The Residential Ocular Care Study: A Multi-Centered, Randomized Controlled Clinical Trial comparing the effectiveness of an innovative and comprehensive new eye care model with usual care for individuals in Residential Aged Care Facilities

The intervention is the Residential Ocular Care (ROC) intervention model, which is a novel model of eye care for people living in residential care facilities. This comprehensive model includes a thorough on-site eye examination with four subsequent intervention options for those with vision impairment, namely: (a) refraction and spectacle provision - glasses will be prescribed; (b) cataract surgery - participants will be referred to the Royal Victorian Eye and Ear hospital as a public patient where surgery costs will be covered, or they can elect to go privately but will have to cover any out of pocket costs. Reimbursement will be covered for travel to and from the surgery as well as for preop assessments and 2 post op assessments; (c) low vision rehabilitation - participants will be referred to Vision Australia where low vision therapists will conduct a low vision examination and dispense low vision aids. A follow up session and training session on how to use the aids will also be provided; and (d) referral to an ophthalmologist for medical and surgical treatments for conditions likely to cause loss of sight or ocular discomfort. If our vision assessment uncovers cases of vision impairment not covered by the other interventions a referral will be made to an appropriate ophthalmologist at a local public hospital for medical treatment or surgical interventions as required at no cost to the participant. Participants will only be given one of the 4 interventions specified above that best suits their need. The ROC Model of care will be administered at Baseline visits where one of the four interventions will be given. Quality of life questionnaires will be administered at baseline, 2 month and 6 month. At 6 month optometrists will conduct another comprehensive eye tests The onsite comprehensive eye examinations are carried out by the Optometrist from the Australian College of Optometry and involve testing of visual acuity, subjective refraction and reading fluency. Examinations will be carried out to assess intraocular eye pressures, visual fields and dilated examinations of the back of the eye. Scans will also be taken of the back of the eye.