Prognostic factors for a change in eye health or vision: A rapid review

The general public are advised to have regular routine eye examinations to check their vision and ocular health; however current UK guidance on how often to have eye examinations is not evidence-based and was issued in 2002.This Rapid Review aims to provide an evidence base that stakeholders can use to form updated guidance for Wales by asking the question ‘What are the prognostic factors for a change in ocular status in the general population attending routine eye examinations?’ The review included evidence available from January 2009 up until August 2023. Evidence was included from 2011 up until 2023. 19 studies were included: two systematic reviews; nine prospective cohort studies; three retrospective cohort studies; two longitudinal studies; two case-control studies; and one cross-sectional study were included. Research Implications and Evidence Gaps Future research to inform appropriate eye examination intervals should be narrower in focus to ensure as much relevant and useful evidence as possible is gathered. There are large amounts of evidence on prevalence and prognostic factors for prevalent conditions, which did not meet the inclusion criteria of this rapid review which looks at incident or changing conditions. Policy and Practice Implications Caution should be taken if using this review for decision making on appropriate eye examination intervals due to low certainty and generalisability. This review should be used to identify key prognostic factors and suggesting these for further targeted research and evidence synthesis. Economic considerations Sight loss costs the UK economy 25 billion pounds per annum, with more than 2 million people in the UK currently living with sight loss. The economic implications of appropriate or inappropriate testing intervals for different causes of vision loss will be different. When captured at a population wide scale, the earlier detection of conditions through examination can result in significant economic savings. Funding statement The Centre for Health Economics and Medicines Evaluation, the Bangor Institute for Medical and Health Research, and the Swansea Centre for Health Economics were funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Funding statement: The Centre for Health Economics and Medicines Evaluation, the Bangor Institute for Medical and Health Research, and the Swansea Centre for Health Economics were funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * AMD : Age-related macular degeneration CI : Confidence interval CRVO : Central retinal vein occlusion HR : Hazard ratio IOP : Intraocular pressure OR : Odds ratio QUIPS : Quality in Prognostic factor Studies RCT : Randomised controlled trial ROBIS : Risk of Bias in Systematic reviews RR : Risk ratio / relative risk SER : Spherical equivalent refraction VA : Visual acuity