Opportunistic screening of visual acuity of elderly patients attending outpatient clinics

A standard Snellen letter chart was used to screen the visual acuities of 202 elderly patients while they attended outpatients clinics. Patients overestimated the adequacy of their vision: only 34 patients reported inadequate vision while 72 had significant measured visual impairment. Of these, 30 patients had refractive errors and 42 primarily non-refractive problems. Thirty patients were examined by an ophthalmologist, of whom 24 had previously undiagnosed conditions. Eighteen patients had treatable conditions, predominantly cataracts and glaucoma. Ten patients with untreatable conditions had the benefit of a definitive diagnosis, most commonly of age-related macular degeneration, and an assessment of eligibility for registration of blindness. The routine assessment of elderly patients should include objective screening of their visual acuity.