Eye care in the skilled nursing facility: a pilot study of prevalence and treatment patterns of glaucoma.
OBJECTIVE
The objective of this study was to determine the rates of ophthalmic examinations for glaucoma, prevalence rates of glaucoma, ongoing evaluation (follow-up) rates and rates of treatment for a population of residents in a skilled nursing facility.


METHODS
We conducted a retrospective evaluation and chart review of glaucoma-related ophthalmology services.


METHODS
This study was conducted in a skilled nursing facility located in a large metropolitan area located in the Midwest.


METHODS
We studied all nursing home residents of the facility on October 1, 2002 (n = 160).


METHODS
We conducted a retrospective evaluation and chart review of glaucoma-related ophthalmology services for 160 patients. The medical records used for review included admission records, physician history and physical records, hospital notes, nursing assessments, consultation notes, and medication reviews (including medications administered during hospital stays). Minimum data set (MDS) data and individual patient interviews were used to supplement and verify chart abstraction findings.


RESULTS
Eighty-three residents (52%) had evidence of assessment for glaucoma. Thirty-three of these residents (40%) had documentation of a diagnosis of glaucoma; 25 (76%) had current treatment orders for a topical ophthalmic agent. Nine patients were using combination therapy; four used topical and oral beta-adrenergic-blocking agents.


CONCLUSIONS
Visual impairment remains a serious problem for nursing facility residents. Assessment of visual abilities is infrequent or nonexistent. Education for nursing home personnel, discussion and activation among nursing home thought leaders, and guidelines for the evaluation and management of glaucoma in this care environment are needed.
Voytas
John J
JJ
Woodward Hills Nursing Center, 39312 Woodward Avenue, Bloomfield Hills, MI 48304, USA. jvoytas@beaumont.edu
Kowalski
Debra
D
Wagner
Samuel
S
Carlson
Angeline M
AM
Maddens
M
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D005901:Glaucoma / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D010865:Pilot Projects; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012866:Skilled Nursing Facilities / Q000592:standards* / Q000706:statistics & numerical data
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions