Abstract
Abstract: :
Purpose: Nursing home residents have a high prevalence of remediable visual impairment and blindness. Here we report baseline visual function data for nursing home residents who participated in our larger study designed to evaluate the impact of vision interventions on visual function and quality of life. Methods: Visual function was assessed in a heterogeneous sample of nursing home residents 60 years or older residing in 17 facilities. Persons with severe dementia were excluded (MMSE score < 13). Binocular near and distance visual acuity and contrast sensitivity were assessed using ETDRS and Pelli–Robson charts, respectively. Vision function data reported by the nursing staff was collected from the most recent Minimum Data Set form located in the resident’s medical chart. Eye health was evaluated during an in–house comprehensive eye exam performed within at least 6 mo. of visual assessments. Results: A total of 394 residents participated with a mean age of 83 years (SD=8.1). Eighty–one percent were female, with 73% of the sample White and 26% African American. Visual impairment was defined as 20/40 or worse. Fifty–five percent had impaired binocular distance acuity and 70% had impaired near acuity. Over 30% of those assessed did not use spectacles. Eighty–three percent had binocular contrast sensitivity of 1.50 or worse. Eye exam data suggested some ocular conditions may be under reported with 10% of the sample diagnosed with glaucoma, 5% diabetic retinopathy, 67% cataract, and 19% age–related maculopathy. In spite of eye care providers coming to each facility and the majority of annual eye exams being covered by Medicaid, 25% of participants who had been in the facility for at least 1 year had not received an eye exam. Residents are most often referred to the eye care provider when vision problems are noted by the nursing staff. The nursing staff Minimum Data Set (MDS) data suggest nurses have difficulty evaluating vision problems. According to the MDS, 60% percent of residents had adequate vision and 95%had no visual limitations or difficulties.Conclusions: Nursing home residents have high rates of visual impairment. Multiple factors are likely to contribute to this including under reporting of eye disease and visual impairment, and under utilization of eye care services.
Keywords: aging • clinical (human) or epidemiologic studies: prevalence/incidence • visual acuity