihpai Eye Study

PURPOSE To describe the epidemiology of dry eye in an elderly Chinese population in Taipei, Taiwan. DESIGN A population-based cross-sectional study. PARTICIPANTS The Shihpai Eye Study was a population-based survey of eye diseases in the elderly (> or =65 years) in Shihpai, Taipei, Taiwan. Noninstitutionalized residents, as of July 1999, were identified by using the official household registration database. A total of 2045 subjects were selected, and 1361 (66.6%) people participated in the study. Among them, 822 (60.4%) were men. METHODS Trained interviewers administered a standardized questionnaire pertaining to dry-eye symptoms. Objective examinations of dry eye included tear film breakup time, Schirmer test, fluorescein stain of the cornea, and anatomic assessment of the meibomian glands via slit-lamp biomicroscopy. MAIN OUTCOME MEASURES Frequency of dry-eye symptoms and positive dry-eye tests. RESULTS In this population, 33.7% (459/1361) were symptomatic, defined as reporting 1 or more dry-eye symptoms often or all of the time. Women were more likely to report frequent symptoms of dry eye (odds ratio, 1.49; 95% confidence interval, 1.19-1.87). Among those who were symptomatic, 78.9% (362/459) had a low tear film breakup time (< or =10 seconds), 62.5% (287/459) had a low Schirmer test result (< or =5 mm), and 61.7% (283/459) had abnormal anatomic features of the meibomian glands. Furthermore, 85.4% (392/459) were symptomatic and had either a low Schirmer score or an abnormal meibomian gland assessment. Of those symptomatic, 49.9% (229/459) indicated that they had visited an eye doctor, 5.4% (25/459) responded that they had been diagnosed with dry eye, and 47.5% (218/459) reported current use of eyedrops. CONCLUSIONS This is the first report of population-based data of dry eye that includes symptoms and signs in elderly Asians. The prevalence of dry eye, although varied according to definition, is relatively higher in this study than that reported for whites. Further studies are needed to determine whether this is due to racial or environmental factors.

Impact of stereopsis on quality of life

PurposeTo investigate the impact of stereopsis on vision-related quality of life and general health status of the elderly.MethodsA quota of 200 subjects aged 65 years or older and had their households registered in Guando district was recruited for a general physical examination including ophthalmic evaluation. A structured questionnaire consisting of seven vision-specific items as well as 36-item short-form survey of the Medical Outcomes Study (SF-36) was administered. Stereoscopic level was divided into three groups: no stereopsis, gross stereopsis, and fine stereopsis. Fishers exact test was used to detect any difference in subjective visual functioning and Mann–Whitney U test was used for analyses of SF-36 scores.ResultsA total of 187 volunteers were recruited and 150 were analysed for stereoscopic levels. There was no significant difference in vision-specific difficulty among the three stereoscopic groups. For SF-36, having no stereopsis scored significantly less than having gross (P=0.005) and fine (P<0.0001) stereopsis in the vitality/energy dimension. General health perception dimension fared significantly lower in the group with no stereopsis compared to the fine stereoscopic group (P=0.01). In multivariate analysis, having fine stereopsis scored significantly higher in the energy/vitality dimension than having no stereopsis (P=0.02). On the other hand, visual impairment imposed significant adverse effect on five vision-specific items and had no significant relationship with the eight dimensions of SF-36.ConclusionsDefective stereopsis in the elderly imposes no significant adverse effect on vision-related quality of life. However, subjects may feel more exhausted in accomplishing their usual tasks.