[Evaluation of moderate and severe visual impairments in patients attending an ophthalmology clinic. A prospective study of 1,172 patients]. / Evaluation des handicaps visuels modérés et sévères dans une population de consultants en ophtalmologie. Etude prospective sur 1,172 patients.

PURPOSE: Data on blindness and visual impairment in patients attending ophthalmology clinics at the Orleans regional hospital center serving a semi-rural area in France were prospectively studied to examine prevalence of visual impairment. MATERIAL AND METHODS: Clinical data on 1,172 consecutive and different patients attending the ophthalmology department during half-days over a 3-month period were collected and analyzed using a computerized system. RESULTS: Prevalence of visual impairment (20/30 or less in the better eye) was 3% in subjects under 60 years of age and rose to 13.7% and 35.9% for patients in the 60-79 age range and over 80 years respectively. For patients under 60, the prevalence of severe visual impairment (20/200 or less in the better eye) was 1.2% and rose dramatically in older patients: 5.8% and 14.6% in the 60-79 year old patients and the over 80 patients respectively. There was no significant difference in the prevalence of visual impairment by sex. Leading causes of severe visual impairment among patients aged 60 years or older were macular degeneration (40%), diabetic retinopathy (16.6%) and cataract (13.3%). The prevalence of irreversible severe visual impairment was 7.4% among patients 60years of age or older. CONCLUSION: A large number of patients attending our ophthalmology clinic have severe visual impairment, particularly those over 60 years of age. Our findings are comparable with extrapolations for population-based studies in English speaking countries and can be used to evaluate the prevalence of visual impairment in French rural areas. As the population ages, need for eye health care becomes more and more evident. It is important to organize systematic visual examination in subjects aged 70 to 80 years and to implement educational programs as part of local national health care policies for helping the visually impaired.

[Visual acuity and ocular diseases in aged residents of nursing homes: study of 219 persons in Orléans]. / Acuité visuelle et pathologie oculaire chez le sujet âgé résidant en maison de retraite: étude orléanaise sur 219 personnes.

PURPOSE: To measure the visual acuity and to determine the etiological causes of visual impairment in the elderly residing in nursing homes. METHODS: 219 elderly persons residing in nursing homes were examined in the residence. The ophthalmological examination consisted in a visual acuity measurement, a slit-lamp examination and a fundus examination. RESULTS: This study included 145 women and 74 men. Mean age was 79.1 years (range 41-101 years). Visual acuity could be measured in 181 subjects (82.6%): it was 1/10 or worse in the better eye in 23 of them (13%) and 2/10 to 3/10 in 36 patients (20%). In 21 (17.6%) out of the 119 patients aged over 74 years, visual acuity was 1/10 or worse in the better eye. Visual impairment significantly increased with age (p < 0.05). There was no difference between men and women in the prevalence of visual impairment. Among the 55 subjects with visual impairment, the main causes of vision loss were: cataract in 36 patients (66%), age-related macular degeneration in 9 patients (16%) and optic neuropathies in 5 patients (9%). Only one (2.8%) out of the 36 patients with cataract could be operated. CONCLUSION: The rate of visual impairment of people in nursing homes was higher than in corresponding age groups in the general population. The main cause of vision loss was cataract; however, only a few patients could benefit from an operation. These results confirmed that a systematic ophthalmologic examination should be performed before general health problems prevent patients from being operated.