Evaluation of low vision services in adults to assess impact on functional status and quality of life

Poster Details

First Author: R.Deshpande INDONESIA

Co Author(s):    M. Deshpande              

Abstract Details

Purpose:

There are currently an estimated 180 million visually impaired persons globally. Out of the total of 171 million which comprises 135 million persons with ‘low vision’ (ICD-10) and 36 million blind with residual vision, an estimated 60% can be improved with surgical treatment. This accounts for an estimated total of 103 million persons who would benefit from treatment. The remaining estimated 68 million persons require low vision care and are likely to benefit group1, 2. A recent population based study has shown the prevalence of low vision to be 1.05% in India 3 .It has been observed that almost 90% of those considered blind retain a degree of potentially useful residual vision. Low vision is associated not only with decreased visual acuity, but also with increased risk for depression and decreased functional status and quality of life. So low vision rehabilitation does not include only prescribing optical aids but it also includes improvement in patient’s quality of life. Despite their increasing public health significance, the functional status and quality of life of patients with low vision have been incompletely studied8 .As the population of low-vision patients continues to grow, attention must be focused on evaluating the effectiveness of low-vision services.

Setting:

H.V.Desai Eye Hospital,Hadapsar,Pune,Maharashtra,India

Methods:

A clinical interventional study was carried out during period of 1st October 2010 to 1st October 2011. In this study adults (>16years) with low vision were assessed..The sample size was 50..Brief demographic details, regarding age, sex, education details and onset, duration and progress of visual loss were recorded. Data was collected by detailed history and examination of adults with low vision. Complete visual assessment was done. Visual acuity was tested using BAILEY LOVIE log MAR charts for near and distance. Dry retinoscopy was done and whenever needed radical retinoscopy. After radical retinoscopy acceptance was assessed and glasses were prescribed to those with low vision .Anterior segments and posterior segments of the eyes were examined using a slit lamp. The posterior segment was examined using slit lamp biomicroscope with +90D lens, a direct ophthalmoscope and indirect ophthalmoscope after dilatation of pupil depending on case. Other visual functions like contrast sensitivity, colour vision, visual field, difficulty in night vision, photophobia were assessed. Appropriate aids - optical (for near and distance) and non optical - were tried depending upon magnification required and they were prescribed. Quality of life was assessed by standardised questionnaire. The data was analyzed using SPSS software version 17.0.

Results:

67 patients were assessed. Among them 52.4% were above 50 years of age. 75% were males.Among congenital determinants of low vision neurological causes- most common while in acquired retinal causes(67.79%) -most common.Among 67 ,71.64% accepted aids for distance, while 85.08% accepted aids for near.Most accepted aid for distance-spectacles 50%.Most common aid accepted aid for near-stand magnifier(49.12%) .Before giving devices 71.64% were < 1m but after giving devices, only half of them i.e..35.82% Were <1m while 1.49% show improvement till 0.5M.For near 81% were improved to 1M ,which is statistically significant, showed by p value less than 0.05%.64.18% showed improvement > 1M in distant vision and 55.55% showed one LOG MAR improvement for distance.While for near vision there was marked improvement, 44.44% showed one LOG MAR while 22.22% showed two LOG MAR lines improvement. Quality of life showed significant improvement after use of devices especially in activities like reading and writing, which is statistically significant, showed by p value less than 0.05%. Compliance as measured in terms attending follow-ups and regular usage of aids provided was around 90% along with improvement in routine and outdoor activities proved the beneficial changes noticed in the quality of life.

Conclusions:

Low vision aids are very useful to those who have some residual vison.Low vision affects not only visual acuity but also quality of life which can be improved with low vision aids. FINANCIAL DISCLOSURE?: No