title: [Avoidable visual impairment among residents in care institutions: lessons from an intervention project in the Den Bosch region].
abstract: BACKGROUND
  Many elderly in care institutions in The Netherlands are visually impaired (visual acuity < 0.3). They fall more frequently, are more depressed and require more care. In this project visually impaired residents were identified and referred for adequate eye care. The aim of this study is to evaluate the intervention, including validation of the screening, assessment of the prevalence and causes of visual impairment as well as the outcome of the treatment. The effectiveness of the care chain is also evaluated.
  
  
  METHODS
  640 residents were offered a basic eye examination and 210 of them were referred, via their general practitioner, to an optometrist (10), ophthalmologist (98), or centre for visually impaired persons (1).
  
  
  RESULTS
  Compliance in this study was poor. The prevalence of visual impairment (24%) was lower than in comparable studies. Cataract was the main cause in 51%. Overall 17 (8.1%) residents were treated by ophthalmologists and nine (4.3%) were referred to optical shops. Constraints in the care chain are identified.
  
  
  CONCLUSIONS
  Vision screening in care institutions for elderly is feasible and useful. The care chain should be shorter and simpler. That will increase the effectiveness of this intervention, and thereby the quality of life for many residents.
authors.affiliation: Health Information Services, Nijenburg 32, 1613 LC, Grootebroek, The Netherlands, hlimburg@quicknet.nl.
authors.forename: J J
authors.initials: JJ
authors.lastname: Limburg
authors.forename: E T
authors.initials: ET
authors.lastname: Smith
authors.forename: F G
authors.initials: FG
authors.lastname: van der Horst
authors.forename: R A G J M
authors.initials: RA
authors.lastname: Gruntjes
authors.forename: P F J
authors.initials: PF
authors.lastname: Verstraten
authors.forename: J A M J
authors.initials: JA
authors.lastname: Bartels
authors.forename: J M P
authors.initials: JM
authors.lastname: van Langen
mesh_terms: D000375:Aging / Q000502:physiology; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018434:Sickness Impact Profile; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D015351:Vision Screening / Q000379:methods / Q000592:standards*; D015354:Vision, Low / Q000175:diagnosis / Q000628:therapy; D014792:Visual Acuity; D019987:Persons with Visual Disabilities