title: Use of eye care services and need for assistance in the visually impaired.
abstract: OBJECTIVE
  To assess the use of eye care services and unmet need for assistance in visually impaired people.
  
  
  METHODS
  Cross-sectional population-based survey on a sample representing the Finnish population aged 30 years and older. Of the 7979 eligible people, 6645 (83.3%) were both interviewed and had their distance visual acuity (VA) assessed. One hundred forty-seven people were classified as visually impaired (VA < or = 0.25). A home interview included an assessment of the use of eye care services, need for assistance, sociodemographic variables, cognitive functioning, and mobility. Binocular VA for distance was measured with the participants' current spectacles, if any, as a part of a comprehensive health examination.
  
  
  RESULTS
  One-half (58%) of visually impaired people had had a recent vision examination and 79% had received some vision rehabilitation services, mainly in form of spectacles (70%). Only one third (31%) had received formal low vision rehabilitation. People with moderate visual impairment (VA 0.1 to 0.25) were less likely to have received low vision rehabilitation, magnifying glasses, or other low vision aids compared with people with severe low vision (VA < 0.1). Furthermore, low cognitive capacity and living in an institution were associated with limited use of vision rehabilitation services. Of the visually impaired people living in the community, 71% reported need for assistance and 24% of them had unmet need for assistance in everyday activities. Although need for assistance was more common in people with severe low vision (83% vs. 67%, p = 0.09), unmet need for assistance seemed to be more common in people with moderate low vision (20% vs. 9%, p = 0.23).
  
  
  CONCLUSIONS
  Many visually impaired people, older persons in particular, have not had a recent vision examination and lack adequate low vision rehabilitation. This highlights the need for regular evaluation of vision function in elderly people and for actively supplying information about rehabilitation services.
authors.affiliation: Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland. arja.laitinen@ktl.fi
authors.forename: Arja
authors.initials: A
authors.lastname: Laitinen
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Rudanko
authors.forename: Tuija
authors.initials: T
authors.lastname: Martelin
authors.forename: Leila
authors.initials: L
authors.lastname: Laatikainen
authors.forename: Arpo
authors.initials: A
authors.lastname: Aromaa
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D005260:Female; D005387:Finland / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D014786:Vision Disorders / Q000453:epidemiology / Q000628:therapy*; D015348:Vision, Binocular / Q000502:physiology*; D015354:Vision, Low; D014792:Visual Acuity; D019987:Persons with Visual Disabilities