Abstract
Background The demographic change in Germany will lead to an increase in irreversible age-related
eye diseases. This will increase the need for specialised care facilities for visually
impaired people. Due to reduced mobility, residents in such facilities often do not
receive adequate ophthalmological care. New concepts must therefore be considered
for this group of patients. One approach is to set up an ophthalmological examination
unit within the facility combined with regular visits by an ophthalmologist. We now
present the experience with such a model in a home for the blind.
Patients and Methods The project was initiated in 2009. Since then there have been visits by medical staff
of the Eye Center at Medical Center, University of Freiburg, every two weeks. All
patient records (2010 – 2017) were reviewed systematically. The following data were
extracted in a structured and anonymous way: Age at first presentation, gender, ophthalmological
diagnoses and if a therapy was initiated. This data set was finally analysed descriptively.
Results Out of 130 residents aged between 48 and 100 years, half were between 78 and 90 years
old. The youngest resident was 48, the oldest 100 years old. The median visual acuity
was 0.2. Sixty percent of the residents had at least mild visual impairment according
to the WHO (visual acuity < 0.5; category 1 – 6). In one of 6 – 7 residents, visual
acuity could not be determined using Snellen charts. The most frequent ophthalmological
diagnoses included cataract (44%), age-related macular degeneration (36%) and glaucoma
(29%). In 67 residents (52%), the ophthalmological examination lead to treatment,
such as application of local therapy or planning an operation.
Conclusion In every second resident, the ophthalmologistʼs visit lead to treatment during the
observation period. This underlines the difficulty of providing ophthalmological care
even in specialised institutions for the blind and visually impaired, which is possibly
due to the residentsʼ mobility problems. The concept presented here has established
a low-threshold, sustainable and high-quality ophthalmological service on site. These
positive experiences indicate that corresponding measures may also be useful for other
locations. However, in order to implement such a project on a larger scale, suitable
financing and accounting modalities for the construction measures, the nursing staff
and the ophthalmological procedure still need to be developed.
Key words
blindness - visual impairment - low vision - care facility - home for the blind -
care research
