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Judith E Goldstein, Bonnielin K Swenor; Study of the Uptake of Low Vision Rehabilitation Services: Examining the Magnitude and Characteristics of Service Utilization. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1622.
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© ARVO (1962-2015); The Authors (2016-present)
To estimate the prevalence of patients with low vision who obtain low vision rehabilitation (LVR) services and compare their characteristics to individuals who do not access services.
Electronic medical record (EMR) data was obtained for 104,668 patient encounters at the Wilmer Eye Institute main campus and all 8 satellite locations with at least one visit in 2014. Low vision status at each visit was categorized as visual acuity (VA) worse than 20/40 in the better-seeing eye. Best-corrected VA was the primary variable used, and if not recorded, the better of the pinhole or habitual VA was relied upon. A “low vision index appointment” was classified as the first visit in 2014 where the patient fit these criteria for low vision. Utilization of LVR services at Wilmer was determined using EMR over the 12 months following this index date. Based on this data, patients with low vision were classified as “users” or “non-user” of LVR over this period. Demographic and clinical data obtained from the EMR were used to compare the characteristics of LVR “users” and “nonusers”.
A total of 93,455 patients had visual acuity data, of which 9,772 (10.5%) were classified as having low vision in 2014. Of these patients with low vision, 1,568 (16.3%) utilized low vision services over the 12 months following the low vision index appointment. The mean time from the low vision index appointment and the initial LVR appointment was 221 days. LVR users were more likely to be be older (67 vs 60 years old) and female (60% vs 56%) (p<0.01 for all comparisons) than non-users of LVR. The majority of low vision patients attending LVR had at least one retina (33.3%), glaucoma (10.9%), anterior segment (9.2%), or comprehensive eye (6.8%) visit over this period.
This study indicates that up to 85% of low vision patients seeking ophthalmic care may not be obtaining LVR services. Estimating the magnitude of LVR service underutilization is important for health care planning and for developing interventions aimed at improving LVR utilization to enhance visual ability and quality of life.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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