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H. Taylor, H.T. Vu, C.A. McCarty, J.E. Keeffe; The Need for Routine Eye Examinations . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1395.
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Purpose: To determine the incidence and causes of vision loss and the preferred frequency of routine eye examinations for those with normal vision and a normal examination. Methods: The Melbourne Visual Impairment project was a prospective, population–based study of people aged 40 years and older. Standardized examination protocols were used that included presenting and best–corrected visual acuity, visual field–testing and comprehensive eye examination with dilation. We determine the incidence of vision loss over the 5–year period with 1606 participants who had normal vision and a normal examination at the baseline survey and attended the follow–up survey. Fisher’s exact tests were used to calculate the p values for the tests of whether there was any (unadjusted) association) between age groups and various groups of participants and odds ratios adjusted for age and gender were obtained from logistic regressions. Results: There were 2529 people with a full data set, including 1606 with a normal baseline examination. The 5–year incidence of vision loss (<6/12 presenting acuity in the worst eye) was 2.20%. Those with a family history of eye disease were at greater risk of vision loss. Overall 22 of 36 (61%) of those with vision loss had noticed a change in their vision, but 5 of these 22 (23%) who had noticed a change in their vision had not sought an eye examination. It turns out only 8/1606 (0.50%) to 14/1606 (0.87%) had developed unrecognised vision loss in this 5–year period. Conclusions: We wanted to determine the number of people who had a normal baseline eye examination and who developed asymptomatic and unrecognised vision loss. These people form the target group that a "routine" screening program would be designed to detect. Frequent "routine" eye examinations of those who have had a normal examination will have a low yield and may not be cost–effective. Health promotion messages should target those who notice a change in vision, and those at risk such as those with diabetes or a family history of eye disease
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