Lack of a national policy on eye health in care homes leaves many older people without the most basic eye care says a new report (1) by the International Longevity Centre UK (ILC-UK) (2) and the sight loss charity, Thomas Pocklington Trust (3).  

“Undetected sight loss in care homes: an evidence review” is a comprehensive review of sight testing and sight loss in care homes.  It reveals that eye care and sight testing are both seriously neglected in care homes, leading to potential discrimination against those living in them compared to those who are cared for in the community (4).

“About half of those living in care homes are estimated to have sight loss and much of it is treatable, yet eye health is frequently ignored,” said Baroness Greengross, Chief Executive of ILC-UK.  “Eye health is not enshrined in the quality guidelines for care homes and while this remains the case, people in residential homes will continue to have lower standards of eye care than they deserve.”

Around 400,000 older people currently live in care homes across the UK and half of these are estimated to have some form of sight loss.  Much of that is partially or wholly treatable but eye health is frequently ignored as a health outcome in care homes.  In particular, people with dementia may lose out on eye care as there is often a false assumption that sight testing someone with dementia is not worthwhile.

“Undetected sight loss in care homes: an evidence review” provides a comprehensive picture of the current approach to eye care in care homes.  It reveals that:

  • Nationally, there is no standard requirement for care homes to ensure appropriate eye health care and sight tests for all residents. (5)
  • Appropriate testing is not consistently available to all residents, is often not taken up where it is offered and all too commonly there is inadequate attention to follow on support - such as ensuring spectacles are clean, up to date and in use.
  • In many care homes eye health and sight is ignored.  Overstretched care staff do not see sight problems as a threat to residents’ health and there is a lack of training in its importance and the possibility of treatment.
  • Sight loss remains a “silent” problem where many older people assume it is inevitable with age, and irreversible. They live with varying stages of deteriorating sight, unaware of their need for better care and therefore unable to ask for it.

Says Sarah Buchanan, Research Director, Thomas Pocklington Trust: “The review shows there is an unacceptably high rate of treatable sight loss in care homes.  While eye care and sight tests are neglected this will never change. Eye care is not a minor part of general health - it is a crucial priority, vital to people’s health, wellbeing and independence.  Only by recognising it as such will older people in care homes receive reliable, high quality eye care.”

Recommendations in the review include:

  • The Care Quality Commission should incorporate eye health indicators into their assessment criteria for care homes.
  • Care home providers should be encouraged to add eye health and sight loss testing to their key performance indicators.
  • Care home staff and managers should be trained in issues of sight loss and eye health.

For more information please contact Sue Cooper:  Tel:  07775558395  Email:

Editor’s Notes:

1. “Undetected sight loss in care homes:  an evidence review” was carried out by Jessica Watson and Sally-Marie Bamford of the International Longevity Centre – UK, and funded by Thomas Pocklington Trust.  It will be presented at the British Society of  Gerontology conference tomorrow (11th July) and is available today from and

2. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change:

3. Thomas Pocklington Trust is a charity which is a leading provider of housing, care and support services for people with sight loss in the UK.  It also funds an annual programme of research to identify ways to improve the lives of people with sight loss:

4. Equal access to services of all kinds should be provided to older people living in care homes under the Equality Act (2010). The lack of access and priority given to sight testing and subsequent lower standards of care could be considered indirect discrimination on grounds of both disability and age for this group.

5. Recently, the need to improve eye health has been included in national public health planning. In the Public Health White Paper ‘Healthy Lives, Healthy people’, the Department of Health drew attention to avoidable sight loss with the inclusion of an eye health indicator in the Health Outcomes framework (Department of Health, 2012).  However, there is no standard requirement for care homes to ensure appropriate eye health care and sight tests for all residents.

There are many examples of excellent practice of sight testing in care homes. The review does not aim to reduce the laudable outcomes of these examples, but to highlight the importance of this practice being repeated across the country.   The authors acknowledge that there are related issues with access to good eye health faced by older people being cared for in the community; people with learning disabilities, and access to care for older people with hearing loss.


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