Mitchell P, Hayes P, Wang J J
Department of Ophthalmology, University of Sydney, NSW.
Med J Aust. 1997 Jan 20;166(2):73-6. doi: 10.5694/j.1326-5377.1997.tb138724.x.
To assess the prevalence and causes of visual impairment, and the proportion of treatable eye conditions, among nursing home residents.
The Blue Mountains Eye Study is a population-based survey of vision and common eye diseases in people aged 50 or older in two postcode areas west of Sydney. Nursing home examinations were conducted during 1993.
Three representative nursing homes were selected from the nine in the study area. There were 128 residents aged 50 or older (64% females), representing 21% of all eligible nursing home residents in the two postcode areas.
Blindness or visual impairment in one or both eyes.
Eye examinations were refused by five nursing home residents, and dementia precluded eye examination in 34 (28%) of the remainder. We found significantly higher prevalences (fivefold increase) of bilateral (11%) and unilateral (21%) blindness in nursing home residents compared with local community residents (bilateral, 0.5%; unilateral, 2%). In seven of the 10 blind nursing home residents, the blindness was potentially reversible (advanced cataract); late age-related macular degeneration (AMD) was the second most frequent cause of blindness, affecting one or both eyes of 12% of residents. Open-angle glaucoma affected 10% and advanced cataract 11%; a history of past cataract surgery was obtained in 14%.
These data confirm earlier reports of a substantial number of treatable eye diseases, particularly advanced cataract, in nursing home residents, and indicate a need for increased surveillance of these communities. The high rate of visual impairment and blindness, compared with similar age groups in the local community, suggests that visual disability may contribute to nursing home placement.
评估疗养院居民视力损害的患病率及原因，以及可治疗眼部疾病的比例。
蓝山眼研究是一项针对悉尼以西两个邮政编码区域内50岁及以上人群的视力和常见眼病的基于人群的调查。1993年对疗养院居民进行了检查。
从研究区域的9家疗养院中选取了3家具有代表性的疗养院。有128名50岁及以上的居民（64%为女性），占两个邮政编码区域内所有符合条件的疗养院居民的21%。
单眼或双眼失明或视力损害。
5名疗养院居民拒绝眼部检查，其余居民中有34名（28%）因痴呆症无法进行眼部检查。我们发现，与当地社区居民相比，疗养院居民中双眼失明（11%）和单眼失明（21%）的患病率显著更高（增加了五倍）（双眼失明，0.5%；单眼失明，2%）。在10名失明的疗养院居民中，有7名的失明可能是可逆的（晚期白内障）；晚期年龄相关性黄斑变性（AMD）是第二常见的失明原因，影响了12%居民的一只或两只眼睛。开角型青光眼影响10%，晚期白内障影响11%；14%的居民有白内障手术史。
这些数据证实了早期报告中关于疗养院居民中存在大量可治疗眼部疾病，尤其是晚期白内障的情况，并表明需要加强对这些社区的监测。与当地社区的同龄人相比，视力损害和失明的高发生率表明视力残疾可能是入住疗养院的一个因素。
