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Visual field loss tied to impaired daily functioning in elderly

NEW YORK (Reuters Health) – Nearly 6% of community-dwelling elderly people have visual field loss, and often the deficit interferes with daily functioning, according to a report published in the December issue of the Archives of Ophthalmology.

Dr. Paulus T. V. M. de Jong, from the Netherlands Ophthalmic Research Institute in Amsterdam, and colleagues performed a population-based cohort study to assess the prevalence and causes of visual field loss in 6250 community-dwelling elderly residents.

The researchers found that 5.6% of residents had visual field loss. Furthermore, 2% of subjects had bilateral visual field loss. The prevalence of visual field loss increased dramatically from 3% for residents 55 to 64 years of age to 19% for subjects 85 years of age and older.

Glaucoma was the leading cause of visual field loss. For subjects younger than 75 years, the next most common causes were optic nerve head diseases and stroke. In older age groups, age-related macular degeneration and retinal vascular occlusive disease ranked second and third, respectively, after glaucoma.

Regardless of visual acuity, visual field loss was tied to increased disability, diminished enjoyment of reading and watching television, and a higher risk of incident falling, the investigators note. The risk of hip fracture, however, was not linked to visual field loss.

Findings from previous studies suggest that visual field loss may cause an impairment of daily functioning, the authors state. However, "these studies were cross-sectional and clinic based, or did not exclude the effect of low visual acuity," they add.

Arch Ophthalmol 2001;119:1788-1794.

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