Visual impairment and blindness in institutionalized elderly in Germany

  • Petra P. Larsen
  • Sarah Thiele
  • Tim U. Krohne
  • Focke Ziemssen
  • Frank Krummenauer
  • Frank G. Holz
  • Robert P. FingerEmail author
  • on behalf of the OVIS-Study Group
Low Vision



To determine the prevalence of and identify factors associated with visual impairment and blindness in institutionalized elderly in Germany.


In this prospective multicenter cross-sectional study, ophthalmic health care need and provision were investigated in institutionalized elderly in 32 nursing homes in Germany. All participants underwent a standardized examination including medical and ocular history, refraction, visual acuity testing, tonometry, biomicroscopy, and dilated funduscopy. A standardized questionnaire was used to identify factors associated with eye healthcare utilization, visual impairment and/or blindness.


Visual acuity of 566 (94.3%; 413 women and 153 men) of a total of 600 institutionalized elderly was determined. Mean age of the included patients was 82.9 years (± 9.8). Of all participants, 30 (5.3%; 95% CI 3.4–7.2%) were blind and 106 (18.7%; 95% CI 15.5–21.9%) were moderately or severely visually impaired according to the World Health Organization definition. The 136 blind and moderately or severely visually impaired participants were older (OR, Odds Ratio = 1.1, 95% CI 1.0–1.1; p < 0.001), and more likely to have reduced mobility (OR = 12.6, 95% CI 2.8–57.6; p = 0.001).


A high proportion of blindness and visual impairment was found amongst nursing home residents. Age and reduced mobility were factors associated with an increased likelihood of blindness and visual impairment. Any surveys of blindness and visual impairment excluding nursing homes may considerably underestimate the prevalence of visual impairment and blindness.


Aging Low vision Visual loss Blindness Nursing homes 



This study was supported by the Ernst und Bertha Grimmke Foundation, Germany (PPL and TUK).


The Department of Ophthalmology, University of Bonn, received research funding from the Stiftung Auge (German Eye Foundation) of the German Ophthalmological Society (DOG) with support of Bayer and Novartis for the OVIS study. The Medical Biometry and Epidemiology Unit of Witten/Herdecke University received research funding from the University of Bonn (Eye Hospital) for the methodological counseling of this investigation.

Compliance with ethical standards

Disclosure of potential conflicts of interest

S. Thiele reports personal fees from Carl Zeiss MediTec, Heidelberg Engineering, and Optos, outside the submitted work. T. U. Krohne reports personal fees from Alimera Sciences, Bayer, Heidelberg Engineering, and Novartis, outside the submitted work. F. Ziemssen has received honoraria for consultation and research from Alimera, Allergan, Bayer, Biogen, MSD, Novartis, NovoNordisk and Roche, none was related to the topic. F.G. Holz reports personal fees from Acucela, Allergan, Bayer, Bioeq, Boehringer Ingelheim, Carl Zeiss MediTec, Genentech/Roche, Heidelberg Engineering, Merz, NightstarX, Novartis, Optos, Pixium and Thea, outside the submitted work. R. P. Finger reports personal fees from Bayer, Opthea, Santen, Novartis, Retina Implant and Novelion, outside the submitted work.

None of the sponsors had any role in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication. None of the authors has any proprietary or competing interests to disclose.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local ethic committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants or their legal guardians included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Petra P. Larsen
    • 1
  • Sarah Thiele
    • 1
  • Tim U. Krohne
    • 1
  • Focke Ziemssen
    • 2
  • Frank Krummenauer
    • 3
  • Frank G. Holz
    • 1
  • Robert P. Finger
    • 1
    Email author
  • on behalf of the OVIS-Study Group
  1. 1.Department of OphthalmologyUniversity of BonnBonnGermany
  2. 2.Centre for OphthalmologyEberhard-Karls-University TuebingenTuebingenGermany
  3. 3.Institute for Medical Biometry and Epidemiology, Faculty of HealthWitten/Herdecke UniversityWittenGermany

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