Abstract
Purpose :
A previous records review at a low vision rehabilitation (LVR) service in a department of ophthalmology revealed a relatively low rate of improvement in distance visual acuity (VA) by ≥2 lines with refraction for 11% of low vision (LV) patients, and did not consider improvements at near or LV assistive devices. We hypothesized that this published data may underestimate the potential benefits of LVR.
Methods :
A retrospective review of electronic health records was conducted for 230 patients seen by three optometrists at the UCLA Vision Rehabilitation Center within the past six years with best-corrected VA ≥0.18 logMAR in the better eye at baseline. Presenting mean VA was 0.69 logMAR, half were female, and mean age was 69 years (range 5-98), 24% had congenital or retinal dystrophy, while 42% had age-related macular degeneration.
Results :
To improve distance and/or near vision, a new spectacle prescription and/or LV devices were recommended for the vast majority (92%). LV devices were recommended to 61% of all patients: 43% were for near tasks and 18% were telescopic devices for distance; 54% of these devices were dispensed. For the 90% in whom refraction was completed, VA improved in either eye by ≥2 lines at distance for 24%, or at distance and/or near for 43%. Odds of post-refraction distance VA improvement by ≥2 lines was not significantly related to age, gender, whether they had any habitual correction or previous LVR exam, but was significantly more likely for those with worse presenting distance VA (OR: 2.6; 95% CI: 1.2-5.8; p=0.02). VA improved with refraction by ≥1 line at distance for 53%, or at distance and/or near VA in 67%. Nearly half (47%) had mild VA loss (0.18-0.54 logMAR), of whom 40% were prescribed a high add ≥+4D for near, 48% were recommended LV devices, and 63% were recommended high adds and/or LV devices. There was a significant increase in the chief complaint of reading digital devices: 6% pre-pandemic (n=3 of 50) vs. 30% during the pandemic (n=15 of 50)(p=0.002).
Conclusions :
To help increase referrals for LVR, it is important to promote the success rate for LVR services, which was greater in the present study than reported in the literature. Mild VA loss patients were also recommended LV strategies. Future studies should be conducted at other centers to determine whether these findings are similar to outcomes for other LVR practitioners.
This is a 2021 ARVO Annual Meeting abstract.