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H. J. Court, B. Ryan, C. Bunce, T. H. Margrain; Evaluating the Effectiveness of Low Vision Services in Wales. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4715.
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The purpose of this study was to evaluate the ability of a hospital and community based low vision service to reduce visual disability in Wales. The community based Welsh Low Vision Service (CLVS) is a flag-ship initiative of the Welsh Assembly Government which has attracted substantial interest from around the UK and internationally. The CLVS currently operates in over 200 optometry practices. The CLVS was designed to run in parallel with the hospital low vision service (HLVS) which currently operates in 19 hospitals. However, although these services have run alongside one another since 2004, until now there has been no evidence about their effectiveness.
Participants were recruited on a consecutive basis from both the hospital and community based services that served a similar geographical area from September 2007 for 12 months. The inclusion criteria for both services: at least 18 years of age, distance visual acuity of 6/12 or worse and/or; near acuity of N6 or worse or; significant contraction of visual field and requirement for low vision rehabilitation. Visual disability was measured at baseline and at three months post-assessment with the 7-item NEI-VFQ and scored using Rasch analysis.
Pre and post visual disability scores were obtained on 222 CLVS participants (63 male, 159 female; median age 82, range 35-99 years) and 74 HLVS participants (27 male, 47 female; median age 81, range 22-95 years). We found little evidence of any difference at baseline between participants attending the services in gender, age, ocular pathology or registration status. Baseline visual disability scores were 0.79±1.70logits and 0.63±1.80logits in the CLVS and HLVS respectively. At three months visual disability scores reduced to 0.02±1.96logits and 0.28±1.68logits in the CLVS and HLVS respectively. Data was pooled to maximise power and a paired t-test comparing baseline scores with post-assessment scores showed a statistically significant reduction in visual disability scores (P < 0.001).
The data suggests that low vision services in Wales significantly reduce visual disability in an elderly population.
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