Prevalence of cataract in Australia: the Blue Mountains eye study.

PURPOSE The authors determined the age and gender-specific prevalence of nuclear, cortical, and posterior subcapsular cataract (PSC) in a representative sample of older Australians. METHODS As part of a population-based study of eye disease in the Blue Mountains, west of Sydney, 3654 people aged 49 to 96 years underwent a detailed eye examination, including lens photography (slit-lamp and retroillumination). The photographs were assessed by masked graders using the Wisconsin Cataract Grading System, with acceptable reproducibility. RESULTS Past cataract surgery had been performed in either eye of 6.0% and in both eyes of 2.9% of participants in this study, equally in men and women. Moderate or advanced nuclear opacities were present in 53.3% of women and 49.7% of men. Moderate cortical cataract was present in 25.9% of women and 21.1% of men. Posterior subcapsular cataract was less frequent, found in 6.2% of women and 6.5% of men. After adjusting for age, these gender differences were statistically significant only for cortical cataract. The age-specific prevalence rates found for early and late cataract or for past cataract surgery are very similar to rates reported in the Beaver Dam Eye Study (BDES), Wisconsin, using the same definitions. Comparison of age-specific rates for each cataract type indicated lower rates for nuclear cataract, slightly lower rates for PSC and slightly higher rates for cortical cataract compared with the BDES. However, the rates for nuclear cataract were the only statistically significant differences between the two studies. Previously described susceptibility of the lower nasal lens to cortical cataract was confirmed, supporting a potential role of sunlight exposure in its development. CONCLUSIONS The Wisconsin cataract grading system was used in an older Australian population with acceptable reproducibility. The Blue Mountains Eye Study found similar age-specific prevalence rates for most of the types and stages of cataract compared with the BDES.

[1]  P. Mitchell,et al.  Visual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study. , 1996, Ophthalmology.

[2]  D. Streiner,et al.  Health Measurement Scales: A practical guide to thier development and use , 1989 .

[3]  K L Linton,et al.  Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. , 1992, Ophthalmology.

[4]  R. Klein,et al.  The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. , 1992, Ophthalmology.

[5]  R. Klein,et al.  Is There Evidence of an Estrogen Effect on Age-Related Lens Opacities?: The Beaver Dam Eye Study , 1994 .

[6]  H. Taylor.  The prevalence of corneal disease and cataracts in Australian aborigines in Northwestern Australia. , 1980, Australian journal of ophthalmology.

[7]  S. West,et al.  The clinical grading of lens opacities. , 1989, Australian and New Zealand journal of ophthalmology.

[8]  R. Klein,et al.  Relation between lens opacities and vitamin and mineral supplement use. , 1994, Ophthalmology.

[9]  I L Bailey,et al.  Clinical grading and the effects of scaling. , 1991, Investigative ophthalmology & visual science.

[10]  M. C. Leske,et al.  The Lens Opacities Classification System III , 1993 .

[11]  M. Coroneo.  Pterygium as an early indicator of ultraviolet insolation: a hypothesis. , 1993, The British journal of ophthalmology.

[12]  B. Munoz,et al.  Prevalence of lens opacities in surgical and general populations. , 1991, Archives of ophthalmology.

[13]  R. Klein,et al.  Ultraviolet light exposure and lens opacities: the Beaver Dam Eye Study. , 1992, American journal of public health.

[14]  R. Klein,et al.  Cigarette smoking and lens opacities: the Beaver Dam Eye Study. , 1993, American journal of preventive medicine.

[15]  P. Pasquini,et al.  Distribution of lens opacities in the Italian-American Case-Control Study of Age-Related Cataract. The Italian-American Study Group. , 1990, Ophthalmology.

[16]  J. Lepkowski,et al.  Associations among cataract prevalence, sunlight hours, and altitude in the Himalayas. , 1983, American journal of epidemiology.

[17]  R. Milton,et al.  A dose-response effect between a sunlight index and age-related cataracts , 1994 .

[18]  M Palta,et al.  Serum carotenoids and tocopherols and severity of nuclear and cortical opacities. , 1995, Investigative ophthalmology & visual science.

[19]  J C Javitt,et al.  The content and cost of cataract surgery. , 1993, Archives of ophthalmology.

[20]  T. Dawber,et al.  The Framingham Eye Study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973-1975. , 1980, Survey of ophthalmology.

[21]  P. Mitchell,et al.  Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study. , 1996, Ophthalmology.

[22]  R. Klein,et al.  Alcohol use and lens opacities in the Beaver Dam Eye Study. , 1993, Archives of ophthalmology.

[23]  M. Coroneo.  Albedo concentration in the anterior eye: a phenomenon that locates some solar diseases. , 1990, Ophthalmic surgery.

[24]  R. Klein,et al.  Diet and nuclear lens opacities. , 1995, American journal of epidemiology.

[25]  N. Brown,et al.  Is cortical spoke cataract due to lens fibre breaks? The relationship between fibre folds, fibre breaks, waterclefts and spoke cataract , 1993, Eye.

[26]  B. Munoz,et al.  Cortical lenticular opacification: distribution and location in a longitudinal study. , 1994, Investigative ophthalmology & visual science.

[27]  A D Négrel,et al.  Global data on blindness. , 1995, Bulletin of the World Health Organization.

[28]  L T Chylack,et al.  Lens opacities classification system II (LOCS II) , 1989, Archives of ophthalmology.

[29]  F S Rosenthal,et al.  Effect of ultraviolet radiation on cataract formation. , 1988, The New England journal of medicine.

[30]  J. J. Wang,et al.  Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. , 1995, Ophthalmology.

[31]  R. Klein,et al.  Is age-related maculopathy associated with cataracts? , 1994, Archives of ophthalmology.

[32]  H R Taylor,et al.  A population-based estimate of cataract prevalence: the Melbourne Visual Impairment Project experience. , 1994, Developments in ophthalmology.

[33]  R. Anderson,et al.  The optics of human skin. , 1981, The Journal of investigative dermatology.

[34]  K L Linton,et al.  Assessment of cataracts from photographs in the Beaver Dam Eye Study. , 1990, Ophthalmology.

[35]  A. Ho,et al.  Peripheral light focusing by the anterior eye and the ophthalmohelioses. , 1991, Ophthalmic surgery.

[36]  S. Zigman,et al.  The role of sunlight in human cataract formation. , 1983, Survey of ophthalmology.