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Vision screening for frail older people: a randomised trial
  1. B Swamy1,
  2. R G Cumming2,3,
  3. R Ivers4,
  4. L Clemson5,
  5. J Cullen3,
  6. M F Hayes2,3,
  7. M Tanzer2,3,
  8. P Mitchell1
  1. 1
    Centre for Vision Research (Department of Ophthalmology), University of Sydney, Sydney, Australia
  2. 2
    School of Public Health, University of Sydney, Sydney, Australia
  3. 3
    Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia
  4. 4
    The George Institute for International Health, Sydney, Australia
  5. 5
    School of Occupation and Leisure Sciences, University of Sydney, Sydney, Australia
  1. Dr R G Cumming, Centre for Education and Research on Ageing, Building 18, Concord Hospital, Concord NSW 2139, Australia; bobc{at}health.usyd.edu.au

Abstract

Aim: To assess the effects of vision screening, and subsequent management of visual impairment, on visual acuity and vision-related quality of life among frail older people.

Design: Randomised controlled trial.

Setting: Community in Sydney, Australia.

Participants: 616 men and women aged 70 years and over (mean age 81 years) recruited mainly from people attending outpatient aged care services.

Control: No vision assessment or intervention

Interventions: Comprehensive vision and eye examinations conducted by an optometrist. Three hundred subjects were seen by the study optometrist, with 146 judged to need treatment for a vision or eye problem. The optometrist arranged new glasses for 92 subjects; 24 were referred for a home visit by an occupational therapist; 17 were referred for glaucoma management; and 15 were referred for cataract surgery.

Main outcome measure: Distance and near visual acuity (logMAR) and composite scores on the 25-item version of the National Eye Institute Visual Function Questionnaire, both assessed at a 12-month follow-up home visit.

Results: After 12 months’ follow-up, the mean (logMAR) distance visual acuity was 0.27 in the intervention group and 0.25 in the control group (p = 0.32). The mean (logMAR) near visual acuities were −0.01 in the intervention group and −0.03 in the control group (p = 0.26). The mean composite score on the National Eye Institute Visual Function Questionnaire was 84.3 in the intervention group and 86.4 in the control group (p = 0.49).

Conclusions: Vision screening by an optometrist for frail older people living in the community in Australia does not lead to improvements in vision or vision-related quality of life after 1 year’s follow-up.

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Footnotes

  • Competing interests: None.

  • Funding: This study was funded by the National Health and Medical Research Council of Australia (Project Grant No 211031).

  • Contributors: BS: acquisition of subjects and data, analysis and interpretation of data, preparation of manuscript. RC: study concept, study design, acquisition of subjects, analysis and interpretation of data, preparation of manuscript. RI, LC and PM: study design, interpretation of data, preparation of manuscript. JC: study design, acquisition of subjects, interpretation of data, preparation of manuscript. MH: acquisition of subjects and data, interpretation of data, preparation of manuscript. MT: acquisition of data, interpretation of data, preparation of manuscript.

  • Ethics approval: Ethics approval was provided by the University of Sydney Human Ethics Committee and the Central Sydney Area Health Service Human Ethics Committee (Royal Prince Alfred Hospital and Concord Hospital Zones).

  • Patient consent: Obtained.

  • See Editorial, p 704

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