Background:
In the Netherlands, the prevalence of blindness and low vision is highest among the
elderly in care institutions and in home healthcare (20-25%). A recent cross-sectional
pilot study with one of the largest home healthcare organizations in the Netherlands
(i.e. 'Buurtzorg Nederland') showed that simple eye-screening by community nurses helps
to detect eye complaints among elderly people living independently. Of all patients who
were referred to a general practitioner (GP), optician, optometrist or ophthalmologist
based on this screening (20% of the total group), it was found that almost half had
severe visual impairment, whereas others had eye complaints that had affected acuity to a
smaller extent. In most cases, eye complaints could be treated with spectacles or
cataract surgery, but also untreatable eye diseases were found. These complaints may not
have been detected without eye-screening and treatment would not have been offered.
Often, the elderly themselves or family/friends or care providers, do not recognize that
their eyesight has decreased. However, this can negatively affect their quality of life
and health status. To increase access to eye care the investigators will perform a study
using an online eye screening, which can be performed by the community nurses or possibly
the participants themselves in their home environment.
Purpose:
The aim of this study is to investigate the cost-effectiveness of a nurse-assisted online
eye-screening in home healthcare in reducing eye complaints.
Method:
The investigators will perform a cluster-RCT to compare online eye-screening guided by
community nurses in addition to care as usual to a control condition, receiving only care
as usual. It will be performed in collaboration with several home healthcare
organizations. Measurements in both groups will take place at baseline, after 6 months
and 12 months. This will include visual acuity measurements, questionnaires and an
optometric examination.
This study will be conducted among 220 participants. Elderly clients, 65+, who receive
home healthcare will be invited to participate. Clients who have a serious health
condition, clients who are cognitively unable to participate, or clients who had received
an optometric consultation within the last 6 months, will be excluded.
The eye-screening is developed by Easee and is CE marked. During the test, the visual
acuity will be measured both near and at distance, and the Amsler grid test will be
performed. The results of the eye-screening will be checked by an optometrist, and will
be made available to the participant. This will be done by letter including a
recommendation for a referral, if necessary.
