PURPOSE. To assess visual function of the homebound elderly, to determine patient access to visual care services, and to evaluate the social and medical implications of visual dysfunction. METHOD. A two part survey consisting of the National Eye Institute’s 25 point visual function questionnaire (VFQ-25) and questions regarding demographics, social environment and access to health care services were administered to 51 homebound elderly in the greater Boston area. The surveys were administered in person or by phone. A small internal validation study was conducted in which ten individuals received visual screenings and results were compared to survey responses. The results of the VFQ-25 were scored according to guidelines established by RAND. Descriptive analysis, correlation analysis and chi-square analysis were performed for statistical interpretation.
RESULTS. The homebound population surveyed had an average age of 77, was largely female, predominantly white and African American, had an education level below high school and lived alone. The average time from their last eye exam was 2.5 years and 60% had not received eye care in the last year. The VFQ scores observed in the homebound population were lower than those observed in a disease-free reference group. Due to small sample size, none of the statistical analysis yielded statistically significant results but a negative association was observed between time from last eye exam and near activities subscale score.
CONCLUSIONS. Homebound elderly suffer from poor vision. Both physical (lack of transportation) and psychological (elderly and primary care physicians underestimate visual impairment in the elderly) barriers to eye care exist; therefore, services should be brought to them.