The epidemiology of cataract in Autralia Original Reearch Article

PURPOE: To decribe the prevalence and rik factor for cataract in an Autralian population aged 40 year and older. METHOD: Participant were recruited by a houehold cenu and tratified, random cluter ampling to repreent reident of Victoria, Autralia, aged 40 year and older. The following information wa collected: initial viual acuity and bet-corrected viual acuity, demographic detail, health hitory, dietary intake of antioxidant, lifetime ocular ultraviolet B expoure, and clinical eye examination, including len photography. Cortical opacitie were meaured in ixteenth. Cortical cataract wa defined a opacity greater than or equal to 4/16 of pupil circumference. Nuclear opacitie were graded according to the Wilmer cataract grading cheme, and cataract wa defined a greater than or equal to nuclear tandard 2.0 of four tandard. The height and width of any poterior ubcapular opacity wa meaured and recorded. Poterior ubcapular cataract wa defined a poterior ubcapular opacity greater than or equal to 1 mm2. The wore eye wa elected for analyi. Backward tepwie logitic regreion wa ued to quantify independent rik factor for cataract. REULT: A total of 3,271 (83% of eligible) of the urban reident, 403 (90% of eligible) nuring home reident, and 1,473 (92% of eligible) rural reident participated. The urban reident ranged in age from 40 to 98 year (mean, 59 year), and 1,511 (46%) were men. The nuring home reident ranged in age from 46 to 101 year (mean, 82 year), and 85 (21%) were men. The rural reident ranged in age from 40 to 103 year (mean, 60 year), and 701 (47.5%) were men. The overall weighted rate of cortical cataract wa 11.3% (95% confidence limit, 9.68%, 13.0%) excluding cataract urgery and 12.1% (95% confidence limit, 10.5%, 13.8%) including cataract urgery. The rik factor for cortical cataract that remained in the multivariate logitic regreion model were age, female gender, diabete duration greater than 5 year, gout duration greater than 10 year, arthriti diagnoi, myopia, ue of oral beta-blocker, and increaed average annual ocular ultraviolet B expoure. Overall, 12.6% (95% confidence limit, 9.61%, 15.7%) of Victorian aged 40 year and older had nuclear cataract including previou cataract urgery, and 11.6% (95% confidence limit, 8.61%, 14.7%) had nuclear cataract excluding previou cataract urgery. In the urban and rural cohort, age, female gender, rural reidence, brown iride, diabete diagnoed 5 or more year earlier, myopia, age-related maculopathy, having moked for greater than 30 year, and an interaction between ocular ultraviolet B expoure and vitamin E were all rik factor for nuclear cataract. The rate of poterior ubcapular cataract excluding previou cataract urgery wa 4.08% (95% confidence limit, 3.01%, 5.14%), wherea the overall rate of poterior ubcapular cataract including previou cataract urgery wa 4.93% (95% confidence limit, 3.68%, 6.17%). The independent rik factor for poterior ubcapular cataract in the urban and rural cohort that remained were age in year, rural location, ue of thiazide diuretic, vitamin E intake, and myopia. CONCLUION: The expected increae in the prevalence of cataract with the aging of the population highlight the need to plan appropriate medical ervice and public health intervention for primary and econdary prevention. Many of the identified rik factor for cataract in the population have the potential for being modified through public health intervention.