Visual impairment in an aged care ward

Abstract

Introduction: Visual impairment is common in older people, and is a risk factor for falls and hip fractures, reduced independence and quality of life. Objectives: To assess the prevalence and causes of visual impairment in an aged care ward, and to evaluate whether routine eye assessment, and referral to an eye specialist was worthwhile to detect patients with low vision that could be correctable. Method: Clinical eye examination of 100 consecutive inpatients and review of medical records. Patients with a new diagnosis of visual impairment were referred for ophthalmology or optometry assessment. Results: The prevalence of low vision was 36% and the prevalence of blindness was 9%. There were 18 patients referred for specialist review, three patients were recommended a new treatment but only two received treatment. Conclusion: Visual impairment was prevalent. Although refractive error and cataracts were common, in only a few cases did detection and specialist referral lead to improved visual outcomes.

Prevalence of vision loss among hospital in‐patients; a risk factor for falls?

“…22 Our prevalence of low vision based on VA is a little lower than has been reported in geriatric units. Carcenac et al and Rush et al studied patients in long-term care facilities and geriatric wards, using the same criterion as in the current study (poorer than 0.3 logMAR) and reported vision loss in 51% and 45% respectively, 19,20 which can be compared to 30% in the current study (36% in the 60 + age group). Jack et al found a similarly high prevalence of reduced VA (50.5% had VA of 0.5 logMAR (6/18, 20/60) or poorer).…”

“…and Rush et al . studied patients in long‐term care facilities and geriatric wards, using the same criterion as in the current study (poorer than 0.3 logMAR) and reported vision loss in 51% and 45% respectively, which can be compared to 30% in the current study (36% in the 60 + age group). Jack et al .…”

“…One limitation of this study is the relatively small sample size, especially for the fallers, although for the whole group, it is comparable to studies of geriatric patients . The strength of the study is that the vision of the patients was actually measured (compared with taking retrospective information from charts), but this meant that the sample may not be fully representative.…”

“…found a higher prevalence of reduced VA (49.5%) among older adults who were hospitalised for falls compared to non‐fallers (15.3%) . Among geriatric hospital patients, a high prevalence of vision loss (45–51%) has also been reported . Jack et al .…”

“…18 Among geriatric hospital patients, a high prevalence of vision loss (45-51%) has also been reported. 19,20 Jack et al found that 50.5% of older patients admitted for an acute illness had impaired vision. 15 This compares with 6.7% to 8.8% for 60+ year olds in the general population.…”