Nursing home residents underserved by eye care specialists

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July 9, 2007 (Insidermedicine) Many nursing home residents do not get regular eye exams despite being visually impaired, according to a report published in the Archives of Ophthalmology.

It is estimated that nursing home residents have visual impairment rates anywhere from three to 15 times higher than their elderly peers living in the community. While the reason for the high rates of vision impairment isn’t well understood, a variety of factors may be involved. These include limited access to doctors’ offices due to lack of transportation, a belief that older people with impaired vision do not benefit from treatment to improve vision, and a shortage of eye care specialists who serve nursing home residents.

To assess resident access and use of eye care specialists, researchers interviewed 380 older individuals living at 17 nursing homes that were regularly serviced by licensed optometrists. Each resident and family member or guardian was questioned about the use of eyeglasses and eye care. Medical records and the date of the last eye exam and other health information were collected.

They found that more than half of the residents were visually impaired, defined as having visual acuity less than 20/40 in the better eye, and 10% had visual acuity of 20/200 or worse. These rates are up to five times the rate of older adults living in the community. As well, while 90% of the residents had some form of health insurance, two-thirds had no record of an eye exam in their medical records. When asked about their most recent exam, 28% said it was in the previous year, 20% indicated it was more than two years ago, and one-third did not know.

Considering that many cases of visual impairment and blindness among nursing home residents can be remedied by corrective lenses or surgery, steps need to be taken to better understand why this population is at risk and to evaluate ways to improve care.

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