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Alexandra Selivanova, Mary Lou Jackson; Positive impact of Comprehensive Vision Rehabilitation on psychosocial well-being. Invest. Ophthalmol. Vis. Sci. 2014;55(13):188.
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To assess patient-reported outcomes pre- and post-multidisciplinary rehabilitation.
Subjects completed the National Eye Institute Vision Function Questionnaire (NEI VFQ-25) pre- and post-rehabilitation. Comprehensive Vision Rehabilitation included vision rehabilitation consultation, occupational therapy training and acquisition of devices. Visual assessment included visual acuity (VA), contrast sensitivity (CS) and central visual field. Patient characteristics included living situation, medications being taken and time spent with an occupational therapist (OT).
39 subjects were enrolled. Mean (SD) age was 70±19 years, 51% had macula disease and 56% were female. In the better eye, mean VA was 0.47±0.37 LogMAR and mean CS was 1.23±0.39 log measured with Pelli-Robson chart. With 100 being the best score, the NEI VFQ-25 vision specific subscales for mental health symptoms and dependency were low (43 and 55) pre-rehabilitation, but significantly improved (53 and 65) post-rehabilitation (P = 0.01 and P = 0.03). After adjusting for age, gender and vision, only improvement in the mental health subscale remained significant (P = 0.02). Most patients (87%) lived independently in the community: alone, with a spouse or with children. The dependency and role difficulty subscales were significantly associated with living with children (P = 0.02 and P = 0.03). Following adjustments, no significant associations were found for number of medications being taken or time spent with an OT.
Vision loss impacts well-being and these findings support that vision rehabilitation likely plays an important role in reducing mental health symptoms. Limitations of results include small sample size, selection bias and lack of controls; however, given that psychosocial well-being is impacted by vision loss, positive impact on this domain by Comprehensive Vision Rehabilitation is an important clinical observation. Future study can identify which components of vision rehabilitation or patient characteristics correlate with change in patient reported mental health.
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