Factors Associated with Visual Impairment in Chinese American Adults: The Chinese American Eye Study

Purpose: To assess associations between multiple factors comprising a conceptual model of visual impairment (VI) in a population of Chinese Americans (CAs), and identify independent VI risk factors. Methods: A population-based study of 4582 CAs aged 50 years and older residing in Monterey Park, California. A comprehensive eye examination was performed. VI was defined as best-corrected visual acuity <20/40 (US definition) in the better-seeing eye. Results: Of five independent risk factors identified, age and self-reported history of ocular disease were most strongly associated with VI. Participants 70 years and older were 10.0 times as likely to have VI compared to those in their 50s (95% confidence interval (CI) 4.0-25.0), while those with a history of ocular disease were 4.2 times as likely to have VI (95% CI 2.2-7.8). Additional risk factors included low education (OR 2.8, 95% CI 1.7-4.8), low acculturation (OR 5.9, 95% CI 2.0-17.3) and self-reported history of diabetes (OR 2.0, 95% CI 1.2-3.2). A comparison to data previously described from the Los Angeles Latino Eye Study indicated that four of the factors that predict VI risk in CAs also represent clinically relevant risk factors for VI in Latinos. Conclusions: Screening programs for individuals with advanced age and a history of ocular disease have the potential to reduce the burden of VI in CAs, as do educational programs for those with fewer years in school, a history of diabetes, and low acculturation.