Assessment of Vision in Frail Elderly Patients

Abstract

Purpose: : Our objective was to evaluate the visual status of frail elderly patients institutionalized in a tertiary care geriatric hospital.

Methods: : A careful review of archived clinical files of patients who had been institutionalized in the long-term care units of the hospital was performed. For practical reasons, it was decided to review the files of all patients who died over a 4 year period (2000-2004). A total of 440 files were available for this project. All pertinent information related to the medical and vision characteristics for each patient were extracted and entered into a database for subsequent analysis.

Results: : The study population included 318 women (87.4 ± 7.2yrs) and 122 men (83.3 ± 7.5yrs). Altogether, 234 patients had been referred for a partial or full eye examination. The visual acuity was available for 178 of these 234 patients. The level of visual impairment was derived from the visual acuity, according to classifications published in the literature. The data showed that visual impairment could be considered as non-existent in 87, mild in 31, moderate in 38 and severe in 11 subjects, whereas 11 were legally blind. The major ocular conditions observed were cataract (n=182), pseudophakia (n=111), conjonctivitis-blepharitis (n= 97), age-related macular degeneration (n= 68), and glaucoma (n= 60). Of all patients referred for a full visual examination (n= 105), an examination including refraction, visual acuity and ocular health was possible in 92 patients, regardless of their Mini Mental State Examination (MMSE) scores.

Conclusions: : These data show that most patients examined had minimal visual impairment, indicating that visual acuity was preserved in elderly individuals. Furthermore, the most prevalent ocular conditions in this population could be treated, emphasizing the importance of regular eye care for the institutionalized elders in our society, even in patients with dementia or communication problems.

Keywords: aging: visual performance • aging • clinical (human) or epidemiologic studies: prevalence/incidence