Methods of screening for dementia: a meta-analysis of studies comparing an informant questionnaire with a brief cognitive test

OBJECTIVE: The Canadian Ophthalmological Society was asked by the Royal Canadian Mounted Police (RCMP) and the Canadian Human Rights Commission to render an opinion on the acceptability of contact lenses as a reasonable accommodation to the uncorrected visual acuity standard. DESIGN: Survey by mailed questionnaire. SETTING: Canada. SUBJECTS: All RCMP general duty constables with a visual acuity code of V3, V4, V5 or V6 (n = 348) and a random sample of approximately 25% of the constables with an acuity code of V2 (n = 809). Of the 1040 questionnaires returned, 1037 were usable (final response rate 89.6%). Of the 1037 respondents 316 were in the V3 to V6 group and 721 were in the V2 group. OUTCOME MEASURES: Reported frequency of problems with spectacles or contact lenses, weighted according to sampling fraction. RESULTS: A total of 934 respondents indicated that they used some form of visual acuity correction while on duty; of the 934, 360 reported that they wore contact lenses at least some of the time. Approximately 75% of the spectacle wearers reported having to remove their spectacles because of fogging or rain. Although contact lens dislogement or fogging (21.2%) was less frequent than spectacle dislogement (59.2%), 35.4% of the contact lens wearers reported that they were unable to wear their lenses because of irritation on at least one occasion in the previous 2 years; the median length of time was 3.14 days. When the additional amount of time due to other causes is factored in, it is clear that contact lens users wear spectacles for substantial periods while on duty. CONCLUSIONS: Not only are RCMP general duty constables who usually wear contact lenses likely to have to wear spectacles at some time, but it is also possible that they will have to remove their spectacles and function in an uncorrected state in critical situations. Thus, altering the current standard to allow the use of contact lenses as a reasonable accommodation would not ensure effective and safe job performance.