Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India–The Hyderabad Ocular Morbidity in Elderly Study (HOMES)

Abstract

Purpose: To investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in 'homes for the aged' in Hyderabad, India. Methods: Individuals aged ≥60 years and residing in 'homes for the aged' in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best-corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE. Results: In total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60-108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5-15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11-2.43) and free homes (OR: 1.67; 95% CI: 1.00-2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07-2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10-2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10-2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self-report of diabetes, and education were not associated with URE. Conclusions: A large burden of URE was found among the residents in the 'homes for the aged' in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three

Near vision impairment among the elderly in residential care—the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

“…Strikingly, nearly half of those studied who had spectacles for use at near still had NVI. As we reported previously, these residents of homes for the elderly need more frequent eye examinations to update their spectacles [17]. Furthermore, nearly half the participants had prior cataract surgery and a substantial proportion of these individuals had presenting NVI.…”

“…Self-report of diabetes and hypertension were also collected. The HOMES examination protocol has been described in detail in our previous publications [16][17][18]. In short, the eye examination included visual acuity (VA) assessment for distance and near, refraction, slit-lamp biomicroscopy, intraocular pressure measurement, undilated fundus examination, and retinal imaging.…”

“…The information from this study is expected to provide the basis for developing eye care programmes for the elderly throughout India. We previously have reported on the burden of vision impairment for distance and uncorrected refractive error in this population [17,18]. The purpose of this paper is to report on the prevalence and risk factors of NVI among elderly individuals living in residential care in Hyderabad in South India.…”

Visual outcomes after cataract surgery among the elderly residents in the ‘homes for the aged’ in South India: the Hyderabad Ocular Morbidity in Elderly Study

“…12 The participating homes for the aged facilities have been described in our previous publications. [12][13][14] Briefly, homes for the aged are a recent phenomenon in India and hence not a wellorganised sector. The homes are diverse both in terms of scope, amenities provided and the number of elderly living in them and are typically run by non-governmental (NGO), religious or voluntary organisations with support from the government and philanthropists (free and subsidised homes).…”

“…Some private homes have nursing staff to attend to medical needs and other support staff to assist elderly residents in their routine tasks. [12][13][14] In HOMES, a total of 46/76 (60.5%) homes for the aged who agreed to participate in the study (including 5 for pilot study) were included. 13 14 A total of 16/76 (21.1%) homes were not interested in participation in the study.…”