Despite the availability of free sight examinations and a well-developed network of NHS specialist eye services, a significant minority of older people have undetected visual impairment.
A substantial proportion of this unrecognised sight loss is treatable, such as refractive errors and cataracts. However, methods of identifying those with unrecognised vision loss and ensuring they attend for eye examinations need to be identified. A Cochrane review of ‘Community screening for visual impairment in the elderly’ which reported in 2008 found that routine screening does not lead to improved visual function in this population.
‘Opportunistic case-finding’, through routine encounters, such as in general practice, may be more effective.
This publication summarises findings from research conducted by Professor Steve Iliffe and Kalpa Kharicha, University College London and Skanda Wijeyekoon, GP. The principal findings were:
- Older people with undiagnosed sight-loss are more likely to have received only basic education, be isolated, depressed, need assistance with daily living, have impaired memory and poorer self-rated health. Stoicism and stigma influence people’s decisions about attending eye examinations.
- These characteristics were built into two heuristics (rules of thumb) to encourage GPs to identify older people who would benefit from an eye examination: FOCUS and BLINDS.
- Testing with 25 GPs found that the heuristics were time consuming, unclear and difficult to remember. More experienced GPs were resistant to using heuristics at all.
- As a result an alternative ‘pattern recognition’ approach is being tested with GP registrars using vignettes of cases where undiagnosed sight loss might contribute to a patient’s difficulties, and with practice nurses, using guidelines on managing patients with complex problems.
This discussion paper was published as:
|Title ||Research Findings No. 37: Improving uptake of eye care among older people: developing a training programme for GPs|
|Date ||February 2013|
|Authors || |
Steve Iliffe & Kalpa Kharicha, Research Department of Primary Care & Population Health, University College London. Skanda Wijeyekoon, General Practitioner, Wood Green, North London.
|ISBN || |
|View or download || |
PDF version (163kb) Word version (48kb)
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