Abstract
Purpose:
Low vision rehabilitation (LVR) aims to maximize visual ability and independence of an individual by helping him/her to make best use of his/her residual vision. Approximately 90% of those with low vision (LV) have useful residual vision and could potentially benefit from LVR. Increasingly the effectiveness of LVR programs is being measured by an improvement in an individual’s vision-related quality of life (VRQoL) and over last two decades, studies albeit from the developed countries, have demonstrated that the VRQoL improves following LVR. Although >90% of the world’s visually impaired population live in developing countries such as India, there has been a relative lack of such literature. The purpose of this study was to evaluate the effectiveness of comprehensive LVR on VRQoL in adults with LV in India using the Veterans Affairs Low Vision Visual Functioning Questionnaire (VA LV VFQ-48) and the Impact of Vision Impairment Questionnaire (IVI).
Methods:
Consecutive adults with LV (mean age; 41.7 years) referred for the first time to Centre for Sight Enhancement were administered the IVI and VA LVVFQ-48 before and after LVR (3 months). Rasch-scaled scores were generated for the 28-item IVI along with its 3 subscales as well as for the VA LV VFQ-48 and its four subscales for baseline and follow-up data. Effect sizes (ES) were calculated using Cohen’s d coefficient.<br />
Results:
Two hundred and fifty-five patients completed LVR. Most patients had retinal disorders (49%) and had moderate VI (52%). Following LVR, the linear measures revealed significant improvements in VRQoL using the IVI at follow-up, with large ES for reading and accessing information (ES= 1.0, p<0.0001) and relatively moderate ES for overall IVI (ES = 0.63; p<0.0001) and mobility subscale (ES = 0.53; p<0.0001). No significant improvement was found on emotional well-being subscale (ES = 0.18; p=0.06). Similarly, significant improvements in VRQoL were found for the VA LVVFQ-48 at follow-up, albeit moderate ES for the overall visual ability (ES=-0.67; p<0.0001) and its subscales (reading [ES=-0.72; p<0.0001], mobility [ES=-0.45; p<0.0001]; visual information [-0.47; p<0.0001); visual motor [ES=-0.54; P<0.0001]).
Conclusions:
The comprehensive LVR program resulted in significant improvement in VRQoL of patients with LV in India, regardless of whether the IVI or VA LV VFQ-48 was used for its measurement.