Abstract
Purpose :
Low vision Rehabilitation (LVR) has a significant benefit in improving the quality of life of visually impaired patients. However, such services are highly underutilized, depriving patients of essential care. This study investigates the barriers to LVR services in a hospital-based setting for patients with impaired vision.
Methods :
A retrospective chart review of low vision patients seen at the University of Texas Medical Branch from 2010-2020 identified 487 subjects that were eligible for low vision referral. Low vision was defined as having a best corrected visual acuity of 20/70 or worse in the better eye, or a visual field of less than 20 degrees. The number of patients referred to LVR services were identified from the EPIC EMR database and were interviewed over the phone regarding their referral experience to the LVR services. Another questionnaire was sent to 9 practicing ophthalmologists to capture their referral patterns. Responses were analyzed and tabulated in percentages.
Results :
Patients with low vision referrals (n=48) were primarily Caucasians (60%), retired (60%), and females (60.4%), with a mean age of 70.7 years. Only 32 patients utilized LVR services, of which 11 agreed to take the questionnaire. About half of the patients (45.5%) did not know if they had been referred to LVR. Qualitative analysis revealed several barriers to accessing LVR services including: poor physical health (81.8%), denial of need for low vision aid (72.7%), lack of transportation (36.3%), and lack of referrals (33.3%). 88.9% of vision care providers reported referring eligible patients to LVR services in their practices. Common factors for not referring low vision patients included: patient’s overall health (66%), older age (33.3%), lack of social support (33.3%), poor cognitive function (33.3%), and less likelihood of following up with LVR services (33.3%). However, all the providers reported familiarity with the available LVR services at the practicing clinic.
Conclusions :
This study identified several addressable barriers that can be eliminated to provide LVR services to patients with low vision. Changing the current provider referral pattern and increasing patient awareness of available LVR resources may tremendously improve the quality of life of low vision patients.
This is a 2021 ARVO Annual Meeting abstract.