How effective is an integrated approach to low vision rehabilitation? Two year follow up results from south Devon.

Abstract

Aims-A survey was undertaken to assess the effectiveness of an integrated approach to the provision of low visual aids (LVAs) in south Devon over a 2 year follow up period. This integrated approach includes the assessment of patient needs by low vision therapists, followed by the provision of suitable LVAs, with particular emphasis on training in their use.Methods-A total of 125 patients were selected at random from the 445 patients seen in the low vision clinic at Torbay Hospital in the year 1991. These patients were sent questionnaires relating to the service over a 2 year period. Questionnaires from 111 patients were analysed at 1 year and 75 questionnaires together with 46 clinical reassessments, after 2 years. Results-Using a similar questionnaire to one used in a previous study in the UK from a unit where LVA taining was not provided, not only was a higher rate of satisfaction found with the services provided, but also the LVAs dispensed were used more frequently. The majority of the LVAs provided were of the simple, inexpensive variety and wastage was very low. Conclusions-It was concluded that this integrated approach to low vision rehabilitation with emphasis on traning in the use of less complex LVAs exceeds the performance of other types of service that rely on the dispensing of more complex LVAs.

Low Vision Aids: The Effectiveness of Low Vision Rehabilitation

“…8 To examine the association between training and treatment success, Shuttleworth et al administered the patient satisfaction questionnaire used by McIlwaine et al to the patients at a low vision clinic in which training was an integral part of the service. 4,13 In total, 92% of patients reported that the service was sufficient to meet their needs, which is higher than the 55% of patients in the original survey study. 13 As Nilsson and Nilsson reported, improvement in distance and near visual acuity obtained with aids cannot be translated directly into improvements in visual performance in daily life; training is necessary.…”

“…4,13 In total, 92% of patients reported that the service was sufficient to meet their needs, which is higher than the 55% of patients in the original survey study. 13 As Nilsson and Nilsson reported, improvement in distance and near visual acuity obtained with aids cannot be translated directly into improvements in visual performance in daily life; training is necessary. 10 We think that low vision clinics must provide training, and motivate patients to use LVAs, which requires additional time and skilled staff.…”

“…12 Based on a survey, Shuttleworth et al reported that the most frequent tasks performed with LVAs were reading correspondence (83%), mainly reading newspapers, magazines, or books (73%) and writing (39%), which is similar to the present study's findings that 78.3% of LVAs were used principally for reading newspapers and 85% were used for all reading-related tasks. 13 Margrain reported that following low vision assessment and provision of a suitable LVA, reading ability improved in 88% of 168 new patients. 12 In another study of 530 cases with ARMD, 94% of patients were able to read after obtaining LVAs, but it is clear that satisfying acuity does not guarantee efficient reading in practical life.…”

How Effective is Low Vision Service Provision? A Systematic Review

“…Early studies tended to judge the outcomes of a service by either evaluating the frequency of use of low vision aids by patients at follow-up of a variable period 103,131,150 or by assessing clinical measures of visual function, such as visual acuity or reading speed. 69,93,100,107 Although clinical outcomes are important, they do not necessarily reflect the abilities that the patients will show in their home environment; for example, a large discrepancy has been demonstrated between individuals with a good near VA in the clinic (75%), and those able to resolve small print at home (39%).…”

Recent advances: Ophthalmology

“…Registration as blind or partially sighted, for all its defects does trigger some support. Local and national organisations for visually impaired people have an important role and have initiated the development of multiprofessional integrated services 36. These organisation often provide low vision aids to help with many daily tasks, including reading.…”