title: Visual impairment in elderly patients receiving long-term hemodialysis.
abstract: BACKGROUND
  Visual impairments are associated with low quality of life, impairment of daily activities, and accidental falls. As dialysis patients are increasingly older and more disabled, we sought to assess visual impairments within an elderly dialysis population. Based on data from the general population, we hypothesized that more than 30% of dialysis patients 65 years or older would have visual impairment manifested by loss of visual acuity, depth perception, or contrast sensitivity.
  
  
  METHODS
  Single-center cross-sectional study.
  
  
  METHODS
  Patients established on hemodialysis therapy, age older than 65 years.
  
  
  RESULTS
  The proportion of elderly hemodialysis patients with impairments in visual acuity, contrast sensitivity, and depth perception.
  
  
  METHODS
  Lighthouse Near Visual Acuity Test, Lea Screener contrast sensitivity test (Goodlite, MA, USA), Titmus Stereotest, Folstein Mini-Mental Status Examination.
  
  
  RESULTS
  152 of 159 patients (95.6%) had visual acuity levels less than age-expected values. Under North American (American Medical Association, edition 4) guidelines for disability compensation, 62 patients (39.0%) fulfilled criteria for legal blindness. Sixty patients (37.0%) had poor contrast sensitivity and 48 (30.6%) failed the Housefly component of the Titmus Stereotest. Failing the Housefly component was associated with a lower Folstein Mini-Mental Status Examination score (23.4 +/- 4.2 v 25.1 +/- 3.5; P = 0.01).
  
  
  CONCLUSIONS
  This study is limited by the cross-sectional study design and abbreviated test protocol used for vision assessment.
  
  
  CONCLUSIONS
  Results of this study suggest that elderly hemodialysis patients have a high frequency of visual impairment. Formal low vision assessment and low vision rehabilitation may be useful in elderly dialysis patients. Additional study is required to determine whether the absence of depth perception in this patient group is associated with deteriorating cognitive function.
authors.affiliation: Nephrology Division, University Health Network, Toronto, Ontario, Canada.
authors.forename: Ernest
authors.initials: E
authors.lastname: Chiu
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Markowitz
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Cook
authors.forename: Sarbjit V
authors.initials: SV
authors.lastname: Jassal
mesh_terms: D000368:Aged; D015350:Contrast Sensitivity; D003430:Cross-Sectional Studies; D003867:Depth Perception; D005260:Female; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D013997:Time Factors; D014786:Vision Disorders / Q000453:epidemiology*; D014792:Visual Acuity