Health and social care services are increasingly shaped by the emergence of new digital developments. Research suggests that older adults are less likely to use digital devices and, therefore, risk missing out on essential health and social care services as these become more digital by design. We carried out an exploratory literature review using the terms ‘onboarding’ and ‘offboarding’ within the design, engineering, health, and social science literature to understand how researchers are currently thinking about older adults’ digital service needs, informed by discussions of stakeholder engagement with older adults in Edinburgh to explore their own experiences of digital transitions. The review process was implemented based on the methodology of Arksey and O’Malley for scoping reviews, and the findings were reported according to the PRISMA-ScR checklist. The databases used were Web of Science, PubMed, CINAHL Plus, IEEE Xplore, Engineering Village, PsycINFO, ASSIA and ACM. In total, 18 studies were finally included. Our findings show different interpretations of onboarding across disciplines and a lack of use of offboarding in the design of digital interventions. Additionally, our findings reveal inequalities in digital onboarding, as evidenced by the limited number of studies. Finally, we share a snapshot of our findings, together with reflections on interdisciplinary and collaborative processes.

Background: Keratoconus has a global prevalence of 0.2 to 4790 per 100 000 persons and there is currently no published report about its incidence, prevalence or the role of optometrists in its management in Uganda. This study looked at the role of optometrists in the diagnosis, management and referral of patients with keratoconus in Uganda. Aim: To determine the knowledge, experiences and practices of optometrists in the management of keratoconus in Uganda. Setting: This study was conducted in Uganda. Methods: Fifteen optometrists who had practiced for at least one year were recruited into the study, which was conducted in accordance with the International Conference on Harmonisation Tripartite Guideline for Good Clinical Practice. The study involved interviews that were conducted over zoom and telephones, which were considered for participants who had internet challenges. The sessions were recorded, transcribed verbatim, coded and themes were derived. Results: The median number of years of experience was 7 years. The participants’ experiences were reported in terms of diagnosis, management and referral of patients with keratoconus and common themes were explored. Retinoscopy and Munson’s sign were the most common diagnostic methods while spectacles were the most common management option used by the optometrists. Conclusion: Most optometrists relied on retinoscopy for diagnosis and spectacles for the management of keratoconus because of the lack of diagnostic equipment and challenges associated with contact lens practice in Uganda. Contribution: This is the first study to explore how keratoconus is managed by optometrists in Uganda and the results can be used to improve patient care in the country.

Visual frailty is a condition which has not been comprehensively explored by researchers and other professionals. This scoping review will be used as a starting point towards development of a comprehensive definition and designing an assessment and screening tool for the condition. It is well-known that vision deteriorates with age due to a range of factors like genetics, family history, ocular conditions, systemic diseases, and trauma but little is known about visual frailty, its definition, screening, and assessment in the ageing population. This scoping review aims to provide a basis for the definition of visual frailty and identify its screening and assessment tools in the ageing population.