Screening for visual problems among elderly patients in general practice

Objective: To screen for visual problems in an elderly population and to assess remedial action required. Design: Included were 798 patients aged 75 years or over, chosen randomly from the lists of 119 generazl practitioners in Ireland. A mental impairment assessment, visual problems screening questionnaire, ophthalmoscopy and Snellen chart test were administered by each patient's family doctor. Doctors also stated what actions were indicated by their findings. Follow-up of half of all proposed referrals to ophthalmologists was undertaken six months later. Results: Of the patients, 42% had difficulty reading newsprint, 89% wore glasses, 36% had had their eyes inspected within the last year and in 11 % this was in the last month. An absent red reflex was found in at least one of the eyes in 33%, while 19% had no red reflex in either eye. Overall, 81% were found to have problems relating to their vision. General practitioners were unaware of the problems found in 31 % of cases. Referral to an ophthalmologist or optician was found to be necessary in 45.2% of cases. In total, 78% of proposed referrals to ophthalmologists and 58% of referrals to opticians were actioned at follow-up. Conclusion: There is a considerable amount of undetected ocular disease in the elderly community. Many cases require ophthalmological assessment. Eur J Gen Pract 2000;6:10-14.