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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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