Many nursing home residents may not be receiving regular eye exams, study suggests

Elderly patients living in nursing homes may not be receiving regular eye examinations, despite having higher rates of visual impairment compared with community-dwelling persons of similar age, according to a study by researchers in Alabama.

Cynthia Owsley, PhD, MSPH, and colleagues at the University of Alabama at Birmingham, evaluated 380 subjects aged 55 years and older living at 17 nursing homes in the Birmingham area. All of the facilities had licensed optometrists regularly available to residents, the authors noted.

The researchers found that 57% of residents were visually impaired, having visual acuity below 20/40 in their better eye, and 10% had a visual acuity of 20/200 or worse. For comparison, about 10% to 20% of persons aged 60 years and older who live in the community nationwide have a visual acuity of 20/40 or worse, according to a press release announcing the study findings.

In addition, 76% of subjects had binocular contrast sensitivity below 1.5, and 14.5% had a contrast sensitivity below 0.9, according to the study.

Also, although 90% of subjects had some form of health insurance, 66% had no reference to eye examinations in their medical records. When asked about their most recent eye exam, 28% said it was in the previous year, 20% indicated that it had been more than 2 years ago and about 33% did not know, according to the release.

"It appears that routine eye care may not be taking place for a substantial segment of the nursing home residents in our sample, as implied by our data in several ways," the authors said.

"These findings underscore the need to better understand the causes of high visual impairment rates in nursing home residents and to evaluate interventions to improve the visual status of this population," they said.

The study is published in the July issue of Archives of Ophthalmology.