Academic Unit of Public Health, University of Leeds, Leeds, UK.
Ophthalmic Physiol Opt. 2014 Jan;34(1):38-45. doi: 10.1111/opo.12100.
Preventable sight loss is one of the Public Health Outcome Indicators in England. Despite availability of NHS-funded eye examinations, many people do not take up their entitlement. This paper explores older adults understanding of eye health and the purpose of eye examinations and the reasons why they do or do not attend for eye examinations. The aim is to provide evidence to inform policy on increasing uptake of eye examinations among older people who have increased risk of preventable sight loss.
10 focus-group meetings were held with people living in deprived areas of Leeds, recruited via community groups and neighbourhood networks. Focus groups were transcribed and a thematic analysis approach was used.
The majority of participants were aged over 60, wore spectacles, and had regular eye examinations. Most were eligible for a NHS-funded eye examination. There was poor knowledge about eye disease and the purpose of different elements of the eye examination. Participants felt very vulnerable about getting the tests 'wrong' and looking foolish. Wearing of spectacles was associated with appearing old and frail. Many did not trust the veracity of optometrists, and perceived opticians to be expensive places, where it was difficult to control spending. Many had experienced 'hard sell' and opaque pricing. Most, but not all, were happy with the optometric services received. Participants indicated a preference for utilising a local optometrist located alongside other familiar health care services.
Not-for-profit services co-located with other public services are needed to address concerns about cost of spectacles, lack of trust in optometrists, and poor access to eye examinations in local settings. It will also be important to raise public understanding about the purpose of eye examinations in terms of other causes of preventable sight loss and not just refractive error and need for spectacles.
可预防的视力丧失是英格兰公共卫生结果指标之一。尽管有国民保健制度资助的眼部检查，但许多人仍未获得应享权益。本文探讨了老年人对眼部健康和眼部检查目的的理解，以及他们是否进行眼部检查的原因。目的是为增加有可预防视力丧失风险的老年人接受眼部检查的政策提供依据。
在利兹贫困地区通过社区团体和邻里网络招募参与者，进行了 10 次焦点小组会议。对焦点小组的记录进行了转录，并采用主题分析方法。
大多数参与者年龄在 60 岁以上，戴眼镜，定期进行眼部检查。大多数人有资格接受国民保健制度资助的眼部检查。他们对眼部疾病和眼部检查不同元素的目的知之甚少。参与者对测试“出错”和看起来愚蠢感到非常脆弱。戴眼镜与看起来年老体弱有关。许多人不信任验光师的诚实性，并认为眼镜店是昂贵的地方，在那里很难控制支出。许多人经历过“强行推销”和不透明的定价。大多数（但不是全部）人对所接受的验光服务感到满意。参与者表示希望利用位于其他熟悉的医疗保健服务旁边的当地验光师。
需要提供非营利服务，与其他公共服务一起定位，以解决眼镜成本、对验光师缺乏信任以及在当地环境中获得眼部检查机会有限的问题。此外，提高公众对眼部检查目的的理解也很重要，包括除了屈光不正和需要眼镜之外，其他导致可预防视力丧失的原因。
