Explore the vast range of titles available.

Background Globally, 2.2 billion individuals live with visual impairment (VI). However, many cases remain undetected, particularly among older adults. Therefore, novel interventions for detection are needed. Community-based interventions (CBIs) that target people where they live provide a promising approach. This systematic review aimed to synthesize the existing literature describing potentials and barriers regarding uptake, feasibility, and effects of CBIs in detecting VI among community-dwelling older adults aged ≥ 75 years. Methods We conducted a mixed methods systematic literature review. PubMed, Scopus, CINAHL, PsycInfo, Cochrane, and Embase were searched for articles with no restrictions on publication date. Studies were eligible if they reported on a CBI to detect VI among older adults aged ≥ 75 years. Two reviewers independently extracted data and appraised the quality and risk of bias of the included studies using the Mixed Methods Appraisal Tool. A narrative meta-synthesis of the relevant evidence was conducted. Results We identified 3,019 articles of which 26 of varying methodological quality were included. The VI detection methods included surveys, optometric tests, eye examinations, and self-reported visual status. Potentials and barriers regarding the uptake, feasibility, and effects of the interventions were identified at the individual, interpersonal, and community and system levels. Key potentials that may lead to successful interventions included leveraging community resources, tailoring of interventions, targeting underserved populations, high participant satisfaction, increased accessibility, and the use of tele-ophthalmology technology. Conversely, barriers that may negatively affect intervention uptake, feasibility, and effectiveness included financial constraints, poor general health, lack of eye-health awareness, poor referral systems, lack of institutional resources or access to detection technology, and technological challenges. Conclusion The synthesized results emphasize the importance of developing CBIs that target multiple levels, including the individual, interpersonal, community and system levels. Our results indicate that this may involve combining components such as eye health education, targeted strategies, use of appropriate detection methodologies, and ensuring affordability. These results may inform the development of novel CBIs to foster more effective detection of VI among older populations, improve community eye health, and reduce the burden of VI. Trial registration CRD42023468155.

Background The atrophic late stage of age-related macular degeneration (AMD) is termed geographic atrophy (GA), and affects visual acuity (VA) as well as quality of life (QoL). Previous studies have found that best-corrected VA (BCVA), the standard vision assessment often underrepresents functional deficits. Therefore, the purpose of this study was to evaluate the correlation between atrophic lesion size, VA and QoL measured with the National Eye Institute Visual Function Questionnaire (VFQ-39) in a Danish population. Moreover, we wanted to evaluate the correlation between comorbidities, behavioural factors, and QoL. Methods This was prospective clinical study of 51 patients with GA in one or both eyes, of these 45 patients had bilateral GA. Patients were consecutively included between April 2021 and February 2022. All patients filled in the VFQ-39 questionnaire except the subscales “ocular pain” and “peripheral vision.” Lesion size was measured from fundus autoflourescense images, and BCVA was assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Results We found an overall low score in each VFQ-39 subscale scores reflected by GA. Lesion size and VA were both significantly associated with all VFQ-39 subscale scores except for “general health.” VA showed a larger effect on QoL than lesion size. Chronic obstructive pulmonary disease (COPD) was associated with a lower score in the subscale score “general health” but none of the other subscale scores were affected. Cardiovascular disease (CVD) was associated with a lower BCVA as well as in QoL reflected in the subscale scores “poor general vision,” “near activities,” and “dependency” of VFQ-39. Conclusion Both atrophic lesion size and visual acuity affects QoL in Danish patients with GA, who reports an overall poor QoL. CVD seems to have a negative effect on disease, as well as in VFQ-39 in several subscales, whereas COPD did not affect disease severity or vision-related subscales in VFQ-39.