VISION CARE REQUIREMENTS AMONG INTELLECTUALLY DISABLED ADULTS - A RESIDENCE-BASED PILOT-STUDY

Intellectually disabled adults have an high incidence of visual proble ms and they are often unable to communicate their visual difficulties. At Lennox Castle and Waverley Park Hospitals, vision care is through referral by medical and nursing staff to designated optometrists and o phthalmologists. This practice has provided a good service when visual difficulties are noticed. The vision care requirements of all residen ts had not been comprehensively assessed and a new interdisciplinary p rocedure developed at Waverley Park Hospital had drawn attention to th e fact that only 11% had been offered vision assessment within the pre vious 5 years. In this study, 63 residents without specific referral r eceived a comprehensive visual and medical assessment. The residents r anged from age 20 to 85 years and included the full range of disabilit ies. Objective assessments, ophthalmoscopy and retinoscopy were genera lly successful for all levels of disability. Visual acuity and visual fields were tested using methods suitable for nonverbal subjects. Succ ess rates for these subjects were generally good, except in the profou ndly disabled group where less than 30% were able to respond. A high p revalence of visual impairment, refractive error, squint and other ocu lar conditions was found. Visual impairment was most common in the sev ere and profoundly disabled groups because of optic nerve or cortical dysfunction. New spectacles were recommended for 23 residents (seven o thers had adequate correction). Nine residents were referred for ophth almologic consultation, mainly for cataract. Three required monitoring for visual conditions. Thirty-one residents (49%) required no immedia te action beyond documentation of the visual status. This study has sh own a high prevalence of visual difficulties which were not previously detected. Routine biennial vision assessment of all residents is reco mmended to allow timely intervention to correct vision problems, and a lso to provide the necessary information about vision to plan appropri ate programmes of activity.