Visual impairment and eye diseases in elderly institutionalized Australians

Ophthalmology. 2000 Dec;107(12):2203-8. doi: 10.1016/s0161-6420(00)00459-0.


Objective: To study the prevalence and distribution of visual impairment and eye diseases by age and gender in an urban institutionalized population.

Design: Cross-sectional study.

Participants: Four hundred three residents of nursing homes and hostels.

Methods: Fourteen nursing homes were randomly selected from 104 nursing homes and hostels located within a 5-km radius of each of nine clusters studied in the Visual Impairment Project (VIP) urban cohort. Participants completed a standardized orthoptic and dilated ophthalmic examination, including measurement of visual acuity and visual fields. The major cause of vision loss was identified for participants with visual impairment.

Main outcome measures: Presenting visual acuity and ophthalmic diagnoses.

Results: The participants' mean age was 82 years (standard deviation, 9.24), with an age range of 46 years to 101 years. Women outnumbered men by 318 to 85. Seventy-one (22%) of 318 women had bilateral profound visual impairment (blindness), defined as best-corrected visual acuity <3/60 and/or visual field constriction <5 degrees compared with 10 (12%) of 85 men. However, this difference is not significant when age-standardized. Age-related macular degeneration was the principal diagnosis of vision loss in the better eye of 74 (44%) of the 167 participants with bilateral low vision (<6/18 and/or visual field constriction to <20 degrees radius). The age-adjusted rate of blindness or profound visual impairment in the VIP institutional cohort of 5.2% (95% confidence interval [CI], 1.8, 8.6) was significantly greater than in the VIP urban and rural cohorts of 0.13% (95% CI, 0, 0.25) and 0.29% (95% CI, 0, 0.57), respectively.

Conclusions: Underestimation of visual impairment may occur in residential population-based studies that exclude institutional or residential nursing homes and hostels for the aged citizens. Expanded methods are required for visual assessment in institutional populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Cross-Sectional Studies
  • Disabled Persons / statistics & numerical data*
  • Eye Diseases / epidemiology*
  • Female
  • Homes for the Aged / statistics & numerical data*
  • Humans
  • Institutionalization
  • Male
  • Middle Aged
  • Nursing Homes / statistics & numerical data*
  • Prevalence
  • Sex Distribution
  • Urban Population / statistics & numerical data
  • Vision Disorders / epidemiology*
  • Visual Acuity
  • Visual Fields