Aims: To evaluate the current visual status and ophthalmic history of a sample of elderly patients with fractured neck of femur and to study the relationship between visual status and demographic factors. Methods: A four-centre study of all patients admitted to hospital with fractured neck of femur. The setting was two district (Ayr, Dunfermline) and two teaching (Glasgow, Dundee) hospitals in Scotland. The study examined 537 patients aged 65 years and over admitted with a cute fractured neck of femur to hospital. Results: Bilateral visual impairment ( binocular visual acuityworse than 6/12)was found in 239 of 518 patients (46%). Of this group, the principal causes for visual deficit were untreated cataract ( 49%), macular degeneration (21%), uncorrected refractive error (17%), and gla ucoma (3%). The visually impaired group were more likely to have symptomatic vi sual complaints (58 vs 26%), however, were less likely to be under optometric c are (71 vs 85%). A higher proportion of the group with visual impairment lived in areas of social deprivation (40 vs 26%). Conclusions: Patients with fracture d neck of femur represent a frail elderly group that have poorer vision than tha t documented in any other elderly population. The visual defect was potentially remediable in the majority of cases but this group of individuals are not genera lly in touch with the ophthalmic services. Social deprivation appears to be asso ciated with this groups’inability to access ophthalmic care. Aims: To evaluate the current visual status and ophthalmic history of a sample of elderly patients with fractured neck of femur and to study the relationship between visual status and demographic factors. Methods: A four-center study of all patients admitted to hospital with fractured neck of femur. The setting was two district (Ayr, Dunfermline) and two teaching (Glasgow, Dundee) hospitals in Scotland. The study examined 537 patients aged 65 years and over admitted with a cute fractured neck of femur to hospital. Of this group, the principal causes for visual deficit were untreated cataract (49%), macular degeneration (21%), uncorrected refractive error (48%), impairment (binocular visual acuity worse than 6/12) was found in 239 of 518 patients The visually impaired group were more likely to have symptomatic vi sual complaints (58 vs 26%), however, were less likely to be under optometric c are (71 vs 85%), and gla ucoma (3%). A higher proportion of the group with visual impairment lived in areas of social deprivation (40 vs 26%). Conclusions: Patients with fracture d neck of femur represent a frail elderly group that have poorer vision than tha t documented in any other elderly population. remediable in the majority of cases but this group of individuals are not genera lly in touch with the ophthalmic services. Social deprivation appears to be asso ciated with this groups’inability to access ophthalmic care.