Visual impairment in the 40- to 64-year-old population of Shahroud, Iran

Purpose

To determine the prevalence of visual impairment by age and gender in Shahroud.

Methods

Using random cluster sampling, 6311 Shahroud inhabitants who were between 40 and 64 years old were invited for ophthalmological examinations. Visual acuity worse than 0.5 LogMAR (20/60) and 1.3 LogMAR (20/400) in the better eye was regarded as low vision and blindness, respectively. The cause of blindness was determined by an ophthalmologist and in a person with more than one cause, the most correctable cause was regarded as the main cause.

Results

This study was conducted on 5190 participants (response rate: 82.2%). On the basis of presenting visual acuity, the prevalence of low vision and blindness was found to be 1.8% (95% confidence interval (CI): 1.4–2.10) and 0.5% (95% CI: 0.3–0.7), respectively. Based on corrected vision, these values were 0.5% (95% CI: 0.3–0.7) and 0.3% (95% CI: 0.1–0.4), respectively. Visual impairment increased with age in women (P<0.001). Uncorrected refractive errors (63.9%), cataract (20.2%), and amblyopia (5.9%) were the most common causes of visual impairment based on presenting vision. Based on corrected vision, however, cataract (42.5%), amblyopia (12.5%), and retinitis pigmentosa (7.5%) were the most common causes of visual impairment.

Conclusion

Although the prevalence of visual impairment in the city of Shahroud was determined to be lower than two previous studies in the country, correction of refractive errors and cataract could minimize the rate of visual impairment in this population as they were shown to comprise 85% of the causes of visual impairment. The elderly women need to receive more attention.     

Visual Acuity in a Community-dwelling Japanese Population and Factors Associated with Visual Impairment

Purpose The aim of this study was to describe the distribution of visual acuity and investigate the predictors of visual impairment in a Japanese population.Methods Best-corrected visual acuity was measured in 2263 subjects aged 40–79 years randomly selected from a local community. Relations between visual impairment and possible risk factors were investigated.Results Among these subjects, 41 individuals (1.8%) were identified as visually impaired (best-corrected visual acuity in the better eye 0.5). Both sexes in the older age groups had a higher frequency of visual impairment (Mantel-Haenszel chi-square test: P 0.001). A multiple logistic regression indicated that an increase in age of 10 years [odds ratio (OR) 3.9; 95% confidence interval (CI) 2.3–6.7] and myopia (OR 2.9; 95%CI 1.4–6.0) were independent risk factors for visual impairment. Individuals with the highest level of education (college or higher) had a lower risk of visual impairment (OR 0.1; 95%CI 0–0.7) compared to individuals with the lowest level of education.Conclusions As expected, visual impairment increased with advancing age, although the prevalence of visual impairment in our population was lower than in other surveys. Racial and regional differences and differences in study design may be responsible for discrepancies between surveys. It is noteworthy that myopia was a significant risk factor for visual impairment, although the reasons for this association are uncertain and need further investigation. Jpn J Ophthalmol 2004;48:37–43 © Japanese Ophthalmological Society 2004     

Visual impairment in a Taiwanese population: Prevalence,causes, and socioeconomic factors

PURPOSE We sought to estimate the prevalence of visual impairment among an elderly population in urban Taiwan, determine the causes of visual impairment, and gain information about certain socioeconomic factors associated with visual impairment.

METHODS A population-based survey of ocular diseases in residents aged 50 years or older was conducted in Peitou Precinct, Taipei, Taiwan. All participants underwent a comprehensive ophthalmic examination, including visual acuity measurement, using standardized protocols. Demographic data, marital status, employment status, and educational level were gathered through an interview.

RESULTS A total of 2034 participants completed the visual acuity measurements. The prevalence of visual impairment (defined as best-corrected visual acuity in the better eye <6/18) among this population was 2.75% (95% confidence intervals: 2.04%–3.46%). Three major causes of visual impairment were cataract (30.4%), high myopic macular degeneration (25.0%), and age-related macular degeneration (14.3%). In multivariate analysis, age was positively correlated with visual impairment (P < 0.001), and higher education level was associated with a significant decrease in the odds of being visually impaired (P < 0.001). No relation was found between visual impairment and sex, or marital and employment status.

CONCLUSIONS This study provides the first information about the prevalence and causes of visual impairment in Taiwan, and identifies age and educational level as the most important factors related to visual impairment. Additional educational programs should be developed to improve individual awareness of age-related ocular diseases and the availability of current ophthalmic intervention.     

Methods for a population-based study of eye disease: the Melbourne Visual Impairment Project

The methodology of the Melbourne Visual Impairment Project, a major population-based survey of eye disease on 3,500 randomly selected individuals aged 40 years of age and over in the Melbourne metropolitan region, is presented. The aims of the study are to determine the distribution and determinants of eye disease in an urban population; the impact of eye disease on visual function and the activities of daily living; and the accessibility of eye health care services in the community. All procedures are conducted according to a standardised protocol to allow for comparison with other population-based studies, both in Australia and overseas. Information collected from this study will be employed in the development of recommendations related to eye health care service delivery and establishment of priorities for future public education programmes and health research.     

Prevalence and Causes of Visual Impairment and Blindness in Adults Aged 45 Years and Older from Parintins: The Brazilian Amazon Region Eye Survey

Purpose: To determine the prevalence and causes of visual impairment and blindness in adults aged 45 years and older from Parintins, Brazilian Amazon Region.

Methods: A random cluster sampling method was used to identify subjects 45 years of age and older from urban and rural census sectors of Parintins city, Amazonas State, from March 2014 to May 2015. Participants underwent a detailed ocular examination, including presenting (PVA) and best corrected visual acuity (BCVA). The main cause of PVA<20/32 per eye was determined.

Results: A total of 2384 subjects were enumerated and 2041 (85.6%) examined. The prevalence of presenting mild visual impairment – MiVI (<20/32 – ≥20/63) in the better-seeing eye was 17.0% [95% CI: 15.3–18.7%], and 8.5% [95% CI: 7.3–9.7%] with best correction. The prevalence of presenting moderate visual impairment – MVI (<20/63 – ≥20/200) was 18.4% [95% CI: 16.2–20.6%], and 6.9% [95% CI: 5.8–8.0%] with best correction. The prevalence of presenting bilateral VA <20/200 was 4.3% [95% CI: 3.6–5.0%], and 3.3% [95% CI: 2.5–4.0%] with best correction and increased with older age. Cataract (47.8%) and glaucoma (7.5%) were its main causes. In less severely affected eyes, uncorrected refractive errors (MVI: 42.6%; MiVI: 79.0%), cataract (MVI: 40.6%; MiVI: 13.7%) and pterygium (MVI: 7.6%; MiVI: 2.7%) were the main causes.

Conclusions: Most cases of visual impairment in Parintins are either preventable or treatable, and public health initiatives should target cataract surgical services and refraction with spectacle provision.     

Visual Impairment and quality of life in the Older European Population,the EUREYE study

Purpose: To determine the prevalence of visual impairment (VI) in populations 65 year or older from six European countries and describe the association with vision‐related quality of life. VI was defined according to WHO as best corrected visual acuity <6/18/log MAR >0,48 (World Health Organization (1992): International Statistical Classification of Diseases and Related Health Problems, 10th revised ed. Vol 1. Geneva). Methods: 4166 participants in The European Eye study, 65 years and older selected randomly from the general census in the participating centres, were interviewed for vision‐related quality of life and underwent an eye exam including distance visual acuity, refraction and fundus photography. Results: The prevalence of VI rose with increasing age and more so in women. There was a pattern of a higher prevalence of VI in the Mediterranean countries compared to Northern European countries with the exception of Tallinn (Estonia) which had higher VI prevalence rates than the other north European centres. The prevalence of low vision was 3% or less in all centres. Blindness prevalence varied from 2% to less than half a per cent. Vision‐related quality of life was strongly associated with visual acuity and the presence of bilateral age‐related macular degeneration. Conclusion: The prevalence of visual impairment in the examined ageing European populations shows a definite increasing trend from north to south.     

Alcohol Consumption and Visual Impairment in a Rural Northern Chinese Population

Purpose: To investigate alcohol drinking status and the association between drinking patterns and visual impairment in an adult population in northern China.

Methods: Cluster sampling was used to select samples. The protocol consisted of an interview, pilot study, visual acuity (VA) testing and a clinical examination. Visual impairment was defined as presenting VA worse than 20/60 in any eye. Drinking patterns included drinking quantity (standard drinks per week) and frequency (drinking days in the past week)

Results: Information on alcohol consumption was obtained from 8445 subjects, 963 (11.4%) of whom reported consuming alcohol. In multivariate analysis, alcohol consumption was significantly associated with older age (p?<?0.001), male sex (p?<?0.001), and higher education level (p?<?0.01). Heavy intake (>14 drinks/week) was associated with higher odds of visual impairment. However, moderate intake (>1–14 drinks/week) was significantly associated with lower odds (adjusted odds ratio, OR, 0.7, 95% confidence interval, CI, 0.5–1.0) of visual impairment (p?=?0.03). Higher drinking frequency was significantly associated with higher odds of visual impairment. Multivariate analysis showed that older age, male sex, and higher education level were associated with visual impairment among current drinkers. Age- and sex-adjusted ORs for the association of cataract and alcohol intake showed that higher alcohol consumption was not significantly associated with an increased prevalence of cataract (OR 1.2, 95% CI 0.4–3.6), whereas light and moderate alcohol consumption appeared to reduce incidence of cataract.

Conclusion: Drinking patterns were associated with visual impairment. Heavy intake had negative effects on distance vision; meanwhile, moderate intake had a positive effect on distance vision.     

Population-based assessment of barriers for uptake of eye care services among elderly people: Findings from rapid assessment of visual impairment studies from Telangana,India

Purpose:To report the barriers for seeking eye care among the elderly population aged ≥60 years with avoidable vision impairment (VI) in the South Indian state of Telangana.Methods:A total of 3640 participants aged ≥60 years were recruited using cluster-random sampling. Demographic information, including presenting visual acuity, was measured using the standard Rapid Assessment of Visual Impairment (RAVI) protocol. “Avoidable VI” was considered if the VI was due to cataract or uncorrected refractive error (URE). A detailed interview was conducted using a validated questionnaire to report the barriers for not seeking eye care. Data were analyzed using the Stata statistical software version 14.Results:Prevalence of avoidable VI was 30.2% (95% CI: 28.02–31.06; n = 1102). Among those who noticed decreased vision (n = 1074), only 392 participants (36.4%) reported that they felt the need for seeking eye care. The major barriers for not seeking eye care were: cannot afford the consultation fee and services (42.0%) and no escort (25.7%). Overall, the personal barriers (57.9%) were the major reason for not seeking care, followed by economic barriers (42.0%). No significant difference was reported in barriers between the participants with unilateral and bilateral VI (>0.05).Conclusion:Overall, among the elderly people, personal and economic barriers were the major reason for not seeking eye care. Health care providers and policymakers should focus on newer models of eye care delivery to ensure better accessibility and uptake of care by the elderly people.     

Population-based survey of prevalence, causes, and risk factors for blindness and visual impairment in an aging Chinese metropolitan population

AIM: To assess the prevalence, causes, and risk factors for blindness and visual impairment among elderly (>60 years of age) Chinese people in a metropolitan area of Shanghai, China. METHODS: Random cluster sampling was conducted to identify participants among residents ≥60 years of age living in the Xietu Block, Xuhui District, Shanghai, China. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were checked by the Early Treatment Diabetic Retinopathy Study (ETDRS) visual chart. All eligible participants underwent a comprehensive eye examination. Blindness and visual impairment were defined according to World Health Organization (WHO) criteria. RESULTS: A total of 4190 persons (1688 men and 2502 women) participated in the study, and the response rate was 91.1%. Based on PVA, the prevalence of blindness was 1.1% and that of visual impairment was 7.6%. Based on BCVA, the prevalence of blindness and visual impairment decreased to 0.9% and 3.9%, respectively. Older (>80 years of age) women, with low educational levels and smoking habits, exhibited a significantly greater chance for blindness and visual impairment than did those with high educational levels and no smoking habits (P<0.05). Based on PVA and BCVA, the main causes of blindness were cataract, myopic maculopathy, and age-related macular degeneration (AMD). CONCLUSION: Our findings help to identify the population in need of intervention, to highlight the need for additional eye healthcare services in urban China.     

桂林市郊区50岁以上人群视力损伤及致盲眼病调查

目的:调查桂林市农村地区50岁以上人群中视力损伤及盲的流行病学现状,并对产生视力损伤及盲的原因进行初步探索.方法:采取整群随机抽样方法对桂林市下辖5区12县进行抽样调查,共抽取10252人.登记内容包括:姓名、性别、年龄、民族、文化程度、经济状况、既往患病史、吸烟饮酒史等.登记资料及眼科检查结果输入计算机,采用SPSS 19.0软件进行统计描述.结果:共计调查10252人,其中男4958人(48.4％),女5294人(51.6％);汉族9218人(89.9％),少数民族1034人(10.1％).目前在桂林市农村地区排名前3位导致双眼视力损害和盲的眼病分别是白内障(0.7％)、黄斑病变(0.2％)、糖尿病视网膜病变(0.1％).结论:白内障仍是目前桂林市农村地区50岁以上人群视力损伤的主要原因.高血压、糖尿病等所致视力下降及致盲疾病的发病率有一定程度的增长.加强基础卫生教育,提高基层医疗资源仍是今后防盲、治盲工作的重点.     

Prevalence of visual impairment and related factors in Nangarhar Province of Afghanistan: a cross sectional study

AIM: To determine the prevalence, main causes, and related factors of visual impairment (VI) among people aged 50y and over in Jalalabad City and four surrounding districts of Nangarhar Province of Afghanistan. METHODS: The data for the population based cross-sectional study was collected in 2015. The calculated sample size was 1353, allocated to urban-rural strata using probability proportion to size method. At the end of the study, 1281 people participated in to the study. VI was defined as presenting visual acuity (VA) of less than 6/18 and blindness as VA less than 3/60 in the better eye by using Snellen chart only. Data was analyzed using IBM SPSS 21.0 software. RESULTS: The prevalence of VI was 22.6% (95%CI, 20%-25%) of which 13.9% (95%CI, 12%-16%) was low vision and 8.7% (95%CI, 7%-10%) was blindness. The most common causes of the VI were cataract (52.8%), followed by uncorrected refractive error (URE) (26.9%) and glaucoma (8.6%). Number one cause of the low vision was URE (42%), followed by cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR), while for blindness they are cataract (72%), other posterior segment disorders, glaucoma, URE and AMD. Illiteracy, bad economic status, hypertension and overweight were factors independently associated with both VI and low vision, whereas, age, illiteracy, bad economic status, hypertension and using of sunglasses were independently associated with blindness. CONCLUSION: Cataract, URE, glaucoma, AMD and DR are the leading causes of VI and blindness in the study area. They are mostly avoidable. In order to decrease the burden of VI and blindness in the study area as well as the whole country, it is strongly recommended to apply the prevention policies of VI and blindness.     

Future trends in global blindness

The objective of this review is to discuss the available data on the prevalence and causes of global blindness, and some of the associated trends and limitations seen. A literature search was conducted using the terms "global AND blindness" and "global AND vision AND impairment", resulting in seven appropriate articles for this review. Since 1990 the estimate of global prevalence of blindness has gradually decreased when considering the best corrected visual acuity definition: 0.71% in 1990, 0.59% in 2002, and 0.55% in 2010, corresponding to a 0.73% reduction per year over the 2002-2010 period. Significant limitations were found in the comparability between the global estimates in prevalence or causes of blindness or visual impairment. These limitations arise from various factors such as uncertainties about the true cause of the impairment, the use of different definitions and methods, and the absence of data from a number of geographical areas, leading to various extrapolation methods, which in turn seriously limit comparability. Seminal to this discussion on limitations in the comparability of studies and data, is that blindness has historically been defined using best corrected visual acuity.     

Visual impairment and functional status from the 1995 National Health Interview Survey on Disability

purpose?The purpose of this project is to evaluate the association of vision limitation and function among a population of older and younger adults. methods?The effects of self-reported serious difficulty with vision and legal blindness were evaluated on six activities of daily living (ADLs) and six instrumental activities of daily living (IADLs). Subjects were 67,570 adults over the age of 18 who participated in the 1995 National Health Interview Survey on Disability. results?Serious difficulty with vision (SDV) and legal blindness (LB) were independently associated with increased odds of poorer function for each of the ADLs and IADLs. In stratified analysis, the effect of vision on function was modified by age. Both SDV and LB produced a greater impact on performance of ADLs and IADLs among younger rather than older subjects. conclusions?Vision had an impact on all ADLs and IADLs evaluated, with greater impact on self-reported function for younger adults. This suggests that younger adults perceive limitations associated with visual disability differently than do older adults.     

The Brazilian Amazon Region Eye Survey: Design and Methods

Purpose: To describe the study design, operational strategies, procedures, and baseline characteristics of the Brazilian Amazon Region Eye Survey (BARES), a population-based survey of the prevalence and causes of distance and near visual impairment and blindness in older adults residing in the city of Parintins.

Methods: Cluster sampling, based on geographically defined census sectors, was used for cross-sectional random sampling of persons 45 years and older from urban and rural areas. Subjects were enumerated through a door-to-door survey and invited for measurement of uncorrected, presenting and best-corrected visual acuity and an ocular examination.

Results: Of 9931 residents (5878 urban and 4053 rural), 2384 individuals (1410 urban and 974 rural) were eligible and 2041 (1180 urban and 861 rural) had a clinical examination (response rate 85.6%). The majority of participants were female (1041, 51.0%); the average age was 59.9 ± 11.1 years (60.2 ± 11.2 years for urban and 59.4 ± 11.1 years for rural); 1360 (66.6%) had primary schooling or less (58.1% in urban and 78.4% in rural) and 57.8% were resident in urban areas. The age distribution between sexes was similar (p = 0.178). Both sex and age distributions of the sample were comparable to that of the Brazilian Amazon Region population.

Conclusions: The BARES cohort will provide information about the prevalence and causes of near and distance vision in this underprivileged and remote population in Brazil.     

Prevalence and causes of visual impairment and blindness in Icelanders aged 50 years and older: the Reykjavik Eye Study

Purpose: This study aimed to study the prevalences and causes of visual impairment and blindness in an Icelandic adult population. Methods: The Reykjavik Eye Study includes a random sample of citizens of Reykjavik aged ≥ 50 years, with an equal proportion (6.4%) for each year of birth and each sex. A total of 1045 persons were examined, representing a response rate of 75.8%. All participants underwent an extensive ophthalmological examination using a standard protocol. We used World Health Organization (WHO) definitions for bilateral visual impairment (best corrected visual acuity [VA] < 6/18 or visual field of ≥ 5 ° and < 10 ° around the fixation point in the better eye) and blindness (VA < 3/60 or visual field < 5 ° in the better eye). We also used US criteria, which define bilateral visual impairment as present if VA is < 6/12 and blindness as present if VA is ≤ 6/60 (both in the better eye). The causes of visual loss were determined for all participants found to be visually impaired in one or both eyes. Results: The prevalences of bilateral visual impairment and blindness were 0.96% (95% confidence interval [CI] 0.37–1.55) and 0.57% (95% CI 0.12–1.03), respectively, using the WHO criteria, and 2.01% (95% CI 1.16–2.86) and 0.77% (95% CI 0.24–1.29), respectively, using the US criteria. The prevalence rates were 4.40% and 5.45% for unilateral visual impairment and 1.72% and 3.06% for unilateral blindness, using the WHO and US criteria, respectively. Age‐related macular degeneration (AMD) was the major cause of bilateral visual loss, whereas the most common causes of unilateral visual loss were, in this order, amblyopia, cataract and glaucoma. Conclusions: Prevalence of visual loss increases with age. The leading cause of bilateral visual impairment and blindness was AMD, accounting for more than half of all cases, and cases of geographic atrophy outnumbered those of exudative AMD by two to one.     

Danish Rural Eye Study: Epidemiology of Adult Visual Impairment

Purpose: To examine the frequency and causes of visual impairment (VI) in a select population of Danish adults.

Methods: A total of 3843 adults aged 20–94 years from the Danish General Suburban Population Study (GESUS) were included in the population-based, cross-sectional ophthalmological study, Danish Rural Eye Study (DRES). All DRES participants received a comprehensive general health examination preceding their eye examination, including measurement of best-corrected visual acuity (BCVA) for each eye, bilateral 45° retinal fundus photographs and further ophthalmological examination where indicated.

Results: Overall, 3826 of 3843 participants (99.6%) had bilateral visual acuity measurements. The overall frequency of VI (BCVA <20/40 in the better-seeing eye) was 0.4% (95% confidence interval, CI, 0.2–0.7%; n = 15) among all DRES participants, 0.6% (95% CI 0.3–1.0%; n = 15) among participants >50 years and 3.7% (95% CI 2.1–6.5%; n = 11) in participants >80 years. The primary causes of VI in the better-seeing eye were age-related macular degeneration (AMD) in 46.7% (7/15) and cataract in 26.7% (4/15). A total of 43.3% (n = 115) of participants >80 years were pseudophakic in one or both eyes. The frequency of diabetes (HbA_1c ≥48 mmol/mol or self-reported diagnosis) was 5.9% (n = 227), including 1.3% (n = 51) newly diagnosed in the GESUS. Of participants determined to have VI due to exudative AMD, 50% had received anti-vascular endothelial growth factor (VEGF) treatment.

Conclusion: We report a relatively low frequency of VI among Danish adults over 59 years of age compared with that observed 10–15 years ago, which is both consistent with other recent Scandinavian studies and reflective of our relatively healthy and mobile population sample.     

The global burden of trachomatous visual impairment: II. assessing burden

This paper builds on results of a previous paper on the prevalence of trachomatous visual impairment as the foundation for assessing the global burden of trachomatous blindness and low vision: approximately 2.9 million cases of trachomatous blindness and 3.8 million low visioned corresponding to a global prevalence of trachomatous visual impairment equal to 1.3/1,000 in 1990 was estimated. For each visually impaired person, the years of life lost due to premature mortality and the years lived in a handicapped state are added to yield a single measure of disease burden called handicap adjusted life years (HALYs). Age, gender and visual acuity group specific HALYs are multiplied by the prevalence of trachomatous visual impairment to yield an estimate of the global burden of trachoma visual impairment equal to 80 million HALYs. Analysis of the distribution of the global burden by age, gender, visual acuity and region provide direction for trachoma research and programme priorities. Sensitivity analysis reveals that the burden estimates of trachomatous visual impairment may vary from as low as 15 million to as high as 500 million HALYs. Given this degree of variability, burden comparisons with other blinding and non-blinding conditions for the purposes of identifying health sector priorities may be misleading.Paper supported by The Edna McConnell Clark Foundation.     

The global burden of trachomatous visual impairment: I. Assessing prevalence

This paper summarizes primary epidemiologic studies of trachomatous blindness to develop age-/sex-/region-specific estimates of the global prevalence of trachomatous blindness and low vision. These studies are first examined for their validity and then employed to derive a minimum prevalence of trachomatous visual impairment. This method yields a global total for 1990 of approximately 640,000 cases of trachomatous blindness, corresponding to a prevalence of 0.12/1,000 (lower and upper bounds, 0.10 to 0.14/1,000). When those with low vision due to trachoma are included, 1.5 million cases of visual impairment are estimated, corresponding to a prevalence of 0.28/1,000 (lower and upper bounds, 0.15 to 0.75/1,000). A second approach, labeled the projected prevalence of trachomatous visual impairment, selects country-wide studies to derive representative regional prevalence values. A global total of 2,899,000 blind (projected prevalence of 0.55/1,000 with lower and upper bounds, 0.37 to 0.83/1,000) is estimated for 1990. With trachomatous low vision included, greater than 6.7 million individuals in 1990 have visual impairment from trachoma (projected prevalence of 1.28/1,000 with lower and upper bounds, 0.53 to 4.29/1,000). Analysis of the distribution of the global prevalence by age, gender, visual acuity and region provide direction for trachoma research and programme priorities. Attention is drawn to the limited studies and resulting wide variation in the estimates of trachomatous visual impairment prevalence as indicated by the lower and upper bound estimates. It is recommended that this epidemiologic uncertainty be reflected in global and regional estimates of trachomatous visual impairment prevalence in order to draw attention to how little is known and emphasize the need for further surveys. A second paper incorporates these findings in an assessment of the global burden of trachomatous visual impairment.Supported by the Edna McConnell Clark Foundation.     

Visual acuity in an Australian Aboriginal population

Background: Australia is a developed country, However; Aboriginal Australians have rates of blindness comparable to Third World countries. There have been well-funded eye health programs for 15 years in Central Australia. This paper examines if there has been an improvement in visual disability of one traditional group of Aboriginal Australians. Methods: Results from an eye health survey of the Anangu Pitjantjatjara of South Australia in 1990 are presented. These data are compared with results for ‘blindness’ and ‘poor vision’ from a national survey undertaken in 1976. The two surveys were comparable in design, both were cross-sectional population-based prevalence surveys. Prevalence rates were adjusted for the size of the source population. Results: Young rural Aboriginal Australians have good visual acuity. Low vision and blindness (WHO definitions) occur in 19.6% and 10.4% of 60+ year olds, respectively. Women were more likely than men to be blind or have low vision (OR= 1.93; 1.06-3.58). There was a decline in ‘poor vision’ between surveys (OR=2.86; 1.86-4.75) but not in ‘blindness’. Conclusion: Although there has been a reduction in the prevalence of visual disability in rural Aboriginal Australians, improvements in the provision of eye care for the elderly need to occur.