Smeeth L
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine and University College London Medical School, UK.
Fam Pract. 1998 Apr;15 Suppl 1:S24-9.
Screening for visual impairment is frequently included in multiphasic screening assessments for older people, although evidence for the effectiveness of screening from randomized trials is lacking. This paper uses previously developed criteria for assessing the likely effectiveness of community screening programmes to review the non-trial evidence around visual screening. Unreported or undiagnosed visual impairment is common among older people and is associated with considerable morbidity. Testing for visual acuity is easy and quick, but may not accurately reflect the level of functional disability caused by the visual problem in everyday living. Effective therapeutic interventions exist for most symptomatic patients, but the effects of treating unreported visual impairment detected by screening have not been evaluated. Existing barriers to effective treatment for older people with symptomatic visual problems include financial costs to the patient, and an inability of ophthalmic services to meet demand. These same factors may be barriers to the uptake of treatment following screening. Further work is needed to assess the needs of older people with unreported visual problems, and to clarify barriers to effective screening.
视力损害筛查经常被纳入针对老年人的多阶段筛查评估中，尽管缺乏来自随机试验的筛查有效性证据。本文采用先前制定的评估社区筛查项目可能有效性的标准，来回顾围绕视力筛查的非试验性证据。未报告或未被诊断出的视力损害在老年人中很常见，且与相当高的发病率相关。视力测试简单快捷，但可能无法准确反映日常生活中视力问题所导致的功能残疾程度。对于大多数有症状的患者存在有效的治疗干预措施，但筛查发现的未报告视力损害的治疗效果尚未得到评估。有症状视力问题的老年人有效治疗的现有障碍包括患者的经济成本，以及眼科服务无法满足需求。这些相同因素可能也是筛查后接受治疗的障碍。需要进一步开展工作来评估有未报告视力问题的老年人的需求，并明确有效筛查的障碍。
