Impact of an intervention for avoidable vision loss on visual function in the elderly-The Hyderabad Ocular Morbidity in Elderly Study (HOMES).

BACKGROUND/

OBJECTIVES

To report the impact of interventions for avoidable vision impairment (VI) on the visual function of elderly residents in 'homes for the aged' in India.

METHODS

Participants aged ≥60 years were recruited. A comprehensive eye examination was conducted by trained examiners and interventions were provided. Trained social investigators administered the Indian Vision Function questionnaire (INDVFQ) to assess visual function before and after the intervention (spectacles, cataract surgery or laser capsulotomy). Lower scores on IVFQ imply better visual function. VI was defined as presenting visual acuity worse than 6/18 in the better eye. VI due to cataract, uncorrected refractive errors, and posterior capsular opacification after cataract surgery were considered avoidable VI.

RESULTS

The mean age of the participants (n = 613) was 73.8 years (standard deviation: 8.1 years) and 378 (62.2%) were women. 64/103 (62.1%) participants who had avoidable VI at baseline were evaluated after the intervention. Significant gains were observed in all four domains of visual function. There was a 14.9% improvement in mobility scores (33.8 versus 28.8; p = 0.03), a 19.9% improvement in the activity limitations score (36.8 versus 29.5; p < 0.01), a 10.9% improvement in the psychosocial impact score (41.1 versus 36.6; p < 0.01) and a 13.6% improvement in the visual symptoms score (49.2 versus 42.5 p < 0.01). Overall, the mean IVFQ score improved by 16.4% (47.6 versus 39.8; p < 0.01).

CONCLUSION

Elderly individuals in residential care with avoidable VI had a significant improvement in visual function after relatively low-cost interventions such as spectacles and cataract surgery. Strategies are needed to provide these interventions for the elderly in 'homes for the aged' in India.