AGE-SPECIFIC PREVALENCE AND CAUSES OF BLINDNESS AND VISUAL IMPAIRMENTIN AN OLDER POPULATION - THE ROTTERDAM STUDY

Objective: To study the prevalence and causes of blindness and visual impairment in various age categories of a large population-based study . Methods: For the study, 6775 subjects aged 55 years or older underwe nt an extensive ophthalmologic screening examination, including measur ements of visual acuity and the visual field and fundus photography. T he causes of blindness or visual impairment were determined using all screening information and medical records. Results: The prevalence of blindness, according to World Health Organization criteria, ranged fro m 0.1% in subjects aged 55 to 64 years to 3.9% in subjects aged 85 yea rs or older; the prevalence of visual impairment ranged from 0.1% to 1 1.8%. For persons younger than 75 years, my epic degeneration and opti c neuropathy were the most important causes of impaired vision. For pe rsons aged 75 years or older, age-related macular degeneration was the major cause of the increased prevalence of blindness, whereas age-rel ated cataract predominantly caused the increased prevalence of visual impairment. Conclusions: The hierarchy of causes of blindness and visu al impairment is highly determined by age. As yet, little can be done to reduce the exponential increase of blindness; however, adequate imp lementation of surgery to treat cataract could reduce visual impairmen t by one third. Underuse of ophthalmologic care is a prominent cause o f the high frequency of untreated cataracts among the elderly.