Visual acuity and use of eye care services in elderly population

Purpose: To assess the use of eye care services and associated socio-economic factors in different visual acuity categories. Methods: Cross-sectional population-based survey on a sample representing Finnish population aged 55 years and older. Of the 3392 eligible people, 2781 (82.0%) were both interviewed and had distance visual acuity (VA) assessed with the current spectacles. Home interview included an assessment of socio-economic variables, use of eye care services and possession of vision aids. Results: Prevalence of vision examination and spectacles decreased with decreasing VA (p<0.001). Of elderly persons with good VA (VA≥0.8), three-quarters (73%) had had a vision examination during the past five years and almost all (97%) had spectacles. On the contrary, only one half (58%) of visually impaired person (VA≤0.25) had had a vision examination and two-thirds (62%) had spectacles. Of visually impaired, 34% had magnifying glasses or other low vision aids and 28% had received formal low vision rehabilitation. Living in an institution, lower annual income level and decreased cognitive capacity seemed to decrease the use of vision examination and possession of spectacles in all VA categories. Also, men had spectacles less frequently than women and persons with lower educational level had less likely had vision examination. In visually impaired persons, decreased cognitive capacity and living in an institution were associated with limited use of low vision rehabilitation services. Conclusions: Low prevalence of regular vision examinations and vision rehabilitation services in visually impaired persons highlights the need for screening the visual function in elderly persons and for actively delivering information on rehabilitation services.