ABSTRACT: BACKGROUND: To evaluate the impact of blindness on hospitalization rates of children. DESIGN: Matched cohort study. PARTICIPANTS: Children confirmed as legally blind (2003-2009), age and gender matched to control cohort of normally sighted children from the state register of births. METHODS: The rates and reasons for admission to hospital were compared using hospital morbidity records. The association of blindness with rates of admission and length of stay in hospital, 2003-2010, were estimated using multivariate negative binomial regression models. MAIN OUTCOME MEASURES: Descriptive statistics, incident rate ratios and predicted means for hospital separations and length of stay. RESULTS: 59 blind and 59 control children had a combined total of 107 separations accounting for 237 bed days in hospital, after the index date of legal blindness. The median age at the index date was 8 years. Over 90% of separations and 92% of bed days were incurred by 22 blind children. Blind children had 4 (95%CI 1.9 - 9.3) times more hospital separations and stayed in hospital 6 (95% CI 1.9 - 17.5) times longer than the control cohort children. There were more than 40 times as many comorbidities recorded by the blind children (n=201) compared to the control children (n=5). A third of the blind children were hospitalized for respiratory conditions. CONCLUSIONS: Children who are born or become blind in childhood have more and longer periods in hospital than sighted children, likely due to complex co-morbid health problems. There was a disproportionate incidence of comorbid respiratory diseases in the blind children.
Clinical and Experimental Ophthalmology 02/2013; · 1.98 Impact Factor
ABSTRACT: To validate the accuracy of clinical ophthalmic information held on the West Australian blind register.
Community-based cross-sectional study.
Legally blind or severely vision-impaired people were selected randomly from the Association for the Blind of Western Australia register.
Individuals were reviewed by one of two consultant ophthalmologists.
The positive predictive value (ppv), sensitivity and specificity for legal blindness status and diagnostic causes of vision loss were calculated using data extracted from the Association for the Blind of Western Australia blind register.
273 blind or near blind people were reviewed from the register total of 4271 individuals. There were more women (57%) than men, median age 81 years. For legal blindness status the ppv was 0.88 (95% confidence interval [CI] 0.82-0.92), sensitivity 0.75 (95% CI 0.74-0.84) and specificity 0.6 (95% CI 0.46-0.73). The ppv for the diagnostic causes of blindness were: age-related macular degeneration = 0.95 (95% CI 0.91-0.97), retinitis pigmentosa ppv = 1 (95% CI 0.81-1.0), diabetic retinopathy ppv = 0.9 (95% CI 0.57-0.99), optic neuropathies ppv = 0.77 (95% CI 0.51-0.92) and glaucoma ppv = 0.87 (95% CI 0.7-0.96). Forty individuals (15%) had treatable conditions contributing to their vision loss.
The blind register diagnoses and legal blindness status are of high accuracy. This information allows useful linkages to other databases for studies of blindness interactions. A regular updating mechanism would improve the future accuracy of this valuable regional asset. The presence of untreated cataract suggests that regular follow up and appropriate treatment may help optimize vision in blind patients.
Clinical and Experimental Ophthalmology 08/2011; 39(6):494-500. · 1.98 Impact Factor
ABSTRACT: To explore the interaction between vision impairment, perceived quality of life loss and willingness to trade remaining life for vision gain.
Community-based cross-sectional study.
Legally blind or severely vision-impaired people selected randomly from the Association for the Blind of Western Australia register.
Individuals were examined by consultant ophthalmologists and completed the Impact of Vision Impairment profile quality of life assessment and a Time Trade-Off evaluation. Vision-related utility values were calculated. The results were analysed using univariate and multivariate regression methods.
IVI Rasch Logits and TTO utility values (TTO UV).
156 people volunteered to contribute to the study. The median age was 80 (19-97) years, and 56% were female. Being legally blind (logMAR > 1) (95% CI 1.1 to 5.2, P = 0.003), clinically depressed (95% CI -11.2 to -1.8, P = 0.007) or more than 40 years of age (95% CI 0.9 to 8.1, P = 0.015) significantly lowered overall impact of vision impairment scores. The emotional domain of impact of vision impairment was associated with willingness to trade part of remaining life. A 5-Logit increase in impact of vision impairment emotional score resulted in a 21% (95% CI 10 to 31) decrease in the odds of being likely to trade life for sight. The Australian definition of blindness compared with World Health Organisation or USA best separates those with perceived loss and appears useful in identifying vision loss-related morbidity.
These results suggest that emotional health and lack of depression are important determinants for quality and value of life.
Clinical and Experimental Ophthalmology 11/2010; 39(4):336-43. · 1.98 Impact Factor
Clinical and Experimental Ophthalmology 04/2010; 38(7):736-7. · 1.98 Impact Factor