Eye diseases in the elderly in Singapore.

Objective: The study was conducted to determine the prevalence rates of blindness and visual impairment in those aged 60 years and above in Singapore and to determine the pickup rate of undiagnosed eye diseases through an active screening programme. Method: A random frame of 3,000 elderly persons aged 60 years and above was obtained from the Ministry of Home Affairs in Singapore. They were invited by mail to attend eye screening at Hougang Senior Citizens' Health Care Centre. The eye screening was in two parts: the first part by a trained registered nurse or therapy aide and the second part by the opthalmologist. For each respondent, autorefraction, tonometry, retinal photography and visual field analysis were done. Examination criteria and disease classification were modelled after the Framingham Eye Study. Results: 574 subjects attended the screening, giving a response rate of 22.2%. The prevalence rates for blindness and visual impairment in the elderly screened were 3.0% and 15.2% respectively. The prevalence rates for cataract, age-related macular degeneration, glaucoma and diabetic retinopathy were 78.6%, 27.0%, 5.7% and 5.1% For every person known to have cataract, 2 were unknown; for every person with age-related macular degeneration, 154 were unknown. None of the 29 persons with diabetic retinopathy was diagnosed previously. Conclusion: Almost 1 in 5 of the elderly screened had some degree of visual disability. The rates of visual impairment and blindness were similar to those reported in other studies and indicate a significant burden of visually impairing diseases in the community.