Prognostic factors for a change in eye health or vision: A rapid review

Abstract

AbstractThe general public are advised to have regular routine eye examinations to check their vision and ocular health; however current UK guidance on how often to have eye examinations is not evidence-based and was issued in 2002.This Rapid Review aims to provide an evidence base that stakeholders can use to form updated guidance for Wales by asking the question ‘What are the prognostic factors for a change in ocular status in the general population attending routine eye examinations?’The review included evidence available from January 2009 up until August 2023. Evidence was included from 2011 up until 2023. 19 studies were included: two systematic reviews; nine prospective cohort studies; three retrospective cohort studies; two longitudinal studies; two case-control studies; and one cross-sectional study were included.Research Implications and Evidence GapsFuture research to inform appropriate eye examination intervals should be narrower in focus to ensure as much relevant and useful evidence as possible is gathered. There are large amounts of evidence on prevalence and prognostic factors for prevalent conditions, which did not meet the inclusion criteria of this rapid review which looks at incident or changing conditions.Policy and Practice ImplicationsCaution should be taken if using this review for decision making on appropriate eye examination intervals due to low certainty and generalisability. This review should be used to identify key prognostic factors and suggesting these for further targeted research and evidence synthesis.Economic considerationsSight loss costs the UK economy 25 billion pounds per annum, with more than 2 million people in the UK currently living with sight loss. The economic implications of appropriate or inappropriate testing intervals for different causes of vision loss will be different. When captured at a population wide scale, the earlier detection of conditions through examination can result in significant economic savings.Funding statementThe Centre for Health Economics and Medicines Evaluation, the Bangor Institute for Medical and Health Research, and the Swansea Centre for Health Economics were funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government.