EYE SCREENING IN THE ELDERLY

Poor vision is considered to be a common unreported illness in the eld erly population, To determine its prevalence we carried out an eye scr een on 150 randomly selected co operative elderly subjects attending S t James's Hospital, A database [mean age 78.2 years (range 65 to 97)], medical history, mini-mental test score [mean score 9.1 (range 2 to 1 0)], mobility assessment and history of eye problems was gathered, A v isual test of both eyes together (standard N6 and N8), inspection of t he eyes, tonometry (Perkin's handheld tonometer) and fundoscopy were p erformed on each subject and the need and reason for referral to an op tician or an ophthalmologist was documented, Results show that 64% of subjects could read N6 or N8, Tonometry revealed no subject with raise d intraocular pressure, including 4 subjects who were currently on tre atment for glaucoma, Fundoscopy showed that 57.3% of subjects had some evidence of cataracts, 16.6% moderate and 3% severe. The retina appea red normal in 58.6% of subjects, 20.6% of the population had hypertens ive changes, 4.6% had diabetic changes, 3% had optic atrophy, 1.3% had macular degeneration and a further 10% could not be clearly visualise d due to cataracts. 90% of subjects wore glasses and the average durat ion since the glasses were last changed was 3.7 years (range 2 weeks t o 20 years), No glasses examined were in need of cleaning or repair, 3 6% of subjects could not read NS (28 of these had forgotten their glas ses and were advised to visit their optician if they could not read ne wsprint). 7.3% of subjects were referred to an optician for new glasse s, 1.3% were referred to an ophthalmologist for newly diagnosed catara cts and 6.6% were regular attenders to an ophthalmologist. We conclude that the rate of new referrals for the occurence of correctable undet ected visual acuity deficit was lower than expected at 8.6% of subject s screened.