Government-insured routine eye examinations and prevalence of nonrefractive vision problems among elderly.

Objective: To assess whether lack of government-insured annual routine eye examinations was associated with reduced vision health status among elderly Canadians.

Methods: Cross-sectional survey. Methods: Respondents aged ≥ 65 years in the Canadian Community Health Survey 2000-2001. Methods: The prevalence of nonrefractive vision problems (i.e., unable to see close or distance when wearing glasses or contact lenses) between Canadians with and without government-insured annual eye examinations was compared.

Results: Uninsured white individuals had a greater prevalence rate of vision problems (8.5%; 95% CI 6.8-10.2) than insured white individuals (6.4%; 95% CI 5.2-7.6) if their household incomes were less than the midlevel. In those with household incomes at the midlevel or higher, the prevalence rate was similar between the insured (4.3%) and uninsured (3.6%; p>0.05). Compared with elderly adults in the mid- to high-income level and living in insured provinces, white elderly adults residing in provinces with no insurance had 50% higher odds of reporting vision problems (adjusted odds ratio [OR] 1.5; 95% CI 1.1-2.0) if their income was less than the midlevel, but a 30% lower likelihood of having vision problems if their income was in the midlevel or higher (adjusted OR 0.7; 95% CI 0.6-1.0). The mean age at diagnosis of glaucoma and cataracts was about 2 years older for uninsured versus insured white individuals. Analyses among non-white individuals were not permitted because of small sample size.

Conclusions: Lack of government-funded annual routine eye examinations is associated with increased levels of nonrefractive vision problems among low-income elderly adults.