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Vision screening for frail older people: a randomized trial
  1. Brighu Narayan Swamy (brighu{at}eye.usyd.edu.au),
  2. Robert G Cumming (bobc{at}health.usyd.edu.au),
  3. Rebecca Ivers (rivers{at}george.org.au),
  4. Lindy Clemson,
  5. John Cullen,
  6. Maggie F Hayes,
  7. Michael Tanzer,
  8. Paul R Mitchell (paul_mitchell{at}wmi.usyd.edu.au)
  1. Centre for Vision Research (Department of Ophthalmology), University of Sydney, Sydney, Australia, Australia
  2. School of Public Health, University of Sydney, Sydney, Australia, Australia
  3. The George Institute for International Health, Sydney, Australia, Australia
  4. School of Occupation and Leisure Sciences, University of Sydney, Sydney, Australia, Australia
  5. Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia, Australia
  6. School of Public Health, University of Sydney, Sydney, Australia, Australia
  7. School of Public Health, University of Sydney, Sydney, Australia, Australia
  8. Centre for Vision Research (Department of Ophthalmology), University of Sydney, Sydney, Australia, Australia

    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: Randomized 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 one year follow-up. Trial registration number ACTRN012605000144617 Key words aged 80 and over, randomized controlled trials, screening, vision disorders

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