June 2017
Volume 58, Issue 8
ARVO Annual Meeting Abstract  |   June 2017
Low Vision Needs Assessment of Essex County, MA
Author Affiliations & Notes
  • Alexis G Malkin
    New England College of Optometry, Boston, Massachusetts, United States
  • Robert W Massof
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Alexis Malkin, None; Robert Massof, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5068. doi:
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      Alexis G Malkin, Robert W Massof; Low Vision Needs Assessment of Essex County, MA. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5068.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Low vision (LV) patients have transportation limitations that require service to be available locally. Thus, LV needs assessments must be performed at a local level. We also must be concerned with serving areas that have a higher fraction of foreign-born residents. Therefore, LV incidence and prevalence data for subpopulations, combined with a poll of available services must be done to better estimate the needed distribution of services.

Methods : Essex County, MA was used as an exemplar for estimating LV service need/availability due to its percentage of foreign-born residents. National Health And Nutrition Examination Survey (NHANES) vision examination data representing the total US population and the foreign-born US population by age were fit with exponential prevalence rate models for 3 definitions of LV: <20/40, <20/60, and <20/200 (BCVA in the better eye). Annual incidence rate vs age models also were estimated for each definition. To estimate the current fraction of patients served, LV service providers, identified through state societies and the MA Commission for the Blind were surveyed.

Results : Essex County has an estimated annual incidence of 763 and prevalence of 7625 people with low vision (<20/40). There is no significant difference between foreign born and US-born NHANES samples in the estimated incidence and prevalence rate vs age for any of the LV definitions. The percent of foreign-born citizens in Essex county is 15.3% with concentrations as high as 35% in the urban areas in the county. In the county, there are a total of 2 LV service providers at 3 service locations, serving a total of 120 LV patients per year (16% of the annual incidence).

Conclusions : Essex County, MA has a severe shortage low vision services. It has a higher percentage of foreign born residents than other regions of MA. Past reports suggested higher rates of low vision in immigrant populations, but analysis of NHANES data suggests that the same model correctly estimates LV need regardless of immigrant status. Service in the county is insufficient. Travel to more distant providers is not feasible. Using a county-specific needs assessment enables better planning of service delivery, especially for populations that are most underserved. The next phase of the study is to increase the number of LV practitioners in the county, with particular emphasis on recruiting Spanish-speaking practitioners in the county’s metro areas.

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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