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T.S. Tay, E. Rochtchina, P. Mitchell, R. Lindley, J.J. Wang; Eye Health Care in Older Persons Seeking Aged Care Services . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1942.
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Purpose: In older, frail persons seeking aged care services, we aimed to assess the need for, and the use of eye health care services and associated outcomes. Methods: In a pilot study we assessed visual function in 188 persons (62.7% of those eligible) aged 65+ years who were seeking aged care services at an assessment center, west of Sydney, Australia, in 2003. Presenting visual acuity (VA) was assessed randomly in half the participants, using a logMAR chart, with pinhole correction if VA was reduced. Visual impairment was defined when presenting VA was <20/40 in the better eye. Under–corrected refractive error was suggested if pinhole VA improved >10 letters (2 lines) in persons with VA <20/20. Persons with measured or self–reported visual impairment were referred to ophthalmologists or optometrists. One year later we contacted all participants and repeated the interview and vision assessment. Results: Of the 188 baseline participants, 121 (70.3% of survivors) were re–visited after one year; 16 had died, 26 were admitted to a nursing home and 25 either moved away, refused or lost contact. At baseline, 29/96 participants (30.2%) who had VA assessment were found to have visual impairment, and 14/84 (16.7%) with VA <20/20 were found to have under–corrected refractive error. This group together with 3 persons who had self–reported visual loss but did not have VA measured were referred to an eye care practitioner. Of those referred, 42 were re–visited. Overall, 38 (90.5%) had seen eye health professionals during the 12–month period; 76.3% were seen by an ophthalmologist and 79.0% were seen by an optometrist. This compared with 53/79 persons (67.1%) who were not referred to eye health care professionals at baseline but saw either an ophthalmologist or optometrist in the last 12 months. Of those who complied with the recommendation, 10/33 subjects (30.3%) with VA measured at both visits had at least a 2 line improvement in the presenting VA in at least one eye 12–months later. In contrast, only 1/17 (5.9%) persons who had VA assessment and saw an eye care practitioner in the last 12–months without baseline referral, had at least a 2 line improvement in the presenting VA of at least one eye. Conclusions: These pilot data indicate that a third of frail elderly persons living in the community could benefit from regular visits to eye care professionals. Despite having multiple co–morbidities, this sample of older persons demonstrated relatively high utilization and compliance with recommendation for eye examinations.
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