Vision screening for frail older people: a randomised trial
- 1Centre for Vision Research (Department of Ophthalmology), University of Sydney, Sydney, Australia
- 2School of Public Health, University of Sydney, Sydney, Australia
- 3Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia
- 4The George Institute for International Health, Sydney, Australia
- 5School of Occupation and Leisure Sciences, University of Sydney, Sydney, Australia
- 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
- Accepted 1 June 2008
- Published Online First 9 July 2008
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.
Footnotes
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Competing interests: None.
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Funding: This study was funded by the National Health and Medical Research Council of Australia (Project Grant No 211031).
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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.
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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).
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Patient consent: Obtained.
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See Editorial, p 704
