Abstract
Abstract: :
Purpose: Education is often considered important to increase awareness of eye health and hence should lead to increased use of eye care services. Participation in an eye study should improve awareness. We aimed to examine use of eye care services over 5 years in a general population and whether this is affected by participation in the study. Methods: The Blue Mountains Eye Study examined 3654 residents aged 49+ living in 2 postcode areas west of Sydney in 1992–4 (BMES I). Five years later, 2334 of these (75% of survivors) were re–examined in 1997–9 (BMES IIA). A further 1174 residents were recruited from the area and examined in 1999–2000 (BMES IIB). Most recent use of eye care services (ophthalmologist or optometrist) was determined in a standard questionnaire administered by face–to–face interview. Presenting visual acuity (VA) was measured using a logMAR chart. Reports with recommendations were sent to participants after examination. The effect of participation in the study was assessed by comparison between participants at IIA (follow–up group) and IIB (newly recruited). Results: At the baseline examination, 89% of participants had seen any eye care service provider (ophthalmologist or optometrist) in the previous 5 years. At the 5–year exam (IIA), 62% of this cohort’s participants had seen an ophthalmologist or optometrist in the follow–up interval, compared to 88% of those newly recruited at IIB (age–sex adjusted OR 0.4, 95% CI 0.3–0.5). However, the follow–up group (IIA) were less likely to have completed questions regarding visits to eye care service providers in the questionnaire than new participants (23% vs 2%, p<.0001). Mean presenting VA in the better eye was significantly better in those who had visited an eye care service provider during the previous 5 years, than those who had not (p = 0.007), although the mean VA difference between these two groups was clinically insignificant (51 vs 50 letters read correctly, respectively). While those with correctable visual impairment (<39 letters read correctly) had improved between I and IIA (33.7, CI 32.8–34.7, vs 40.7, CI 38.6–42.8), they were not more likely to report eye care service visits. Conclusions: Participation in the study (which provided reports, recommendations and further information about any detected eye condition) did not appear to have increased participants’ visits to eye care service providers. It is possible that participation in the study could have been regarded as a substitute for regular visits. A high proportion with incomplete information in the follow–up group is a limitation.
Keywords: visual acuity • clinical (human) or epidemiologic studies: health care delivery/economics/manpower