Prevalence and Causes of Vision Impairment and Blindness in Older Adults in Brazil: The S√£o Paulo Eye Study

  • The purpose of this study is to Investigate prevalence and causes of vision impairment/blindness in older adults in a low-middle income area of São Paulo, Brazil.

  • Cluster sampling, based on geographically defined census sectors, was used in randomly selecting cross-sectionally persons 50 years of age or older. Subjects were enumerated through a door-to-door survey and invited for measurement of presenting and best-corrected visual acuity and an ocular examination. The principal cause was identified for eyes with presenting visual acuity less than 20/32.

  • A total of 4,224 eligible persons in 2,870 households were enumerated, and 3,678 (87.1%) examined.

  • The prevalence of presenting visual acuity ≥20/32 in both eyes was 61.6% (95% confidence interval [CI]: 59.4%–63.9%), and 80.4% (95% CI: 78.8%–82.1%) with best correction.

  • The prevalence of visual impairment (<20/63 to ≥20/200) in the better eye was 4.74% (95% CI: 3.97%–5.53%), and 2.00% (95% CI: 1.52%–2.49%) with best correction.

  • The prevalence of presenting bilateral blindness (<20/200) was 1.51% (95% CI: 1.20%–1.82%), and 1.07% (95% CI: 0.79%–1.35%) with best correction.

  • Presenting blindness was associated with older age and lack of schooling. Retinal disorders (35.3%) and cataract (28.3%) were the most common causes of blind eyes.

  • Cataract (33.2%), refractive error (32.3%), and retinal disorders (20.3%) were the main causes of vision impairment <20/63 to ≥20/200, with refractive error (76.8%) and cataract (12.2%) as main causes for eyes with acuity <20/32 to ≥20/63.

  • Vision impairment is a significant problem in older Brazilians reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling.

Publication date

November 19, 2018


Ophthalmic Epidemiology


Salomao, S. R., Cinoto, R. W., Berezovsky, A., Araujo-Filho, A., Mitsuhiro, M. R., Mendieta, L., Morales, P. H., Pokharel, G. P., Belfort, R., Ellwein, L. B.
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