PREVALENCE OF HOW VISION IN ELDERLY PATIENTS ADMITTED TO AN ACUTE GERIATRIC UNIT IN LIVERPOOL - ELDERLY PEOPLE WHO FALL ARE MORE LIKELY TO HAVE LOW-VISION

The prevalence of visual impairment among elderly patients admitted to hospital is unknown. This group of patients may be particularly at ri sk from poor vision which could jeopardise their independence. A prosp ective study of visual impairment and its aetiology in acute geriatric admissions assessed after the acute illness had settled was performed . Subjects were all patients aged 65 years or over, excluding those ch ronically confused, admitted to the Department of Geriatric Medicine a t the Royal Liverpool University Hospital with an acute medical illnes s. After the acute illness had settled visual impairment, as defined b y the American criteria (best acuity 6/18), was assessed on the ward w ith a Snellen chart read at 6 m using binocular vision and current gla sses. Those patients identified with impaired vision on initial screen ing were formally assessed in the ophthalmology department to identify the cause. 200 patients were examined. 101 patients (50.5%) had impai red vision. In these patients, correctable refractive errors were pres ent in 40%, cataract in 37% and senile macular degeneration in 14%. Of the 101 patients with impaired vision 79% had a reversible cause, Com paring these results with a recent study in the community showed a muc h higher incidence for patients admitted to hospital, There was a part icularly high prevalence in those elderly patients who were admitted w ith falls (76%, p = 0.0003). In conclusion, elderly patients, especial ly those presenting with falls, admitted to hospital have a high preva lence of visual impairment. Visual impairment may be compounding or ca using falls. Hence, screening the elderly 'faller' admitted to hospita l for visual impairment may be beneficial to the patient and cost-effe ctive as many of the causes are simply reversible.