Older Adults Experience More Vision Difficulties at Home

Adults have better vision in clinics rather than at home, due to poor home lighting, according to a study by Anjali M. Bhorade, M.D., MSCI, of the Washington University School of Medicine, St. Louis, and colleagues.

Clinicians often assume that vision measured in the clinic is equivalent to vision at home, according to the study background.  However, many patients report visual difficulties greater than expected based on their vision testing in the clinic.

Between 2005 and 2009, researchers studied 126 patients with and 49 without glaucoma (ages 55 to 90 years old) from the Glaucoma and Comprehensive Eye Clinics at Washington University in St. Louis. Patients underwent clinic and home visits and several aspects of their vision were measured.

According to study findings, the mean scores for all vision tests were better in the clinic than at home for the participants. Glaucoma patients read two or more lines on an eye chart better in the clinic than at home and 39 percent of advanced glaucoma patients read three or more lines better in the clinic. Participants in the clinic also tested better in near visual acuity (NVA) and contrast sensitivity (CS) with glare. Lighting was the largest factor associated with difference in vision between the clinic and home; home lighting was below what was recommended for 85 percent or more of participants.

“In summary, distance and near VA [visual acuity], CS, and CS with glare may be better in the clinic than home for older adults with and without glaucoma,” the authors conclude. “This discrepancy may be owing, in part, to poor home lighting. Clinician awareness of these results may ease confusion regarding inconsistencies between a patient’s stated visual difficulties and their clinical examination.”

(JAMA Ophthalmol. Published online November 21, 2013. doi:10.1001/.jamaopthalmol.2013.4995.