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Objectives: To determine whether regular eye examinations are associated with a greater or lesser rate of loss of ability to read newsprint, onset of blindness or low vision, or onset of limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs). Design: A sample of 14,215 Medicare beneficiaries observed between 1994 and 1999 linked to the 1994 and 1999 National Long-Term Care Surveys (NLTCS). Effects of annual examinations were assessed using instrumental variables. Setting: The Medicare-linked NLTCS is representative of U.S. elderly persons from 1994 to 1999. Participants: Longitudinal observational study of persons aged 65 and older. Measurements: Change in self-reported and provider-reported vision and change in functional limitations associated with vision related to the number of years with eye examinations and other factors. Results: Persons with more-regular eye examinations between 1994 and 1998 were less likely to have experienced a decline in vision or in functional status between 1994 and 1999. On average, an additional year with an eye examination was associated with a decrease in the probability of becoming unable to read newsprint of 0.12 ( P=.03), a lower probability of onset of low vision or blindness of 0.009 ( P=.06), and a decrease in the probability that the number of functional limitations increased of 0.13 ( P=.002) for IADLs and 0.05 ( P=.003) for ADLs. Conclusion: Elderly persons who have regular eye examinations experience less decline in vision and functional status. [ABSTRACT FROM AUTHOR]

Abstract: Importance: National data on eye health‐care service utilization will inform Australia's eye health policy. Background: To investigate the utilization of eye health‐care services by Australians. Design: Cross‐sectional survey. Participants: Indigenous Australians aged 40 years and older and non‐Indigenous Australians aged 50 years and older. Methods: One thousand seven hundred thirty‐eight Indigenous Australians and 3098 non‐Indigenous Australians were recruited from 30 randomly selected sites, stratified by remoteness. Sociodemographic, ocular history and eye health‐care service utilization data were collected, and an eye examination was conducted. Main outcome measures: Recentness of eye examinations, types of providers used and associated risk factors. Results: Approximately 67.0% of Indigenous Australians and 82.5% of non‐Indigenous Australians underwent an eye examination within the previous 2 years. Indigenous status (P < 0.001), male gender (P < 0.001), Outer Regional (P < 0.001) and Very Remote (P < 0.001) residence were associated with less recent examinations. Participants with >self‐reported eye disease or diabetes were most likely to have been examined within the past year (P < 0.001). For Indigenous Australians, older age was associated with recent eye testing (P = 0.001). Those with retinal disease and cataract were more likely to see an ophthalmologist (P < 0.001), and those with refractive error were more likely to see an optometrist (P < 0.001). In Regional Australia, non‐Indigenouspeople were more likely to see optometrists (P < 0.001), and Indigenous Australians were more likely to utilize other, non‐specialistservices (P < 0.001). Conclusions and relevance: Eye examination frequency has improved in Indigenous and non‐Indigenous Australians compared with previous population‐based research. Further improvements are required in risk groups including Indigenous Australians and those living in Regional and Remote areas. [ABSTRACT FROM AUTHOR]