Perform an annual office-based screening of vision and hearing (eg, Snellen eye chart and the whisper test) or when symptoms or signs of visual or hearing problems are noticed, including changes in behaviour or function.131
Refer to optometry
Refer for optometry assessments to detect glaucoma and cataracts every 2 y after age 40.132, 133
Refer for audiology assessments based on screening and for age-related hearing loss every 5 y after age 45.131, 134
Screen for cerumen impaction every 6 mo and address (eg, by advising periodic use of mineral oil drops).134, 136
128. Hey C., Fessler S., Hafner N., Lange B.P., Euler H.A., Neumann K. High prevalence of hearing loss at the special olympics: Is this representative of people with intellectual disability? Journal of Applied Research in Intellectual Disabilities. 2014;27(2):125-33.
129. Herer G.R. Intellectual disabilities and hearing loss. Communication Disorders Quarterly. 2012;33(4):252-60.
130. McClimens A, Brennan S, Hargreaves P. Hearing problems in the learning disability population: Is anybody listening? British Journal of Learning Disabilities. 2015;43(3):153-60.
131. Evenhuis HM, Natzgam LMD. IASSID international consensus statement: Early identification of hearing and visual impairment in children and adults with an intellectual disability. Leiden, the Netherlands: International Association of Scientific Studies on Intellectual Disability (IASSID), Special Interest Group on Health Issues; 1997.
132. Li JC, Wong K, Park AS, Fricke TR, Jackson AJ. The challenges of providing eye care for adults with intellectual disabilities. Clinical and Experimental Optometry. 2015;98(5):420-9.
133. Robinson BE, Mairs K, Glenny C, Stolee P. An evidence-based guideline for the frequency of optometric eye examinations. Primary Health Care. 2012;2(4).
134. Bent S, McShea L, Brennan S. The importance of hearing: A review of the literature on hearing loss for older people with learning disabilities. British Journal of Learning Disabilities. 2015;43(4):277-84.
135. Crandell CC, Roeser RJ. Incidence of excessive/impacted cerumen in individuals with mental retardation: A longitudinal investigation. Am J Ment Retard. 1993;97(5):568-74.
136. Oron Y, Shushan S, Ben-David N, Flaksman H, Korenbrot F, Merrick J, et al. Guidelines for ear, nose, and throat examination of adults with intellectual disabilities: Report of a clinical practice application. Journal of Policy and Practice in Intellectual Disabilities. 2015;12(4):272-8.