Easiest to Implement (Quick Pilot Studies)

1. Feasibility of Physician-Performed Visual Acuity Screening Using the Snellen Chart in a Non-Ophthalmology Setting ✅

   • Low patient burden, simple workflow, minimal equipment.

2. Prevalence of Visual Impairment in Patients with Diabetes and Hypertension Using the Snellen Chart

   • Straightforward cross-sectional study, mostly descriptive.

3. Visual Acuity Patterns Among Chronic Kidney Disease Patients in Outpatient Clinics

   • Simple measurement, good for baseline data.

4. Patient Awareness of Eye Health and Visual Impairment in a Cardiometabolic Clinic Population

   • Surveys + Snellen chart, easy to implement.

5. Evaluation of Snellen Chart Screening as Part of Routine Cardiometabolic Clinic Workflow

   • Measures feasibility + time metrics.

Moderate Implementation (Requires Correlation / Data Collection)

6. Association Between Duration of Diabetes and Reduced Visual Acuity in a Cardiometabolic Clinic

7. Correlation Between Glycemic Control (HbA1c) and Visual Acuity in Diabetic Patients

8. Impact of Blood Pressure Control on Visual Acuity in Hypertensive Patients

9. Relationship Between eGFR and Visual Acuity Among CKD Patients

10. Association of Age and Visual Acuity in Patients with Cardiometabolic Diseases

11. Effect of Combined Diabetes and Hypertension on Visual Acuity in Adult Patients

12. Comparison of Visual Acuity Between Newly Diagnosed and Long-Term Diabetic Patients

13. Patterns of Visual Impairment in Patients with Both Diabetes and Chronic Kidney Disease

14. Relationship Between Lipid Levels and Visual Acuity in Cardiometabolic Patients

These require lab data (HbA1c, BP, eGFR, lipids) but are still manageable in a clinic setting.

Higher Impact / Research Value (Strong Publication Potential)

15. Prevalence of Undiagnosed Visual Impairment in Cardiometabolic Patients in Urban vs Rural Clinics

16. Screening Visual Acuity Using the Snellen Chart as a Predictor for Referral to Ophthalmology

17. Prevalence of Moderate to Severe Visual Impairment in Patients with Multiple Cardiometabolic Risk Factors

18. Correlation Between Retinal Microvascular Changes (if fundoscopy is available) and Snellen Visual Acuity

19. Feasibility and Accuracy of Task-Shifting Visual Acuity Screening to Non-Ophthalmologist Clinicians

20. Assessment of Visual Acuity Using the Snellen Chart in Patients with Diabetes, Hypertension, and CKD: Prevalence and Clinical Correlates

These are more impactful because they can influence screening guidelines, referral systems, and policy, but may require more patients, data, or collaboration with ophthalmologists.