Visual impairment and blindness in institutionalized elderly in Germany

Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):363-370. doi: 10.1007/s00417-018-4196-1. Epub 2018 Nov 27.


Purpose: To determine the prevalence of and identify factors associated with visual impairment and blindness in institutionalized elderly in Germany.

Methods: In this prospective multicenter cross-sectional study, ophthalmic health care need and provision were investigated in institutionalized elderly in 32 nursing homes in Germany. All participants underwent a standardized examination including medical and ocular history, refraction, visual acuity testing, tonometry, biomicroscopy, and dilated funduscopy. A standardized questionnaire was used to identify factors associated with eye healthcare utilization, visual impairment and/or blindness.

Results: Visual acuity of 566 (94.3%; 413 women and 153 men) of a total of 600 institutionalized elderly was determined. Mean age of the included patients was 82.9 years (± 9.8). Of all participants, 30 (5.3%; 95% CI 3.4-7.2%) were blind and 106 (18.7%; 95% CI 15.5-21.9%) were moderately or severely visually impaired according to the World Health Organization definition. The 136 blind and moderately or severely visually impaired participants were older (OR, Odds Ratio = 1.1, 95% CI 1.0-1.1; p < 0.001), and more likely to have reduced mobility (OR = 12.6, 95% CI 2.8-57.6; p = 0.001).

Conclusion: A high proportion of blindness and visual impairment was found amongst nursing home residents. Age and reduced mobility were factors associated with an increased likelihood of blindness and visual impairment. Any surveys of blindness and visual impairment excluding nursing homes may considerably underestimate the prevalence of visual impairment and blindness.

Keywords: Aging; Blindness; Low vision; Nursing homes; Visual loss.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blindness / diagnosis
  • Blindness / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Institutionalization / statistics & numerical data*
  • Male
  • Middle Aged
  • Ophthalmoscopy
  • Prevalence
  • Prospective Studies
  • Vision, Low / diagnosis
  • Vision, Low / epidemiology*
  • Visual Acuity*
  • Visually Impaired Persons / statistics & numerical data*