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D.S. Friedman, S.K. West, B. Munoz, K. Bandeen-Roche, W. Park, J. Deremeik, R. Massof, K. Frick, B. Aimee, W.B. McGill; Prevalence and Causes of Visual Impairment in Nursing Home Residents: The SEEING Project . Invest. Ophthalmol. Vis. Sci. 2003;44(13):788.
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Purpose: To determine the prevalence and causes of low vision in a large sample of nursing home residents. Methods: 28 nursing homes on the Eastern Shore of Maryland and Delaware were enrolled in a clinical trial to assess the impact of vision restoration/rehabilitation on nursing home residents. Visual acuity was measured using both recognition charts and preferential looking techniques. An ophthalmologist examined all residents with visual acuity worse than 20/40 in the better-seeing eye and determined the primary cause for decreased vision. Results are reported for the better-seeing eye. Results: 1591 of 2544 (63%) of eligible residents participated, but 286 residents were unable to respond to visual acuity testing. 496 of the remaining 1305 residents had best-corrected vision worse than 20/40 in the better-seeing eye (38%), however, 27 of these were felt to have poor vision on the basis of cognitive impairment. Several refused an ophthalmic examination or had died prior to evaluation, but causes were ascribed for the 398 remaining subjects. Rates of low vision were similar between blacks and whites (39% and 38% respectively, age-adjusted p = 0.18). Cataract was the leading cause of low vision, responsible for 38% of low vision among whites and 53% of low vision among blacks. Macular degeneration was responsible for 33% of low vision among whites, but only 6% among blacks. Glaucoma caused low vision in 4% of whites and 10% of blacks. Macular degeneration and glaucoma were more common causes of low vision among older residents. Conclusions: Low vision is highly prevalent among nursing home residents with over 30% having vision worse than 20/40 in the better-seeing eye. Cataract is the leading cause of low vision, with cataract responsible for a higher proportion of low vision among black residents than among white residents. Macular degeneration is a common cause of low vision among white nursing home residents, but is rare among blacks, while glaucoma and cataract are more prevalent as a cause of low vision among blacks.
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