Tien Tay

Children's Hospital at Westmead, Sydney, New South Wales, Australia

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Publications (7)12.56 Total impact

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    ABSTRACT: To assess influences from visual or hearing impairment on use of community support services and health-related quality of life in aged care clients. The authors sampled 284 frail elderly individuals presenting for assessment in Sydney, Australia. Moderate to severe visual impairment was defined as visual acuity <20/80 (better eye), and moderate to severe hearing loss as hearing thresholds >40 decibels (better ear). Community support services included home-delivered meals, home help, and community nurse visits. After adjusting for age, sex, and two or more comorbid conditions, moderate to severe visual impairment, but not moderate to severe hearing loss, was significantly associated with increased use of community services (adjusted odds ratio 2.8, 95% confidence interval = 1.0-7.8). Moderate to severe visual impairment was associated with an increased likelihood of community service utilization in this aged care client sample.
    Journal of Aging and Health 04/2007; 19(2):229-41. · 1.56 Impact Factor
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    ABSTRACT: To characterize the ophthalmic features and causes of visual loss in a cohort of Melanesians living in New Caledonia with nanophthalmos. In this observational study, axial length, visual acuity (VA), cycloplegic autorefraction were assessed and dilated fundus examination was performed. Visual impairment was defined as VA<6/12 in the better eye, hypermetropia as >+1.0 dioptre (D), astigmatism as >or=1.0 D and anisometropia as >or=1.0 D difference between both eyes. Unilateral amblyopia was defined as at least a two-line difference in VA between both eyes and bilateral amblyopia as VA<6/12 in both eyes which was not adequately explained by refractive error and macular folds. Seventeen community-dwelling participants (aged 1.1-45.3 years) with short axial length (range from 16.1 to 21.6 mm) were identified. Of the 17 subjects, 14 were found to have crowded optic discs, three with papillomacular folds, three with a papillomacular band and three with macular radial folds. Further, all subjects demonstrated bilateral hypermetropia (range from +1.3 D to +15.1 D). A high proportion of subjects had astigmatism (12) and anisometropia (nine) in at least one eye. Visual impairment was found in nine subjects: five bilateral and four unilateral. Causes of visual impairment included amblyopia (seven), ametropia (seven) and macular folds (two). Amblyopia was attributed to several factors, including hypermetropia, anisometropia, astigmatism and esotropia. In this sample of Melanesians with nanophthalmos, a spectrum of ophthalmic features that was consistent with intraocular crowding was found. Over half of the subjects were visually impaired, mostly due to amblyopia and ametropia. Further characterization of the underlying genetic cause of nanophthalmos in this cohort will be the focus of future studies.
    Clinical and Experimental Ophthalmology 01/2007; 35(4):348-54. · 1.96 Impact Factor
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    ABSTRACT: To assess the association between sensory and cognitive function, and the potential influence of visual function on cognitive function assessment, in a sample of clients accessing aged care services. We recruited 260 non-institutionalised, frail, older individuals who sought aged care services. Visual acuity was assessed using a LogMAR chart and hearing function was measured using a portable pure-tone air conduction audiometer. Visual impairment was defined as visual acuity (VA) <6/12 (<39 letters read correctly in the better eye), moderate-to-severe hearing impairment as hearing thresholds >40 decibels (better ear) and cognitive impairment as Mini-Mental State Examination (MMSE) score <24. Vision and hearing assessments were randomly performed in 168 and 164 aged care clients, respectively. Visual acuity correlated weakly with MMSE scores, either including (r = 0.27, P <0.001) or excluding (r = 0.21, P = 0.006) vision-related MMSE items. After partialling out the effect of age, the association remained (r = 0.23, P = 0.013 including, or r = 0.18, P = 0.044 excluding vision-related items). No correlation was found between MMSE scores and hearing thresholds (r = -0.07, P = 0.375). After adjusting for age, sex and stroke, mean MMSE scores were lower in persons with visual impairment than those with normal vision (25.2 + 0.5 versus 26.8 + 0.4 including, or 18.2 + 0.5 versus 19.2 + 0.3 excluding vision-related items), but were similar between subjects with none or mild and those with moderate-to-severe hearing loss (26.3 + 0.4 versus 26.0 + 0.4). In this study sample, visual and cognitive functions were modestly associated, after excluding the influence of visual impairment on the MMSE assessment and adjusting for age. Hearing thresholds were not found to be associated with cognitive function.
    Annals of the Academy of Medicine, Singapore 05/2006; 35(4):254-9. · 1.36 Impact Factor
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    ABSTRACT: To assess the need for, and the use of eye care services in older people seeking aged care. In total, 188 people (69.1% of those eligible) aged 65+ years who were assessed for aged care provision at Westmead Hospital, Sydney, were recruited in 2003 and re-examined a year later. At baseline, presenting visual acuity (VA) was randomly assessed in half the participants. People with under-corrected refractive error (pinhole VA improved at least 10 letters in those with presenting VA <6/6), bilateral visual impairment (better eye VA <6/12), or self-reported visual problems, were recommended to have further assessment by eye care professionals. At follow up, information on utilization of eye care services in the past 12 months was collected and VA was assessed in all returned participants. Of the 188 baseline participants, 121 (70% of survivors) were revisited a year later. Overall, 90/121 participants (74%) had seen an eye care professional in the previous year. Of the 66 participants who were recommended to see an eye care professional, 42 (64%) were revisited and 37/42 (88%) complied with the recommendation. At revisit, bilateral visual impairment was found in 49/120 (41%). The proportion with bilateral visual impairment was lower in participants whose vision was assessed at baseline (35%) than in those whose vision was not assessed (47%, P = 0.17), and also lower among people who had visited an eye care professional during the previous 12 months (39%) than those who had not (45%, P = 0.57). This pilot study indicates a relatively high need for, and high utilization of eye care services in the subgroup of older people seeking aged care services.
    Clinical and Experimental Ophthalmology 04/2006; 34(2):141-5. · 1.96 Impact Factor
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    ABSTRACT: Explanations for associations found between sensory and cognitive function remain unclear. To assess in an older Australian population: (1) the correlation between sensory and cognitive function across groups with a narrow age range; (2) any independent association between sensory and cognitive impairment. We examined 3,509 non-institutionalised residents aged 50+ years in the second cross-sectional survey of the Blue Mountains Eye Study (1997-2000). Visual impairment was defined for best-corrected visual acuity (VA) < 6/12 in the better eye, moderate to severe hearing loss for hearing threshold > 40 dB (better ear), and likely cognitive impairment for Mini-Mental State Examination (MMSE) < 24 points. We found likely cognitive impairment in 3.3%, vision impairment in 2.7% and moderate to severe hearing loss in 10.5% of this population. Correlation between VA or hearing threshold and MMSE score increased with age. After adjusting for age, weak but significant correlation was evident in the normal ageing sample between vision and MMSE (r = 0.12 with vision items included and r = 0.11 with vision items excluded, both p < 0.0001), and between hearing thresholds and MMSE (r = -0.12, p < 0.0001). After adjusting for age, sex, education and history of stroke, persons with vision impairment had a lower mean MMSE score than those with normal vision, regardless of whether vision-related items were included (27.1 vs. 28.6, p < 0.001) or excluded (19.8 vs. 21.0, p < 0.001). Similarly, persons with moderate to severe hearing loss had a lower mean MMSE score than those without hearing loss (28.1 vs. 28.7, p < 0.001). Persons with likely cognitive impairment also had lower mean VA and higher mean hearing threshold than those without, after adjustment. We have documented an age-related correlation between sensory and cognitive function in a normal ageing sample. The association between sensory impairment and likely cognitive impairment remained significant after excluding vision-related MMSE items and adjusting for confounding factors. Our data suggest that age-related decline and the effect of visual impairment on the measurement of cognition only partly explain the association between sensory and cognitive impairments in older persons.
    Gerontology 01/2006; 52(6):386-94. · 2.68 Impact Factor
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    ABSTRACT: To assess temporal associations between vision and self-rated health. We examined 3654 Australian residents (82.4% response) aged 49+ years in the Blue Mountains Eye Study, during 1992 to 1994, and re-examined 2334 in 1997 to 1999. Change in vision was defined if baseline and 5-year visual acuity (VA) changed by > or =10 letters (2 lines). Change in self-rated health was defined if overall health ranking (excellent, good, fair, poor) changed by > or =1 step. Of 2285 participants with data from both examinations, 59.8%, 23.9%, and 16.3% reported unchanged, declined, and improved self-rated health, respectively. Among persons whose self-rated health declined, the proportions with a decline in presenting VA, no change, or improvement were similar (25.2%, 23.8% and 22.5%, respectively, p for trend = 0.5). Among participants with decline, no change, or improvement in self-rated health, a similar magnitude in the age-sex adjusted mean VA decline (-1.0 to -2.7 letters) was observed. After adjusting for age, sex, hospitalizations, and incident chronic conditions, declining VA was not associated with increased decline in 5-year self-rated health (multivariate-adjusted odds ratio 0.99, 95% CI 0.75-1.30). There were no parallel 5-year changes in self-rated health and vision in this population.
    Ophthalmic Epidemiology 06/2005; 12(3):179-84. · 2.18 Impact Factor
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    ABSTRACT: In this sample of craniofrontonasal dysplasia, a 44.4% prevalence of visual impairment was observed, with more than half being due to potentially correctable causes of visual loss, including amblyopia and anisometropia. High prevalences of strabismus (88.9%) and V-pattern (55.5%) in craniofrontonasal dysplasia were also demonstrated. All three patients who underwent strabismus surgery showed improvement in ocular alignment postoperatively. This group needs regular eye examinations to assess for visual impairment and provide timely intervention for modifiable causes of visual loss.
    Journal of Pediatric Ophthalmology & Strabismus 44(4):251-4. · 0.86 Impact Factor

Publication Stats

55 Citations
12.56 Total Impact Points

Institutions

  • 2007
    • Children's Hospital at Westmead
      Sydney, New South Wales, Australia
    • University of Sydney
      • Centre for Vision Research
      Sydney, New South Wales, Australia
  • 2005–2006
    • Westmead Millennium Institute
      Sydney, New South Wales, Australia