Visual impairment in adult people with moderate, severe, and profound intellectual disability

Abstract

Purpose: To assess visual impairment in adults with intellectual disability after de-institutionalisation.

Patients: The county has a population of 385 483 persons of 18 years and older; 961 were moderately, severely or profoundly intellectually impaired (ID), 837 of them (87 %) participated in the investigation.

Methods: Visual acuity, VA: Østerberg picture charts and reduced copies for near vision could be used in 71% of the patients. Teller preferential looking procedure was applied to people who were unable to cooperate with the picture charts. When examined with picture wall chart VA 0.3-> or =0.10) was found in 10.8%, severe low vision in 1.2% (VA <0.10-> or =0.05), and blindness (VA<0.05) in 3.8%. Poor near vision (<0.3) was present in 19%. Those assessed with Teller acuity cards had poorer vision than the others. It is possible that the low values of assessment with Teller cards represent a combination of gnostic and resolution deficiencies, which means that the results of grating VA and recognition VA are non-comparable. Ophthalmic disorders: The most widespread medical condition was cerebral visual impairment, the most frequent eye disorders were optic atrophy, high myopia, cataract, and keratoconus. Refraction: Refraction was assessed in 710 persons (85%), the most prevalent cause of visual impairment was uncorrected ametropia. Hypermetropia of >+1.50 was found in 151 of 710 subjects (21%), and spectacles were used by 106 (15%); myopia <-1.0 was present in 213 individuals (30%), 95 persons (13%) had lenses <-1.0.

Conclusion: Resettled adult people with intellectual disability have a high prevalence of treatable visual impairment. A structured scheme of referral to optometric and ophthalmological care is essential if these people are to be given the care to which they are entitled.