Does Visual Acuity Form a Barrier for Ophthalmologists to Refer to Low Vision Rehabilitation Services?

Abstract

Purpose: : Ophthalmologists' referral patterns to visual rehabilitation may be influenced by numerous factors. This study examined demographic characteristics of patients receiving services in urban, university-affiliated ophthalmology departments. The main issue centered on the patients' awareness of low vision clinics and full-service agencies providing assistive devices and training for visually impaired people. An additional aim of this study was to determine whether ophthalmologists preferentially refer patients for rehabilitation services, based on their visual acuity.

Methods: : Out of ca. 10 000 reviewed patient charts, approximately 10% of this population met the eligibility criteria for vision rehabilitation (VA less than 20/70 or visual field less than 60 degrees in the better eye, respectively). To date, 326 visually impaired people, ranging in age from 26 to 100, have been recruited. They provided information regarding demographic variables, such as age, income, educational level, etc.

Results: : Three groups were identified based on their response to awareness and/or usage of vision rehabilitation services: those who were not aware of these services (n = 91, 28%), those who were aware and chose not to follow through on the referral (n = 41, 12%), and those who were referred and ultimately received services (n = 194, 60%). Overall, 72% of eligible individuals were aware of vision rehabilitation services. Visual impairment was divided into three categories - mild (20/70 to < 20/200), moderate (20/200 to 20/400). The results indicate that only 57% of the patients with mild visual loss were informed about rehabilitation services, as opposed to 73% and 87% in the moderate and severe groups, respectively.

Conclusions: : Generally, patients' awareness of rehabilitation services was surprisingly high. The pattern of referral, however, clearly demonstrated a bias toward referring late in the impairment process which, in turn, may have significant implications on patients' potential success in rehabilitation. This is of particular importance in the case of seniors affected by age-related visual disorders.

Keywords: low vision • visual acuity • aging