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Ocular care model improves lives of Australian aged-care residents

A novel eyecare model has been shown to improve near vision and the emotional well-being of visually impaired Australians in residential care, prompting calls for further studies to evaluate the program’s financial viability.

The model was investigated in the research paper titled: A Randomized Controlled Trial of the Effectiveness of the Residential Ocular Care (ROC) Model, which also demonstrated improved perceived burden of vision-related symptoms for people living in residential care facilities with vision impairment.

The NHMRC-funded randomised controlled trial, published in the British Journal of Ophthalmology, was conducted in 38 Australian aged-care facilities involving 178 visually impaired people living in residential care. The residents, 65.7% women, aged in their eighties, were randomly grouped into ROC or usual care pathways.

The ROC group comprised a tailored and comprehensive on-site eye examination and care rehabilitation pathway, while usual care participants were given a referral to an external eyecare provider.

To compare the care models, residents were scored on distance and near visual acuity; reading, emotional and mobility; quality of vision; and frequency of falls over six months.

Analysis of the findings showed the ROC model was effective in improving clinical visual outcomes, specifically near vision, as well as subjective quality of vision and emotional well-being for residents living in residential care facilities in Australia.

According to the study’s principal investigator and senior author Professor Ecosse Lamoureux, director of the population health and ocular epidemiology platform at the Singapore Eye Research Institute and Adjunct Professorial Fellow at The University of Melbourne, vision impairment and blindness are significant public health issues, affecting almost 13% of Australians aged over 80.

Compared with individuals living in the community, the research team reported that the prevalence of vision impairment in the Australian residential care community was almost four-fold higher at 46.4%, despite the availability of subsidised public healthcare.

“As such, routine screening and appropriate early interventions are needed to stop or delay the rising tide of vision loss in this vulnerable segment of the population,” he said.

“At the present time, there are no standardised vision screening and intervention programs to identify and treat individuals with vision impairment in the Australian residential care population. To address this unmet need, our group developed a novel model of personalised eye care, the Residential Ocular Care (ROC), for residential care facilities in Australia.”

Medical records of usual care participants showed that many individuals with outdated reading prescriptions opted not to change their glasses.

The study noted: “[This is] in contrast to those who underwent the refractive correction option in ROC, where all eligible participants received new updated reading prescriptions.

“As such, we suspect one of the main reasons to be the costs involved with purchasing a new pair of prescription glasses, which is not covered by the Australian healthcare system.”

The researchers said further work is required to quantify potential cost-savings/effectiveness and improve the efficacy of the ROC model in terms of improving distance vision and reducing the risk of falls before it can be implemented in residential care facilities throughout Australia.

The researchers included academics from Singapore Eye Research Institute, Singapore National Eye Centre; Duke-National University of Singapore Medical School; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital; Ophthalmology, Department of Surgery, University of Melbourne; National Vision Research Institute, Australian College of Optometry; and Royal Victoria Hospital, Belfast.