Community-Based Ocular Screening Integrated into Primary Healthcare for Older Adults: Design and 2-Year Follow-Up...

This research aims to describe the design, objective and feasibility of a pioneering community-based eye screening program intended to facilitate the provision of ocular services to the elderly. As a prospective investigation, this project innovatively integrates comprehensive eye examinations into routine annual physical assessments by leveraging cutting-edge automation, digital documentation, and real-time data transmission technologies. Eligible participants included community-dwelling adults aged ≥ 60 years undergoing health check-ups. Four foundational ophthalmic assessments, namely presenting distance visual acuity, autorefraction, intraocular pressure and non-mydriatic fundus photography, were measured to detect prevalent age-related eye diseases. Further, a dual-validation system combining artificial intelligence-driven analysis with on-site expert confirmation was implemented for high-risk case identification. Additionally, a tiered management strategy featuring rapid referral pathways was established to ensure timely tertiary care access. Among 3785 eligible residents, 3459 (91.4% response rate) completed initial screening, with an average examination duration of 4-8 minutes. Following expert validation, 1679 participants (48.5%) required advanced evaluation. Substantial unmet ophthalmic needs were uncovered, with prevalence rates of cataract (43.5%), age-related macular degeneration (37.5%), uncorrected refractive errors (14.6%), glaucoma suspicion (12.4%) and diabetic retinopathy (4.8%). A two-year follow-up analysis demonstrated observed visual improvements, particularly in younger cohorts (60-69 years). In contrast, the relatively older subgroup (70-74 years) exhibited progressive decline. This investigation establishes a model for geriatric vision care that demonstrated feasibility through its synergistic integration of technological innovation and existing primary community health infrastructure, although scalability to other populations and low referral completion require further evaluation.