title: Optometric and ophthalmic contact in elderly hip fracture patients with visual impairment.
abstract: OBJECTIVE
  To describe previous contact with optometry and ophthalmic services in a group of elderly patients with and without visual impairment (VI) who had fallen and sustained a fractured neck of femur.
  
  
  METHODS
  A cross sectional study of 537 patients aged 65 and over who had undergone hip fracture surgery in four Scottish centres (Glasgow, Ayr, Dundee and Fife). All patients had an in-depth optometric history, ophthalmic history and examination.
  
  
  RESULTS
  Three hundred and ninety-three (79%) patients reported optometric contact in the 3 years preceding surgery and 107 (21%) patients had not seen an optometrist for more than 3 years. In the latter group, 64 had VI, which was due to uncorrected refractive error in 17 (27%) and untreated cataract in 20 (31%). VI (best binocular visual acuity of 6/18 or less) was found in 239 (46%) patients. A past ophthalmic history was present in 257 (50%) patients. Only 39 (16%) patients with VI were under ophthalmic care at the time of the study.
  
  
  CONCLUSIONS
  There was significantly poor optometric and ophthalmic contact in patients who had VI and had fallen and sustained hip fracture. A proportion of the VI (66%) was due to uncorrected refractive error and untreated cataract. Public health providers should be made aware of the fact that current optometric and ophthalmic care pathways are not accessed by this group of elderly patients with VI and at risk of falling.
authors.affiliation: Department of Ophthalmology, Ninewells Hospital, Dundee, UK.
authors.forename: A
authors.initials: A
authors.lastname: Cox
authors.forename: A
authors.initials: A
authors.lastname: Blaikie
authors.forename: C J
authors.initials: CJ
authors.lastname: Macewen
authors.forename: D
authors.initials: D
authors.lastname: Jones
authors.forename: K
authors.initials: K
authors.lastname: Thompson
authors.forename: D
authors.initials: D
authors.lastname: Holding
authors.forename: T
authors.initials: T
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Dobson
authors.forename: R
authors.initials: R
authors.lastname: Sanders
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D003430:Cross-Sectional Studies; D005139:Eyeglasses; D006620:Hip Fractures / Q000150:complications* / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000150:complications; D009885:Ophthalmology; D009907:Optometry; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011610:Psychosocial Deprivation; D012030:Refractive Errors / Q000150:complications; D014786:Vision Disorders / Q000150:complications* / Q000523:psychology; D014792:Visual Acuity / Q000502:physiology