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Screening for visual impairment in elderly patients with hip fracture: validating a simple bedside test
D M Squirrell1, J Kenny, N Mawer
1Department of Ophthalmology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. Dsquirrell123@aol.com
Eye (London, England)
|June 9, 2004
Summary
Visual impairment is common in elderly patients with proximal hip fractures. A simple screening test can effectively identify these patients, justifying its inclusion in rehabilitation assessments.
Area of Science:
- Ophthalmology
- Geriatrics
- Orthopedics
Background:
- Proximal hip fractures are common in the elderly, often resulting from falls.
- Visual impairment is a significant risk factor for falls and can impede rehabilitation.
- The prevalence and impact of visual impairment in hip fracture patients are not well-established.
Purpose of the Study:
- To determine the prevalence of visual impairment in patients with proximal hip fractures.
- To evaluate the effectiveness of a simple screening test for identifying visual impairment in this population.
Main Methods:
- Patients on an orthopedic rehabilitation ward post-hip fracture were assessed.
- Visual acuity and visual fields were tested by nurses and ophthalmologists.
- Ophthalmologists performed dilated slit-lamp examinations to determine causes of impairment.
Main Results:
- 33% of patients met US criteria for visual impairment; 58% had visual acuity of 6/18 or worse in at least one eye.
- The screening test demonstrated high sensitivity (94%) and specificity (92%) for detecting visual impairment.
- The test was less reliable in identifying potentially remedial visual impairments (70% sensitivity).
Conclusions:
- Visual impairment is highly prevalent in elderly patients with proximal hip fractures.
- Screening for visual impairment in this demographic is warranted.
- A simple screening test, administered by trained rehabilitation staff, can effectively identify most patients with visual impairment.
