Abstract

Purpose: To investigate disparities in the prevalence and causes of visual impairment and blindness, cataract surgical coverage, and ocular findings in older adults from two Brazilian geo-socio-demographic areas, São Paulo and Parintins cities. Methods: Data from two population-based studies including participants 50 years and older from the cities of São Paulo (São Paulo Eye Study–SPES, 2004) and Parintins (Brazilian Amazon Region Eye Survey–BARES, 2014) were aggregated. Results: A total of 5318 participants (3677 from SPES;1641 from BARES) were included. The prevalence of severe visual impairment (SVI) and blindness were, respectively, 0.74% (0.46–1.02) and 0.77% (0.48–1.05) in SPES and 1.72% (1.09–2.35) and 3.44% (2.55–4.33) in BARES. SVI and blindness were associated with BARES study [OR = 2.27 (1.30–3.95); p =.004 - SVI] [OR:4.07 (2.51–6.60); p <.001- blindness]; and older age [OR = 10.93 (4.20–28.45); p <.001 - SPES; OR = 17.96 (8.75–36.83); p <.001 - BARES] while higher education level was a protective factor [OR = 0.21 (0.05–0.95) - SPES; p =.042; OR = 0.21 (0.05–0.91); p =.037 - BARES]. Cataract was the main cause of bilateral severe visual impairment (25.93% in SPES and 64.29% in BARES) and bilateral blindness (21.43% in SPES and 35.71% in BARES). Cataract surgical coverage was significantly lower in BARES (36.32%) compared to SPES (57.75%). Conclusion: The prevalence of SVI and blindness was three times higher in older adults from the Brazilian Amazon compared to those living in São Paulo city, despite a 10-year interval between the two studies. These disparities should be mitigated by initiatives to promote access to eye care services targeting underprivileged and remote Brazilian areas.