The Prevalence of Visual Impairment in Retirement Home Residents.

BACKGROUND: Elderly persons often have eye diseases causing either reversible or irreversible visual loss. The prevalence of such problems among retirement home residents is unknown. METHODS: 203 residents of retirement homes in and around Würzburg, Germany, were examined. Clinical histories were taken, including information on prior ophthalmological care, and ophthalmological examinations were performed, including visual acuity, slit-lamp examination of the anterior segment of the eye, fundoscopy (with optical coherence tomography), and measurement of the intraocular pressure. RESULTS: 119 women and 84 men aged 55 to 101 were examined in 6 retirement homes. 44 (21.7% ) had ophthalmological findings that required acute treatment. The most common diagnoses in the anterior segment of the eye were keratoconjunctivitis sicca (160; 78.8% ), cataract (88; 43.3% ), secondary cataract (15; 7.4% ), glaucoma (33; 12.3% ), and eyelid malpositions (25; 12.3% ). In the fundus, 45 residents (22.2% ) had dry age-related macular degeneration (AMD), 7 (3.4% ) had fresh wet AMD, and 7 (3.4% ) had epiretinal gliosis. 81 (39.9% ) could give no information about earlier ophthalmologic examinations, and 42 (20.7% ) had not been to an ophthalmologist for at least 5 years. After correction of refractive errors, their mean decimal visual acuity improved from 0.25 to 0.33. CONCLUSION: The retirement home residents that we examined were not receiving adequate ophthalmological care; in particular, some of them had irreversible eye diseases that were not being treated. The ophthalmological care of retirement home residents needs to be improved through better collaboration of all types of personnel taking care of them.

Quality of life following glaucoma surgery: canaloplasty versus trabeculectomy.

PURPOSE: To evaluate quality of life (QoL) with a new questionnaire after canaloplasty (CP) and trabeculectomy (TE). PATIENTS AND METHODS: We assessed outcomes of surgery, rate of revision surgeries, patients' mood, and influence of postoperative care on QoL, surgery interference with daily activities, and postsurgical complaints. Patients completed the QoL questionnaire 24 months after surgery. RESULTS: Patients who underwent CP (n=175) were compared to TE patients (n=152). In the CP group, 57% of patients expressed high satisfaction, while 41% of patients in the TE group said they were highly satisfied. The satisfaction difference was statistically significant (P=0.034). Significantly fewer second surgeries were needed after CP (8% CP versus 35% TE, P<0.001). Patients were more positive in the CP group (54% CP versus 37% TE, P<0.009). Stress related to postoperative care was lower in the CP group compared to the TE group (14% versus 46%). Difficulties with activities of daily living, such as reading, were much lower or even nonexistent after CP, and complaints like eye burning or stinging were significantly lower in the CP group. CONCLUSIONS: Compared with TE, CP is associated with less QoL impairment and higher patient satisfaction after surgery. However, long-term data on intraocular pressure reduction after surgery are needed to confirm long-term patient satisfaction with this surgery.

Corneal thickness after overnight wear of an intraocular pressure fluctuation contact lens sensor.

PURPOSE: To assess the effect of overnight wear of a contact lens-based sensor (CLS) for monitoring of 24-hr intraocular pressure (IOP) fluctuations on central corneal thickness (CCT). MATERIALS AND METHODS: Changes in the CCT, mid-peripheral corneal thickness and central corneal radius (CCR) during overnight CLS wear in 20 eligible patients with ocular hypertension or established glaucoma were prospectively studied using ultrasound pachymetry and topography. Corneal thickness and CCR changes were evaluated from pre-to-postsleep, with the fellow eye as control. Paired t-test or Wilcoxon signed-rank test was used as appropriate and with α = 0.05. Relationship between the IOP profile recorded by the CLS and the pre-to-postsleep corneal thickness differences was assessed using the Spearman correlation coefficient. RESULTS: After CLS wear, mean CCT had changed from 523 to 537 µm (p = 0.015) in the study eye and from 518 to 522 (p = 0.206) in the fellow eye (n = 15). There was no difference in CCT change between eyes (p = 0.075). There were no statistically significant changes in horizontal or vertical CCR in either eye (p > 0.05 for all). No correlation was found between the pre-to-postsleep differences in the CLS signal and the pre-to-postsleep differences in ultrasound CCT measurements (p = 0.974). CONCLUSION: The continuous IOP monitoring does not appear to be affected by differences in corneal thickness that occur during overnight CLS wear, although the CLS did induce some corneal swelling. This effect was not statistically significantly different from the control eye and does not seem to influence the CLS IOP profile.