Racial Variations in Causes of Vision Loss in Nursing Homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study
Abstract
OBJECTIVE: To determine the prevalence and causes of low vision in a large sample of nursing home residents. METHODS: Twenty-eight nursing homes on the Eastern Shore of Maryland and Delaware were enrolled in a clinical trial to assess the impact of vision restoration/rehabilitation on nursing home residents. Visual acuity was measured using both recognition charts and preferential looking techniques. An ophthalmologist examined all residents with visual acuity worse than 20/40 in the better-seeing eye and determined the primary cause for decreased vision. Results are reported for the better-seeing eye. RESULTS: Of 2544 eligible residents, 1591 (63%) participated, but 286 residents were unable to respond to visual acuity testing. Of the remaining 1307 residents, 496 (37%) had best-corrected visual acuity worse than 20/40 in the better-seeing eye. Causes were ascribed for 412 subjects. Rates of low vision were similar between African American subjects and white subjects (39% and 38%, respectively; age-adjusted P =.18). Cataract was the leading cause of low vision, responsible for 37% of low vision among white subjects and 54% of low vision among African American subjects. Macular degeneration was responsible for 29% of low vision among white subjects but only 7% among African American subjects. Glaucoma caused low vision in 4% of white subjects and 10% of African American subjects. Refractive error was not a frequent cause of low vision in nursing home residents. CONCLUSIONS: Low vision is highly prevalent among nursing home residents, with 37% having visual acuity worse than 20/40 in the better-seeing eye. Differences in causes of low vision between African American subjects and white subjects were noted, with African American subjects more likely to have vision loss on the basis of cataract, a readily treated condition. Appropriate interventions for nursing home residents, who face significant obstacles in accessing eye care services, have the potential to improve the quality of life of this at-risk older population.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The incidence of early AMD, large drusen and pigmentary changes in intermediate AMD, and choroidal neovascularization and geographic atrophy in advanced AMD increase with advancing age.
“The incidence of early AMD, large drusen and pigmentary changes in intermediate AMD, and choroidal neovascularization (CNV) and GA in advanced AMD increase with advancing age (51, 93).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [51]
Epidemiological studies have revealed differences in the prevalence of advanced AMD among different ethnic groups.
“Epidemiological studies have revealed differences in the prevalence of advanced AMD among different ethnic groups (51, 3, 141).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [51]
Cites
Racial Differences in the Cause-Specific Prevalence of Blindness in East Baltimore
Sommer, A., Tielsch, J. M., Katz, J., Quigley, H. A., Gottsch, J. D., Javitt, J. C., Martone, J. F., Royall, R. M., Witt, K. A., & Ezrine, S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199111143252004 · Cited by 764 · see citing works
The Beaver Dam Eye Study: Visual Acuity
Klein, R., Klein, R., Linton, K. L. P., & Mets, D. L. D. (1991) · Ophthalmology · doi:10.1016/s0161-6420(91)32137-7 · Cited by 663 · see citing works
Muñoz, B. (2000) · Archives of Ophthalmology · doi:10.1001/archopht.118.6.819 · Cited by 521 · see citing works
The Cause-specific Prevalence of Visual Impairment in an Urban Population
Rahmani, B., Tielsch, J. M., Katz, J., Gottsch, J. D., Quigley, H. A., Javitt, J. C., & Sommer, A. H. (1996) · Ophthalmology · doi:10.1016/s0161-6420(96)30435-1 · Cited by 327 · see citing works
Racial differences in the prevalence of age-related macular degeneration
Friedman, D. S., Katz, J., Bressler, N. M., Rahmani, B., & Tielsch, J. M. (1999) · Ophthalmology · doi:10.1016/s0161-6420(99)90267-1 · Cited by 304 · see citing works
Self-citationThe Prevalence of Blindness and Visual Impairment among Nursing Home Residents in Baltimore
Tielsch, J. M., Javitt, J. C., Coleman, A. L., Katz, J., & Sommer, A. H. (1995) · New England Journal of Medicine · doi:10.1056/nejm199505043321806 · Cited by 260 · see citing works
Changes in Visual Acuity in a Population
Klein, R., Klein, B. E. K., & Lee, K. E. (1996) · Ophthalmology · doi:10.1016/s0161-6420(96)30526-5 · Cited by 234 · see citing works
Eye care utilization by older americans
Orr, P. R., Barrón, Y., Schein, O. D., Rubin, G. S., & West, S. K. (1999) · Ophthalmology · doi:10.1016/s0161-6420(99)00508-4 · Cited by 151 · see citing works
Causes of blindness and visual impairment in a population-based sample of U.S. Hispanics
Rodriguez, J., Sánchez, R., Muñoz, B. E., West, S. K., Broman, A. T., Snyder, R. W., Klein, R., & Quigley, H. A. (2002) · Ophthalmology · doi:10.1016/s0161-6420(01)01008-9 · Cited by 143 · see citing works
Geographic Variation in Utilization of Cataract Surgery
Javitt, J. C., Kendix, M., Tielsch, J. M., et al. (1995) · Medical Care · doi:10.1097/00005650-199501000-00008 · Cited by 120 · see citing works
Visual acuity measurements in a national sample of British elderly people
van der Pols, J. C. (2000) · British Journal of Ophthalmology · doi:10.1136/bjo.84.2.165 · Cited by 113 · see citing works
Visual impairment in nursing home residents: the Blue Mountains Eye Study
Mitchell, P., Hayes, P., & Wang, J. J. (1997) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1997.tb138724.x · Cited by 110 · see citing works
The Advanced Glaucoma Intervention Study, 6: Effect of Cataract on Visual Field and Visual Acuity
(2000) · Archives of Ophthalmology · doi:10.1001/archopht.118.12.1639 · Cited by 73 · see citing works
Visual impairment and eye diseases in elderly institutionalized Australians
VanNewkirk, M. R., Weih, L. M., McCarty, C. A., Stanislavsky, Y. L., Keeffe, J. E., & Taylor, H. R. (2000) · Ophthalmology · doi:10.1016/s0161-6420(00)00459-0 · Cited by 56 · see citing works
Eye Disease in a Geriatric Nursing Home Population
Whitmore, W. G. (1989) · Ophthalmology · doi:10.1016/s0161-6420(89)32880-6 · Cited by 51 · see citing works
West, S. K., Friedman, D. S., Muñoz, B. E., et al. (2003) · Ophthalmic Epidemiology · doi:10.1076/opep.10.3.193.15081 · Cited by 49 · see citing works
Self-citationMuñoz, B. E., West, S. K., Rubin, G. S., Schein, O. D., Fried, L. P., & Bandeen‐Roche, K. (1999) · Annals of Epidemiology · doi:10.1016/s1047-2797(98)00026-x · Cited by 48 · see citing works
Grating visual acuity using the preferential-looking method in elderly nursing home residents.
Friedman, D. S., Muñoz, B. E., Massof, R. W., et al. (2002) · PubMed · Cited by 42 · see citing works
Self-citationOffice visits to ophthalmologists and other physicians for eye care among the U.S. population, 1990.
Chiang, Y. P., Wang, F., & Javitt, J. C. (1995) · PubMed · Cited by 37 · see citing works
Visual acuity estimates in noncommunicative elderly persons.
Marx, M. S., Werner, P., Cohen‐Mansfield, J., et al. (1990) · PubMed · Cited by 30 · see citing works
Prevalence of Blindness and Visual Impairment among Institutional Residents
Peterson, R., & Kirchner, C. (1980) · Journal of Visual Impairment & Blindness · doi:10.1177/0145482x8007400814 · Cited by 20 · see citing works
Taiel-Sartral, M., Nounou, P., Rea, C., et al. (1999) · PubMed · Cited by 19 · see citing works
Practice Patterns of the Office-Based Ophthalmologist
Sastry, S. M., Chiang, & Javitt, J. C. (1994) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/1542-8877-19940201-04 · Cited by 15 · see citing works
Woodruff, M. E., & Pack, G. (1981) · PubMed · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ranibizumab for Neovascular Age-Related Macular Degeneration
Rosenfeld, P. J., Brown, D. M., Heier, J. S., Boyer, D. S., Kaiser, P. K., Chung, C. Y., & Kim, R. Y. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa054481 · Cited by 5,886 · see citing works
Ranibizumab versus Verteporfin for Neovascular Age-Related Macular Degeneration
Brown, D. M., Kaiser, P. K., Michels, M., Soubrane, G., Heier, J. S., Kim, R. Y., Sy, J. P., & Schneider, S. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa062655 · Cited by 3,522 · see citing works
Age-related macular degeneration
Jager, R. D., Mieler, W. F., & Miller, J. W. (2008) · New England Journal of Medicine · doi:10.1056/nejmra0801537 · Cited by 1,379 · see citing works
Seven new loci associated with age-related macular degeneration
The AMD Gene Consortium (2013) · Nature Genetics · doi:10.1038/ng.2578 · Cited by 788 · see citing works
Age-related macular degeneration
de Jong, P. T. V. M. (2006) · New England Journal of Medicine · doi:10.1056/nejmra062326 · Cited by 787 · see citing works
Combadière, C., Feumi, C., Raoul, W., Keller, N., Rodéro, M., Pézard, A., Lavalette, S., Houssier, M., Jonet, L., Picard, E., et al. (2007) · Journal of Clinical Investigation · doi:10.1172/jci31692 · Cited by 618 · see citing works
Zareparsi, S., Branham, K. E. H., Li, M., Shah, S., Klein, R. J., Ott, J., Hoh, J., Abecasis, G. R., & Swaroop, A. (2005) · The American Journal of Human Genetics · doi:10.1086/431426 · Cited by 371 · see citing works
A rare penetrant mutation in CFH confers high risk of age-related macular degeneration
Raychaudhuri, S., Iartchouk, O., Chin, K., Tan, P. L., Tai, A. K., Ripke, S., Gowrisankar, S., Vemuri, S., Montgomery, K., Yu, Y., et al. (2011) · Nature Genetics · doi:10.1038/ng.976 · Cited by 323 · see citing works
Missense Variations in the Fibulin 5 Gene and Age-Related Macular Degeneration
Stone, E. M., Braun, T. A., Russell, S. R., Kuehn, M. H., Lotery, A. J., Moore, P. A., Eastman, C. G., Casavant, T. L., & Sheffield, V. C. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040833 · Cited by 324 · see citing works
Swaroop, A., Chew, E. Y., Bowes Rickman, C., & Abecasis, G. R. (2009) · Annual Review of Genomics and Human Genetics · doi:10.1146/annurev.genom.9.081307.164350 · Cited by 270 · see citing works
Ma, L., Dou, H.-L., Wu, Y.-Q., Huang, Y.-M., Huang, Y.-B., Xu, X.-R., Zou, Z.-Y., & Lin, X.-M. (2012) · British Journal of Nutrition · doi:10.1017/s0007114511004260 · Cited by 237 · see citing works
Simultaneous perception of prosthetic and natural vision in AMD patients
Palanker, D., Le Mer, Y., Mohand-Said, S., & Sahel, J. A. (2022) · Nature Communications · doi:10.1038/s41467-022-28125-x · Cited by 140 · see citing works
Tuo, J., Ning, B., Bojanowski, C. M., Lin, Z.-N., Ross, R. J., Reed, G. F., Shen, D., Jiao, X., Zhou, M., Chew, E. Y., et al. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0603485103 · Cited by 114 · see citing works
Zysset-Burri, D. C., Keller, I., Berger, L. E., Largiadèr, C. R., Wittwer, M., Wolf, S., & Zinkernagel, M. S. (2020) · npj Genomic Medicine · doi:10.1038/s41525-020-00141-0 · Cited by 94 · see citing works
Kaufman, Y., Ma, L., & Washington, I. (2011) · Journal of Biological Chemistry · doi:10.1074/jbc.m110.178640 · Cited by 78 · see citing works
miRNAs as potential therapeutic targets for age-related macular degeneration
Wang, S., Koster, K. M., He, Y., & Zhou, Q. (2012) · Future Medicinal Chemistry · doi:10.4155/fmc.11.176 · Cited by 67 · see citing works
Bojanowski, C. M., Shen, D., Chew, E. Y., Ning, B., Csaky, K. G., Green, W. R., Chan, C., & Tuo, J. (2006) · Environmental and Molecular Mutagenesis · doi:10.1002/em.20233 · Cited by 62 · see citing works
Lamin, A., Oakley, J. D., Dubis, A. M., Russakoff, D. B., & Sivaprasad, S. (2019) · Eye · doi:10.1038/s41433-018-0234-9 · Cited by 57 · see citing works
Evidence for association between multiple complement pathway genes and AMD
Dinu, V., Miller, P. L., & Zhao, H. (2007) · Genetic Epidemiology · doi:10.1002/gepi.20204 · Cited by 58 · see citing works
Dendritic and Synaptic Protection: Is It Enough to Save the Retinal Ganglion Cell Body and Axon?
Morquette, J. B., & Di Polo, A. (2008) · Journal of Neuro-Ophthalmology · doi:10.1097/wno.0b013e318177edf0 · Cited by 51 · see citing works
Proteomic analysis of mature melanosomes from the retinal pigmented epithelium
Azarian, S. M., McLeod, I., Lillo, C., Gibbs, D., Yates, J. R., & Williams, D. S. (2006) · Journal of Proteome Research · doi:10.1021/pr0502323 · Cited by 35 · see citing works
Sobrin, L., Maller, J. B., Neale, B. M., Reynolds, R. C., Fagerness, J. A., Daly, M. J., & Seddon, J. M. (2010) · European Journal of Human Genetics · doi:10.1038/ejhg.2009.185 · Cited by 31 · see citing works
Parmeggiani, F., Gallenga, C. E., Costagliola, C., Semeraro, F., Romano, M. R., Dell’Omo, R., Russo, A., De Nadai, K., Gemmati, D., D’Angelo, S., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-38919-7 · Cited by 7 · see citing works
Kachi, I., Yasukawa, T., Kato, A., Takase, N., Morita, H., Kubota, A., Hirano, Y., Uemura, A., & Ogura, Y. (2016) · Japanese Journal of Ophthalmology · doi:10.1007/s10384-016-0434-4 · Cited by 6 · see citing works
- Authors
- Friedman, D. S.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Friedman, David S.
- ORCID
- Friedman, David S.
- Venue
- Archives of Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 2004-07-01
- Volume
- 122
- Issue
- 7
- Pages
- 1019
- ISSN
- 0003-9950 (ISSN-L)
- OpenAlex
- W2166208118
- Cited by
- 656
- References
- 24
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 16 · 2020: 19 · 2019: 14 · 2018: 22 · 2017: 18 · 2016: 41 · 2015: 50 · 2014: 49 · 2013: 69 · 2012: 49
- FWCI
- 23.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 15812, R01AG015812)
- Topics
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- low vision, vision loss, nursing home residents, racial disparities, African Americans, cataract, macular degeneration, glaucoma, refractive error, visual acuity, older adults, access to eye care
- MeSH terms
- Aged, Aged, 80 and over, Black or African American, Blindness, Delaware, Eye Diseases, Female, Homes for the Aged, Humans, Male, Maryland, Nursing Homes, Visual Acuity, Vision, Low, Causality, Prevalence, Black People, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
