Abstract
Purpose :
The American Academy of Ophthalmology preferred practice guidelines state patients with 0.3 logMAR or worse visual acuity in their better-seeing eye should be referred to low vision rehabilitation (LVR). LVR is the main treatment method for visually impaired patients when medical treatment has been maximized. The purpose of this study is to estimate the rate of referral for LVR services for patients who meet this guideline in a multi-specialty ophthalmology practice, and to define the percentage of patients who actually receive the services.
Methods :
Subjects with worse than 0.3 logMAR vision in their better seeing eye were identified by retrospective record review of patients seen within the department of ophthalmology between July 2 and July 16, 2018. Data collected on patients who met criteria for LVR included age, gender, visual acuity in each eye, history of LVR services provided at the Mayo Clinic, and presence or absence of documentation of discussion of LVR in patient’s medical record.
Results :
A total of 1113 medical records were reviewed; 51 patients with 20/40 or worse acuity in their better-seeing eye were identified. The average visual acuity of potential LVR subjects was 0.62 logMAR in their better seeing eye and 1.04 logMAR in their worse-seeing eye. Average patient age was 69 ± 18 years (range: 13-93); male/female distribution was 20/31 (39%/61%). 13 (26%) of subjects had received LVR services at Mayo Clinic, while 38 (75%) had not received these services. Of the 38 who had not received LVR services at Mayo, 4 (11%) records documented a conversation between provider and patient regarding LVR. Orders for LVR consultation had been placed for 2 of these 4 patients, but consultation was actually scheduled for only one patient. That patient did not attend the consultation.
Conclusions :
The majority of patients who are visually impaired have not been referred for LVR within our multi-specialty academic medical practice. Documentation of a discussion of LVR services was present in the charts of only 11% of patients who did not receive referral for LVR. The results indicate 26% of our patients have received LVR; while this percentage is relatively low, it is higher than referral rates which have previously been reported. This could be due to the fact that our LVR service is integrated into the department, while LVR was not available within the health care system previously described.
This is a 2020 ARVO Annual Meeting abstract.