title: Refractive errors and visual impairment in 900 adults with intellectual disabilities in the Netherlands.
abstract: OBJECTIVE
  To collect data on refractive errors and visual impairment in adults with an intellectual disability (ID) in the Netherlands.
  
  
  METHODS
  A randomized sample of 2100 participants was drawn from a base population of 9000 adults with intellectual disabilities in the Netherlands. This article reports on the first 900 participants.
  
  
  METHODS
  All participants underwent a protocol-based on-site ophthalmological assessment carried out by skilled investigators.
  
  
  RESULTS
  Co-operation was classified according to the number of tests that could be carried out reliably and was good or excellent in 80% of subjects, average in 13% and poor in 7%. Refraction could be reliably assessed in 505/900 (56%) subjects. There was an increased risk of visual impairment in all subgroups compared to the general Dutch population. Visual acuity (VA) was related to the level of ID, but refractive errors were not. New spectacles were prescribed in 106 cases (12%). Of 374 people in whom both monocular VA and the refractive error of the right eye could be reliably assessed, 153 (41%) had a pretest prescription, 16 (10%) of which we found to be inadequate. Of the 221 participants without a pretest prescription, 41 (19%) benefited from correction. Only 38/84 (45%) subjects aged 50 years or older, who could benefit from correction for near vision, had near spectacles. New correction increased the mean distant VA significantly from 0.44 to 0.65 (p < 0.0005).
  
  
  CONCLUSIONS
  With some adaptations, visual screening is feasible in a majority of adults with ID. Visual impairment and refractive errors are much more prevalent in adults with ID than in the normal population. Accurate spectacle correction resulted in significant improvement in distant VA.
authors.affiliation: Department of Ophthalmology, University Medical Centre, Utrecht, the Netherlands.
authors.forename: Jacques
authors.initials: J
authors.lastname: van Splunder
authors.forename: Jan S
authors.initials: JS
authors.lastname: Stilma
authors.forename: Roos M D
authors.initials: RM
authors.lastname: Bernsen
authors.forename: Trudy G M H J
authors.initials: TG
authors.lastname: Arentz
authors.forename: Heleen M
authors.initials: HM
authors.lastname: Evenhuis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004314:Down Syndrome / Q000150:complications; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D055656:Prescriptions; D015995:Prevalence; D012030:Refractive Errors / Q000150:complications* / Q000453:epidemiology* / Q000534:rehabilitation; D014786:Vision Disorders / Q000150:complications* / Q000453:epidemiology* / Q000534:rehabilitation; D014792:Visual Acuity