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Impact of an intervention for avoidable vision loss on visual function in the elderly–The Hyderabad Ocular Morbidity in Elderly Study (HOMES)



To report the impact of interventions for avoidable vision impairment (VI) on the visual function of elderly residents in ‘homes for the aged’ in India.


Participants aged ≥60 years were recruited. A comprehensive eye examination was conducted by trained examiners and interventions were provided. Trained social investigators administered the Indian Vision Function questionnaire (INDVFQ) to assess visual function before and after the intervention (spectacles, cataract surgery or laser capsulotomy). Lower scores on IVFQ imply better visual function. VI was defined as presenting visual acuity worse than 6/18 in the better eye. VI due to cataract, uncorrected refractive errors, and posterior capsular opacification after cataract surgery were considered avoidable VI.


The mean age of the participants (n = 613) was 73.8 years (standard deviation: 8.1 years) and 378 (62.2%) were women. 64/103 (62.1%) participants who had avoidable VI at baseline were evaluated after the intervention. Significant gains were observed in all four domains of visual function. There was a 14.9% improvement in mobility scores (33.8 versus 28.8; p = 0.03), a 19.9% improvement in the activity limitations score (36.8 versus 29.5; p < 0.01), a 10.9% improvement in the psychosocial impact score (41.1 versus 36.6; p < 0.01) and a 13.6% improvement in the visual symptoms score (49.2 versus 42.5 p < 0.01). Overall, the mean IVFQ score improved by 16.4% (47.6 versus 39.8; p < 0.01).


Elderly individuals in residential care with avoidable VI had a significant improvement in visual function after relatively low-cost interventions such as spectacles and cataract surgery. Strategies are needed to provide these interventions for the elderly in ‘homes for the aged’ in India.

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Fig. 1: Overview of the HOMES study design.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.


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The authors thank the study participants for their committed contribution, Mr. Rajesh Challa and Ms. Madhuri Bhakki for their assistance in data collection, Ms. Muni Rajya Lakshmi for her support in data management, and Prof. Jill E. Keeffe (L V Prasad Eye Institute) for her inputs on earlier versions of the manuscript. Authors thank Ms. Neha Hassija for their language inputs on earlier versions of the manuscript.


This work was supported by Wellcome Trust/DBT India Alliance Fellowship [IA/CPHE/14/1/501506] awarded to Dr. Srinivas Marmamula and Hyderabad Eye Research Foundation (HERF), India.

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Study concept and design: SM. Acquisition, analysis, or interpretation of data: SM, TRK, SBM, RY. Drafting of the manuscript: SM. Critical revision of the manuscript for important intellectual content: SM, RCK, DSF. Statistical analysis: SM

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Correspondence to Srinivas Marmamula.

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Marmamula, S., Barrenkala, N.R., Kumbham, T.R. et al. Impact of an intervention for avoidable vision loss on visual function in the elderly–The Hyderabad Ocular Morbidity in Elderly Study (HOMES). Eye (2022).

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