An evaluation of community-based comprehensive vision care for the ageing population

ABSTRACT Objective This study was conducted to evaluate the real-world effectiveness and potential cost-effectiveness of a community-based vision care programme for the ageing population aged 60 years or above. Methods Data from a total of 8899 subjects participating in a community based comprehensive vision care programme from 2015 to 2019 were extracted and analyzed to evaluate the effectiveness of the programme in terms of the prevalence of visual impairment (VI), the change in the prevalence of VI after refractive error correction, and the types of ocular disorders detected. VI was defined by a) visual acuity (VA) worse than 6/18 in any eye (worse eye) and b) VA worse than 6/18 in the better eye. The cost-effectiveness from the funder’s perspective was also estimated in terms of cost per VI avoided from such a programme. Results The study found that referenced to VA of the worse eye, the prevalence of VI was 39.1% (3482/8899, 95% CI: 38.1%-40.1%) based on presenting VA and reduced to 13.8% (1227/8899, 95% CI: 13.1%-14.5%) based on best-corrected VA. Referenced to the VA in the better eye, the prevalence of VI was 17.3% (1539/8899, 95% CI: 16.5%-18.1%) based on presenting VA and decreased to 4.2% (373/8899, 95% CI: 3.8%-4.6%) after best-corrected VA. Uncorrected refractive error was the major cause of presenting VI. From the funder’s perspective, the cost per VI case prevented was HK$1921 based on VA in the worse eye and HK$3715 based on the better eye. Conclusion A community-based programme was effective to detect the VI and reduced a relative 65% to 76% VI after refractive error correction for the community-dwelling ageing population. The ageing population can benefit from regular comprehensive vision care.