Cataract more prevalent in African American nursing home residents than white residents

Cataract was the primary cause of low vision in 54 percent of African American nursing home residents compared to 37 percent of white residents, according to an article in the July issue of the Archives of Ophthalmology, one of the JAMA/Archives journals.

A cataract is a cloud or film that can form on the lens of a person's eye. The presence of a cataract can degrade the quality of one's vision by blocking and scattering light as it enters the eye. It is often associated with chronic exposure to ultraviolet radiation.

According to background information in the article, blindness and visual impairment rates increase with age, and are also higher among nursing home residents.

David S. Friedman, M.D., M.P.H., of the Wilmer Eye Institute, The Johns Hopkins University, Baltimore, and colleagues measured the vision of 1,307 nursing home residents (304 African Americans, 997 white residents) in 28 nursing homes in Maryland and Delaware. Residents with visual acuity worse than 20/40 in their better-seeing eye (N = 412) were also examined by an ophthalmologist to determine the main cause for reduced vision.

Cataract was the leading cause of low vision in both African American and white residents (54 percent and 37 percent, respectively), and was a more common cause of vision loss among African American patients (24.2 percent) than white patients (11.8 percent). Macular degeneration caused low vision in 29 percent of white residents and 7 percent in African American patients. In four percent of white residents and ten percent of African American residents, glaucoma caused low vision.

"The higher prevalence of cataract among African American persons can be attributed to any of several factors. Previous research...indicates that African American persons are less likely to visit an ophthalmologist, and they obtain cataract surgery at lower rates than white persons," the authors write.

"In summary, low vision and blindness are highly prevalent among residents of nursing homes, with more than one third affected. African American subjects have a greater burden of unoperated cataract and glaucoma, while white subjects have much higher prevalence rates of AMD [age-related macular degeneration]. Cataract remains the most common cause of low vision for both racial groups, pointing to a potential benefit of intervention programs aimed at providing surgical services to this population."

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