Prevalence of self-reported visual impairment among people in Canada with and without diabetes: findings from population-based surveys from 1994 to 2014

James H B Im; Graham E Trope; Yvonne M Buys; Peng Yan; Michael H Brent; Sophia Y Liu; Ya-Ping Jin

doi:10.9778/cmajo.20220116

Prevalence of self-reported visual impairment among people in Canada with and without diabetes: findings from population-based surveys from 1994 to 2014

CMAJ Open. 2023 Dec 5;11(6):E1125-E1134. doi: 10.9778/cmajo.20220116. Print 2023 Nov-Dec.

Authors

James H B Im¹, Graham E Trope¹, Yvonne M Buys¹, Peng Yan¹, Michael H Brent¹, Sophia Y Liu¹, Ya-Ping Jin²

Affiliations

¹ Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont.
² Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont. yaping.jin@utoronto.ca.

Abstract

Background: Diabetes, a leading cause of visual impairment, is on the rise in Canada. We assessed trends in the prevalence of visual impairment among people in Canada with and without diabetes to inform the development of strategies and policies for the management of visual impairment.

Methods: We analyzed self-reported data from respondents aged 45 years and older in 7 cycles of nationwide surveys (National Population Health Survey and Canadian Community Health Survey) from 1994/95 to 2013/14. The age- and sex-standardized prevalence of visual impairment was calculated. We assessed comparisons by levels of education and income, using sex-standardized prevalence owing to sparse data.

Results: Among people in Canada with diabetes, the age- and sex-standardized prevalence of visual impairment was 7.37% (95% confidence interval [CI] 5.31%-9.43%) in 1994/95 and 1996/97 combined, decreasing to 3.03% (95% CI 2.48%-3.57%) in 2013/14, giving a standardized prevalence ratio of 0.41 (95% CI 0.30-0.56) comparing 2013/14 with 1994/95 and 1996/97 combined. Among people in Canada without diabetes, visual impairment prevalence decreased from 3.72% (95% CI 3.31%-4.14%) in 1994/95 and 1996/97 combined to 1.69% (95% CI 1.52%-1.87%) in 2013/14, with a standardized prevalence ratio of 0.45 (95% CI 0.40-0.52). Decreased sex-standardized prevalence of visual impairment was observed among people with high and low education levels and incomes among those with and without diabetes.

Interpretation: Visual impairment prevalence was roughly 2 times higher among those with versus without diabetes in all survey years; from 1994 to 2014, visual impairment prevalence decreased among those with and without diabetes irrespective of education and income levels. These results suggest effective collective efforts by clinicians, researchers, the public and government.