Abstract
Purpose :
Approximately two percent of older adults currently live in nursing homes and this institutionalized population is at substantial risk for vision loss. It is important that the risks for vision loss be characterized to ensure appropriate vision care is provided for nursing home patients. Our objective was to evaluate the association of age-related eye diseases (AREDs) and multi-morbidities with vision impairment (VI).
Methods :
This is a cross-sectional analysis of comprehensive eye examination records for 7927 residents of 74 North Carolina nursing homes who were ≥65 years at time of the initial patient visit. Complete data on outcomes, associated factors, and covariates were included from the standardized Centers for Medicare and Medicaid Services eye exam. We defined VI and blindness respectively as best-corrected visual acuity between 20/40 and 20/200, and 20/200 or worse. Clinical diagnoses of AREDs were defined by the attending clinician. Data were extracted from electronic health records and al analyses were conducted in SAS version 9.4. We used descriptive statistics to summarize the resident characteristics and AREDs and logistic regression analysis to examine independent risk factors for VI.
Results :
A total of 7927 initial eye exam records (mean age 83 (SD = 8.5), 68% female) with complete data were included in the analysis. Overall, 34% of the residents had normal vision, 43% had VI, and 23% were blind. The prevalence of vision impaired/blind among participants with AREDs including untreated cataracts, macular degeneration, glaucoma, and diabetic retinopathy were respectively 71%, 76%, 69%, and 63%. Among patients with AREDs, prevalence of blindness ranged from 53% for patients with cataracts to 23% for patients with diabetic retinopathy.
Conclusions :
Comprehensive eye examinations showed vision impairment and blindness affected 66% of nursing home residents, overall. This study substantiates the positive impact of comprehensive eye examinations to promote visual, systemic and cognitive health and wellbeing and the need that eye care service be used to inform policy and practice to improve patient functioning and independence. Further analyses are being performed to determine whether or not correction of refractive error could reduce vision impairment or blindness.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.