Tool for Screening Visual Acuity in Older Individuals With Dementia

Abstract

Rationale/Objective: To develop a screening and referral algorithm tool to help identify which older institutionalized individuals with dementia need an eye examination. Methods: The visual acuity (VA) screening test was developed on an iPad retina display. Three optotypes were used (letters, numbers, and tumbling E’s) to determine whether one works best with dementia. The screening VA results and algorithm decision were validated against those obtained by an optometrist performing a complete eye examination. Results: Of the 150 participants, 14.7% did not respond to any optotype, while 85.3% responded to letters, 84.0% to numbers, and 66.0% to tumbling E’s. The VA achieved was superior for letters. The concordance for the screening versus eye examination was >80% for VA and 90% for the algorithm. Conclusion: The results indicate that the tool was successful at identifying older individuals with dementia needing an eye examination.