June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Clinical characteristics and benefit of cataract intervention amongst UK domiciliary eye care recipients
Author Affiliations & Notes
  • Amy Louise Sheppard
    School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
    Aston Research Centre for Healthy Ageing, Birmingham, United Kingdom
  • James Stuart Wolffsohn
    School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
    Aston Research Centre for Healthy Ageing, Birmingham, United Kingdom
  • Khaled Rashid
    School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
  • Footnotes
    Commercial Relationships Amy Sheppard, None; James Wolffsohn, None; Khaled Rashid, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1398. doi:
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      Amy Louise Sheppard, James Stuart Wolffsohn, Khaled Rashid, ; Clinical characteristics and benefit of cataract intervention amongst UK domiciliary eye care recipients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1398.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Given the ageing UK population and the high prevalence of activity-limiting illness and disability in the over 65s, the demand for domiciliary eye care services is set to grow significantly. Over 400,000 NHS domiciliary eye examinations are conducted each year, yet minimal research attention has been directed to this mode of practice or patient needs amongst this group. The study aimed to compare clinical characteristics and benefits of cataract surgery between conventional in-practice patients and domiciliary service users.

Methods: Clinical characteristics were compared between patients in North-West England receiving NHS domiciliary eye care services (n = 197; median age 76.5 years), and an age-matched group of conventional in-practice patients (n = 107; median age 74.6 years). Data including reason for visit; logMAR uncorrected and best corrected distance (UDVA and CDVA) and near acuities (UNVA and CNVA); presence of ocular pathology and examination outcome were documented retrospectively. To compare the benefit of cataract surgery in terms of functional capacity between the patient groups, individuals undergoing routine referral for first-eye surgery completed the VF-14 questionnaire pre-operatively, and at 6 weeks post-operatively.

Results: UDVA was similar between the two groups (median 0.48 and 0.50 logMAR in the domiciliary and practice groups, P = 0.916); CDVA was significantly worse in the domiciliary group (median 0.18 vs 0.08 logMAR, P<0.001), who were more likely to have clinically-significant cataract. Both groups showed similar improvements in VF-14 scores following cataract surgery (mean gains 24.4 ± 11.7, and 31.5 ± 14.7 points in the in-practice and domiciliary groups, respectively. P = 0.312).

Conclusions: Patients receiving domiciliary eye care services are more likely to have poorer corrected vision than in-practice patients of a similar age, partly due to a higher prevalence of significant cataract. Despite limitations in their activities due to illness and disability, domiciliary patients experience similar gains in self-reported functional capacity following cataract surgery.

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