This study Is designed to re-examine a large, well-characterized cohort of adults 48-89 years of age living in Beaver Dam, Wisconsin, in order to determine the 5-year incidence and progression of age-related eye disease (cataract, maculopathy, and glaucoma), and visual impairment. Participants will be examined using standardized protocols. As part of the evaluation, refraction, visual acuity, contrast sensitivity, visual field testing, Intraocular, and blood pressure measurements will be obtained. A standardized questionnaire will be administered. Determination of serum glucose, calcium, total cholesterol, HDL-cholesterol, glycosylated hemoglobin, uric acid, and hematocrit will be performed. Objective recording of cataract by use of retroillumination and slit lamp photography, of age-related maculopathy and diabetic retinopathy by use of stereoscopic fundus photography, combined with standardized protocols for grading these diseases will be used. Grading of the photographs by the same methods as used in the prevalence study will provide a sensitive and reproducible method for detection of the incidence or progression of cataract, age-related maculopathy, and diabetic retinopathy. The incidence and causes of visual impairment will be determined.The incidence and progression of age-related cataract, maculopathy, and glaucoma will be evaluated with respect to risk factors such as: medical conditions (e.g., as diabetes, hypertension, etc.); cigarette smoking behavior; ocular characteristics (e.g., iris color, refractive error, etc.); specific drug exposures (e.g., antihypertensive and hypolipidemic drugs, aspirin, etc.); occupational, environmental, and medical exposure to electromagnetic and ionizing radiation; nutritional factors (e.g., alcohol and supplemental vitamin and mineral intake); and familial factors as ascertained at the prevalence examination. The vital status of participants will be determined to provide data regarding the relationship between presence and severity of these age-related eye diseases and other characteristics and prognosis for life. Data from this study will be used for estimating the need for medical counseling and rehabilitative services, projecting medical care costs, measuring temporal trends, developing causal inferences, developing preventive strategies, and designing clinical trials.
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