Provision of eye care services and interventions in care homes: a narrative synthesis review

Background: The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population.

Objective: This paper reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions are: (1) What is the existing evidence for eye care interventions or services (including service configuration) for care home residents? (2) Does the provision of these interventions or services improve outcomes?

Methods: Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data were extracted and evaluated using narrative synthesis.

Results: 13 original papers met the inclusion criteria. Domiciliary optometrist services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions, such as cataract surgery, refractive error correction and low-vision rehabilitation, improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes such as falls.

Conclusion: Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.