Prevalence of Low Vision in Elderly Patients Admitted to an Acute Geriatric Unit in Liverpool: Elderly People Who Fall Are More Likely to Have Low Vision

Abstract

The prevalence of visual impairment among elderly patients admitted to hospital is unknown. This group of patients may be particularly at risk from poor vision which could jeopardise their independence. A prospective study of visual impairment and its aetiology in acute geriatric admissions assessed after the acute illness had settled was performed. Subjects were all patients aged 65 years or over, excluding those chronically confused, admitted to the Department of Geriatric Medicine at the Royal Liverpool University Hospital with an acute medical illness. After the acute illness had settled visual impairment, as defined by the American criteria (best acuity 6/18), was assessed on the ward with a Snellen chart read at 6 m using binocular vision and current glasses. Those patients identified with impaired vision on initial screening were formally assessed in the ophthalmology department to identify the cause. 200 patients were examined. 101 patients (50.5%) had impaired vision. In these patients, correctable refractive errors were present in 40%, cataract in 37% and senile macular degeneration in 14%. Of the 101 patients with impaired vision 79% had a reversible cause. Comparing these results with a recent study in the community showed a much higher incidence for patients admitted to hospital. There was a particularly high prevalence in those elderly patients who were admitted with falls (76%, p = 0.0003). In conclusion, elderly patients, especially those presenting with falls, admitted to hospital have a high prevalence of visual impairment. Visual impairment may be compounding or causing falls. Hence, screening the elderly ‘faller’ admitted to hospital for visual impairment may be beneficial to the patient and cost-effective as many of the causes are simply reversible.

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

“…These can be resolved using appropriate spectacles INTRODUCTION NIHR Journals Library www.journalslibrary.nihr.ac.uk following an eye examination by an eye health professional. The prevalence of undercorrected or uncorrected refractive errors in the UK older population has been reported to be between 9% 27 and 40% 44 for VI defined as VA < 6/12. However, this 40% figure was obtained from a small, enriched sample of patients admitted to a department of geriatric medicine with acute illness and was unrepresentative of older people in general.…”

“…Nor was it always used in the prevalence estimates. 59 Older studies used Snellen VA charts, 44,58 while more recent studies have used logarithm of minimum angle of resolution (logMAR) charts of various types. Testing distances varied between the standard 6-m distance and 3 m. Settings varied from broadly national 56,57 to local.…”

Binocular Visual‐Field Loss Increases the Risk of Future Falls in Older White Women

“…12 Evidence suggests that high risks of falls are associated with poor vision. 13,14 Visual impairment may compound or cause falls. 13 Standard tests of visual acuity and contrast sensitivity (CS) have been used to determine tendency to fall.…”

“…13,14 Visual impairment may compound or cause falls. 13 Standard tests of visual acuity and contrast sensitivity (CS) have been used to determine tendency to fall. CS, the ability to discern small changes in contrast or to see objects and separate them from the background, has been associated with a high risk of falls.…”

Perfil de mulheres idosas segundo a ocorrência de quedas: estudo de demanda no Núcleo de Atenção ao Idoso da UnATI/UERJ

“…9 A ocorrência de quedas foi semelhante entre as idosas com e sem déficit visual. Em outros estudos, 33,34 observou-se maior com- (14) 1 (2) 17 (34) 9 (18) 7 (14) 9 (18) 31 (62) 19 (38) Déficit cognitivo Sim Não 3 (6) 5 (10) 15 (30) 11 (22) 8 (16) 8 (16) 26 (52) A maioria dos idosos do estudo apresentou-se independente na realização das suas atividades diárias. Observou-se, no entanto, que a média de quedas foi discretamente maior no grupo de idosas com capacidade funcional intermediária.…”