Abstract-With the increasing aging population, the number of veterans presenting with dual sensory impairment (DSI) (vision and hearing impairments) will increase. This study determined the prevalence and clinical characteristics of DSI in a veteran population receiving healthcare from the Department of Veterans Affairs (VA). A retrospective review was conducted on 400 charts randomly selected from a database of 1,472 unique veterans enrolled in the audiology and optometry outpatient clinics during a 1-year period. Depending on definition criteria, hearing impairment prevalence was 41.6% to 74.6%, vision impairment/blindness prevalence was 7.4%, and DSI prevalence was 5.0% to 7.4%. The vision impairment/ blindness prevalence governed the DSI prevalence. By age, DSI prevalence ranged from 0% (among veterans <65 years) to >20% (among veterans 85+ years). The complexities encountered in defining DSI are discussed and suggestions are made for determining standardized definitions. More research is needed to determine the unique characteristics of individuals with DSI and their impact on VA resources.

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This study determined the effectiveness of one Veterans Affairs Medical Center facility at providing annual diabetic eye examinations. A medical records review of a simple random sample of 350 diabetic patients was conducted to assess the impact of delayed access to care, practitioner referral patterns, patient no-show rates, and sample sizes used in performance reports. A 55.6% adherence rate was found, which increased to 81% when adjusted for future scheduled appointments. A high rate of physician referral for diabetic eye care was documented (68.9%), with a 10.2% patient no-show rate. The primary factor adversely affecting diabetic eye examination rates at this facility was a delayed access to care, complicated by an increased demand for eye care services. Also, sample sizes used in official performance reports were not sufficient to accurately determine true examination rates at the local level.