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S.K. West, D.F. Friedman, A.T. Broman, B. Munoz, K. Bandeen–Roche, J. Deremeik, W. Park, R. Massof, K. Frick; Effect of a Vision Restoration/Rehabilitation Program on Physical Function in a Population of Nursing Home Residents with Visual loss. SEEING Clinical Trial . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1362.
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Purpose: Visual loss is highly prevalent in nursing homes. However, the impact of improving vision or visual function in this population is unknown and difficult to measure. We undertook a randomized trial, comparing usual care to an intensive vision restoration /rehabilitation program and determined the effect on physical function (as reported by nursing home staff) at 6 months and one year Methods: 28 nursing homes (NH) were enrolled and all residents offered a visual acuity screening and an ophthalmologist's exam if acuity was <20/40. NHs were paired and one of each pair was randomized to usual care and the other to a program offering free refraction and subsidized glasses, transportation and assistance with arranging cataract surgery, and free low vision evaluation, training, and devices. Physical function of each resident was reported by the NH primary caretaker using Minimum Data Set format for mobility and ADL activity and degree of independence. Primary analyses were carried out at the NH level, the unit of randomization, on intent–to–treat basis. Proportions of residents who improved or stayed the same over time was evaluated. Results: 30% of all NH residents who could be tested had VA< 20/40. At six months post intervention, the proportion of residents who’s physical function improved or stayed the same in the NH with visual intervention arm was greater by 12% compared to the NH in the usual care arm (p=.029). By one year, the difference in proportions was 3%, and not significant (p=.56). Conclusions: An intensive visual intervention program appears to delay worsening of physical function by at least six months in nursing home residents with visual loss, but the effect does not persist to one year.
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