Nursing Home Residents Don't Get Routine Eye Exams

Two-thirds had no mention of testing in their records, even though most had insurance, study finds

TUESDAY, July 10, 2007 (HealthDay News) -- Two out of three nursing home residents do not receive eye exams despite nearly half being visually impaired, a new study says.

Nursing home residents have rates of visual impairment between three and 15 times higher than non-resident adults of the same age, according to previous studies.

Cynthia Owsley and colleagues at the University of Alabama at Birmingham analyzed vision and health data from 380 adults age 55 or older living in 17 nursing homes in the Birmingham area. Each resident and a family member were interviewed about the use of eyeglasses and eye care.

More than half -- 57 percent -- of the residents were visually impaired, which the researchers defined as having worse than 20/40 vision in the better eye. The researchers compared this to national data showing visual impairment in approximately 10 percent to 20 percent of adults 60 or over living outside of nursing homes. The researchers said that older people who are visually impaired may be more likely to be admitted to a nursing home, accounting for the higher rate among residents, and that people in nursing homes may be less likely to either have access to an eye doctor or use prescription eyeglasses. There may also be a lack of eye care professionals serving nursing home residents, according to the researchers.

Three out of four participants in the study had abnormal binocular contrast sensitivity, which is an inability to clearly detect boundaries between objects and changes in brightness. This condition makes it difficult to read or move around safely.

Even though the majority (90 percent) of the residents had health insurance, the researchers noted that two-thirds of them had no reference to eye exams in their medical records. When asked, almost one out of three (28 percent) said their last exam was during the previous year, and one out of five (20 percent) said it was more than two years ago. One-third did not know when their last exam was.

The researchers said their data did not indicate whether eye exams would have helped to prevent the visual impairment. However, they cited previous studies that suggested 37 percent of visual impairment and 20 percent of blindness could be corrected with eyeglasses, contacts or surgery.

The findings were published in the July issue of the journal Archives of Ophthalmology.

More information

To learn more about age-related low vision conditions, visit the American Foundation for the Blind.

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