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Previous Volume 332:1205-1209 May 4, 1995 Number 18 Next

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ABSTRACT

Background Although the prevalence of blindness and visual impairment increases with age, most surveys of ocular disease do not include nursing home residents.

Methods We conducted a population-based prevalence survey of persons 40 years of age or older residing in nursing homes in the Baltimore area. Of 738 eligible subjects in 30 nursing homes, 499 (67.6 percent) participated in the study. They had their eyes examined and their visual acuity tested and were interviewed in detail. The nonparticipants were more likely to be older, to be white, and to have lower scores on the Mini–Mental State Examination.

Results The prevalence of bilateral blindness (visual acuity <20/200) was 17.0 percent. The prevalence of visual impairment (<20/40 but >20/200) was 18.8 percent. The frequency of blindness increased from 15.2 percent among those under 60 years of age to 28.6 percent among those 90 or older. The age-adjusted prevalence of blindness was 50 percent higher among blacks than among whites (P<0.01). As compared with the noninstitutionalized population from the same communities, the rate of blindness among nursing home residents was 13.1 times higher for blacks and 15.6 times higher for whites. Cataract was the leading cause of blindness, followed by corneal opacity, macular degeneration, and glaucoma. We judged that 20 percent of the functional blindness and 37 percent of the visual impairment could be remedied by adequate refractive correction.

Conclusions Blindness and visual impairment are highly prevalent among nursing home residents. Much of this loss of vision could be treated or prevented with appropriate ophthalmologic care.

Source Information

From the Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore (J.M.T., J.K.); the Dana Center for Preventive Ophthalmology, Johns Hopkins University Schools of Medicine and Public Health, Baltimore (J.M.T., J.K., A.S.); the Worthen Center, Department of Ophthalmology, Georgetown University School of Medicine, Washington, D.C. (J.C.J.); the Department of Ophthalmology, University of California, Los Angeles (A.C.); and the Office of the Dean, School of Hygiene and Public Health, Johns Hopkins University, Baltimore (A.S.).

Address reprint requests to Dr. Tielsch at the Department of International Health, Johns Hopkins School of Hygiene and Public Health, 615 N. Wolfe St., Room 5515, Baltimore, MD 21205-2103.

Full Text of this Article

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Blindness among Nursing Home Residents
Karlawish J., Schainholz D. C., Tielsch J. M., Katz J., Sommer A., Klein B. E.K., Klein R.
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N Engl J Med 1995; 333:879-880, Sep 28, 1995. Correspondence

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