Refractive Error of the Elderly Presenting to a University Eye Clinic

The prevalence of refractive errors varies by age and gender and is closely related to functional difficulties, ocular diseases, and decreased quality of life. The purpose of this study was to assess associations of age and gender with refractive errors of the elderly presenting at a university clinic. Retrospective review of medical records of elderly patients presenting for eye services in 2020-2021. Demographic, ocular disease and refractive data were collected and analyzed. The number of 1,452 patients aged 60 and over with a mean age of 69.6 ± 8.09 years (range 60 to 101 years) were included. The prevalence of myopia, hyperopia, astigmatism, and anisometropia was 22.4%, 36.5%, 22.7%, and 19.4%, respectively. Compared to those aged 80 and above, myopia increased 5.171 times in those 60-69 yrs and 4.930 times among those 70-79 yrs. Men were significantly more likely to have myopia than women (p<0.001). Hyperopia was significantly less prevalent in those aged 70-79 and aged 80 and above compared to those aged 60-69 (p<0.001). Gender was not associated with hyperopia (p=0.066). The prevalence of astigmatism and anisometropia was higher in older subjects. Astigmatism shifted from with-the-rule (WTR) to against-the-rule (ATR) with age. Astigmatism had no gender difference, but anisometropia was more common in women. Most anisometropia was due to refractive error. Rates of myopia and hyperopia decreased with age while astigmatism increased with age. Thai optometrists need to be aware that refractive error in the elderly is not stationary and frequent changes in spectacle power may be needed.