Universal screening does not reduce the prevalence of visual impairment in older people*1

Abstract

Does targeted or universal screening for visual acuity improve visual outcomes in older people? Cluster randomised controlled trial. There was no significant difference in the proportion of people with poor visual acuity with universal screening compared with targeted screening at follow-up (median follow-up 3.9 years; absolute risk for acuity <6/18 in either eye: 37.0% (339/978) with universal screening vs. 34.7% (307/829) with targeted screening; RR 1.07, 95% CI 0.84 to 1.36; P =0.58). There was no significant difference in visual function between groups at follow up (mean composite NEI score: 86.0 with universal screening vs. 85.6 with targeted screening; mean difference: 0.4, 95% CI –1.7 to 2.5; P =0.69). Universal screening for visual impairment in older people as part of multidimensional screening programme did not significantly decrease the overall prevalence of visual impairment.