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Original Investigation
July 2016

Prevalence and Causes of Visual Impairment and Blindness in Chinese American AdultsThe Chinese American Eye Study

Author Affiliations
  • 1USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles
  • 2Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Ophthalmol. 2016;134(7):785-793. doi:10.1001/jamaophthalmol.2016.1261

Importance  Visual impairment (VI) and blindness continue to be major public health problems worldwide. Despite previously published studies on VI in Chinese and other racial/ethnic populations, there are no data specific to Chinese American adults.

Objectives  To determine the age- and sex-specific prevalence and causes of VI and blindness in adult Chinese Americans and to compare the prevalence to other racial/ethnic groups.

Design, Setting, and Participants  In this population-based, cross-sectional study of 10 US Census tracts in the city of Monterey Park, California, 4582 Chinese American adults 50 years and older underwent complete ophthalmologic examinations, including measurement of presenting and best-corrected visual acuity (BCVA) for distance using the Early Treatment Diabetic Retinopathy Study protocol from February 1, 2010, through October 31, 2013.

Main Outcomes and Measures  Age-specific prevalence and causes of VI and blindness for presenting and BCVA.

Results  Of the 5782 eligible adults, 4582 (79.2%) completed an in-clinic eye examination. Of the 4582 participants, most were born in China (3149 [68.7%]), female (2901 [63.3%]), and married (3458 [75.5%]). The mean (SD) age was 61 (9) years. The prevalence of presenting VI was 3.0% (95% CI, 2.5%-3.5%), with 60.0% of this prevalence being attributed to uncorrected refractive error. The overall age-adjusted prevalence for VI (BCVA of ≤20/40 in the better eye) was 1.2% (95% CI, 0.9%-1.5%). The overall age-adjusted prevalence of blindness (BCVA of ≤20/200 in the better-seeing eye) was 0.07% (95% CI, 0%-0.2%). The prevalence of VI and blindness was higher in older Chinese Americans compared with younger. The primary causes of VI were cataracts and myopic retinopathy; the primary cause of blindness was myopic retinopathy.

Conclusions and Relevance  The prevalence of VI in Chinese Americans is similar to that of non-Hispanic white and Latino individuals in the United States and similar to or lower than the prevalence previously reported for Chinese adults from non-US studies. The prevalence of blindness is lower than that noted in other US or non-US studies. Myopic retinopathy is a frequent cause of VI and blindness in Chinese Americans that has not been commonly observed in other racial/ethnic groups. Because myopia frequently develops at a young age, Chinese Americans should be educated regarding the importance of regular screening of preschool and school-aged children to reduce the development and progression of myopia.