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Alice C. Lorch, Jennifer Wallis, Danielle Trief, Mary Lou Jackson; Outcomes Of Vision Rehabilitation In Patients With Low Vision Who Do, Or Do Not, Participate In Occupational Therapy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4408.
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To assess change in subjective report of visual function and mood over time in patients with low vision who did or did not participate in occupational therapy as part of vision rehabilitation.
As part of a larger study of outcomes of vision rehabilitation, 71 patients (aged 41-95, mean age 76.8; 38 female) completed three questionnaires: the Low Vision Visual Function Questionnaire, Inventory of Vision Impairment and the Depression , Anxiety, Stress Scale (LVVFQ, IVI, DASS) at initial visit to a comprehensive vision rehabilitation clinic (T1) and one year later (T2). Inclusion criteria were best corrected visual acuity of <6/12, adequate hearing, cognition, and English language skills to participate in the project. All subjects received a routine vision rehabilitation consultation, and, when appropriate, a referral to occupational therapy (OT). 49% of patients either were not referred or chose not to participate in OT and so did not receive any OT. Of the patients who did receive OT, average contact time with the OT was 3.4 hours (range .67-12).
As reported earlier, patients reported change on all five subscales of the LVVFQ (see Jackson, Wallis, et al, JAGS in press) from T1 to T2. However no change was observed on the IVI or DASS over time (IVI: t(70)=1.21, p=.23; DASS: t(70)=1.67, p=.64). There was also no difference in visual function and mood over time, as measured by IVI and DASS, in subgroups of patients who did versus did not participate in occupational therapy (IVI for OT users: t(35)=.83, p= .41; OT non-users: t(34)=.87, p=.39; DASS for OT users: t(35)=-.77, p=.44; OT non-users: t(34)=1.15, p=.26 ). That is, the observed improvement in visual function, as measured by the LVVFQ, was present in both groups (Visual Ability for OT users: t(35)=2.59, p=.014; OT non-users: t(34)=2.02, p=.05).
These findings generate many questions for future research on the assessment of outcomes of vision rehabilitation. The questionnaires used in this study may not be sufficiently sensitive to capture change in function as elicited by OT. The benefit from OT may be larger shortly after rehabilitation and then decrease to the level observed in the group who did not access OT by T2. Alternatively, vision rehabilitation consultation alone may be sufficient to improve function for patients with some levels of vision impairment.
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