Visual impairment in nursing home residents: The Blue Mountains Eye Study
Visual impairment in nursing home residents: The Blue Mountains Eye Study
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DOI：
10.5694/j.1326-5377.1997.tb138724.x
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发表时间：
1997-01-20
影响因子：
11.4
通讯作者：
Wang, JJ
中科院分区：
文献类型：
--
作者：
Mitchell, P;Hayes, P;Wang, JJ
目的：评估疗养院居民视力损害的患病率和原因，以及可治疗眼病的比例。设计和设置：蓝山眼科研究是一项以人口为基础的视力和常见眼病调查，调查对象是悉尼西部两个邮政编码地区50岁及以上的人群。1993年期间进行了养老院检查。参与者：从研究区域的九家养老院中选出三家具有代表性的养老院。有128名50岁或以上的居民（64%为女性），占两个邮政编码地区所有合资格养老院居民的21%。主要结局指标：单眼或双眼失明或视力受损。结果：5名养老院居民拒绝眼科检查，其余34人（28%）因痴呆症而无法进行眼科检查。我们发现，与当地社区居民（双侧，0.5%；单侧，2%）相比，养老院居民的双侧失明（11%）和单侧失明（21%）的患病率明显更高（增加了5倍）。在10名养老院失明居民中，有7人的失明可能是可逆的（晚期白内障）；晚期老年性黄斑变性（AMD）是第二常见的致盲原因，12%的居民单眼或双眼受其影响。开角型青光眼占10%，晚期白内障占11%，既往白内障手术史占14%。结论：这些数据证实了早期关于养老院居民中大量可治疗眼病，特别是晚期白内障的报告，并表明需要加强对这些社区的监测。与当地社区的类似年龄组相比，视力障碍和失明的比例很高，这表明视力障碍可能有助于养老院的安置。
Objectives: To assess the prevalence and causes of visual impairment, and the proportion of treatable eye conditions, among nursing home residents.Design and setting: The Blue Mountains Eye Study is a population-based survey of vision and common eye diseases in people aged 50 or older in two postcode areas west of Sydney. Nursing home examinations were conducted during 1993.Participants: Three representative nursing homes were selected from the nine in the study area. There were 128 residents aged 50 or older (64% females), representing 21% of all eligible nursing home residents in the two postcode areas.Main outcome measure: Blindness or visual impairment in one or both eyes. Results: Eye examinations were refused by five nursing home residents, and dementia precluded eye examination in 34 (28%) of the remainder. We found significantly higher prevalences (fivefold increase) of bilateral (11%) and unilateral (21%) blindness in nursing home residents compared with local community residents (bilateral, 0.5%; unilateral, 2%). In seven of the 10 blind nursing home residents, the blindness was potentially reversible (advanced cataract); late age-related macular degeneration (AMD) was the second most frequent cause of blindness, affecting one or both eyes of 12% of residents. Open-angle glaucoma affected 10% and advanced cataract 11%, a history of past cataract surgery was obtained in 14%.Conclusions: These data confirm earlier reports of a substantial number of treatable eye diseases, particularly advanced cataract, in nursing home residents, and indicate a need for increased surveillance of these communities. The high rate of visual impairment and blindness, compared with similar age groups in the local community, suggests that visual disability may contribute to nursing home placement.