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Common eye problems in American Indians/Alaskan Natives Steven L. Mansberger, M.D., M.P.H. Devers Eye Institute Portland, Oregon.

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Presentation on theme: "Common eye problems in American Indians/Alaskan Natives Steven L. Mansberger, M.D., M.P.H. Devers Eye Institute Portland, Oregon."— Presentation transcript:

1 Common eye problems in American Indians/Alaskan Natives Steven L. Mansberger, M.D., M.P.H. Devers Eye Institute Portland, Oregon

2 Disclosure S Santen: C Allergan: C, L National Eye Institute: S Centers for Disease Control and Prevention: S

3 Topics Studies in AI/AN Northwest Tribal Vision Project Results Future Directions

4 Most common causes of visual Impairment Blacks/Whites: Macular Degeneration, glaucoma, uncorrected refractive error (Baltimore Eye Survey) Hispanics: glaucoma, cataract, macular degeneration, diabetic retinopathy (LALES, Proyecto VER) Whites: Macular degeneration (Beaver Dam Study) Japan, Korea, India, Africa, Caribbean

5 Northwest Tribal Vision Project Purpose: Pilot study: To determine the prevalence of eye diseases in NW Native Americans To determine if a screening protocol is as accurate as a full eye exam in an ophthalmologist’s office Funding: American Glaucoma Society, National Eye Institute, and Centers for Disease Control and Prevention (CDC)

6 What is the Prevalence of Eye disease in Native Americans? Vision is the second leading cause of impairment Studies in Native Americans have been chart reviews or convenience Samples Navajo/Pima: diabetic retinopathy, cataracts, and trauma Alaskan Eskimos: angle closure glaucoma

7 Glaucoma in AI/AN Alaskan Eskimos: 0.6% (Arkell, 1987) Northwest AI/AN: 6.2% (Mansberger, 2005) Oklahoma AI/AN: 5.6% (Lee, 2005)

8 Retinal Diseases in AI/AN Diabetic Retinopathy 6.0% (Mansberger, 2005) 20.1% (Oklahoma, Lee, 2005) ARMD 16.9% (NW AI/AN, Mansberger, 2005) 33.6% (Oklahoma, Lee, 2005)

9 Proportion with Visual Impairment/Blindness 6.9% (20/288) with visual Impairment of the better eye with correction (20/40 vision or worse) 21% (61/288) visual impairment without correction 0.9% (3/288) Blind in the better seeing eye (20/200 or worse) Greater than U.S. population (Haymes, et al Ophthalmic Epi 2009)

10 Differences Exist in AI/AN anatomy and Eye Disease OD Vertical C/D = /-.18 (range ) One person (0.3%) had IOP > 21 mm Hg (95%CI=0-1.0%) 15 (6.2%) participants had glaucomatous optic discs and visual fields (95%CI= %). None with an IOP greater than 20 mm Hg.

11 Source: Genetree.com american-test.asp ? Differences also exist within AI/AN

12 Summary Vision problems are the second leading cause of impairment in AI/AN Uncorrected refractive error, cataract, and retinal diseases were the most common causes of visual impairment A rare form of glaucoma was more common in AI/AN Differences in eye problems occur even between AI/AN in different regions Research to determine the factors related to disparities in eye problems in AI/AN are needed


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