June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Developing a care delivery framework for older adults with chronic eye disease and vision impairment: A mixed methods study on patient perspectives
Author Affiliations & Notes
  • Fahd Naufal
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Xinxing Guo
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Catherine Kerr-Niermann
    University of Missouri-St Louis, St Louis, Missouri, United States
  • Judith E Goldstein
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Fahd Naufal None; Xinxing Guo None; Catherine Kerr-Niermann None; Judith Goldstein None
  • Footnotes
    Support  Norman Raab Foundation
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2662. doi:
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      Fahd Naufal, Xinxing Guo, Catherine Kerr-Niermann, Judith E Goldstein; Developing a care delivery framework for older adults with chronic eye disease and vision impairment: A mixed methods study on patient perspectives. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2662.

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

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Abstract

Purpose : To understand the perspective of older adult patients with visual impairment (VI) and develop a framework that integrates eye and supportive health care services.

Methods : Adults ≥60 years recruited between 11/2019-10/2020 with a diagnosis of glaucoma, retina, and/or neuro-ophthalmologic-related disorders participated in an observational mixed-methods study. Eligible participants were identified through an electronic health record-based query using age and ICD-10 diagnostic code criteria for chronic eye diseases; criteria for participation included self-reported difficulty performing everyday activities due to vision loss (functional deficits). All participants completed a questionnaire and a one-on-one interview. We analyzed perspectives on major themes including changes in vision and condition; loss of functional ability; emotional health and healthcare delivery.

Results : Participants (N=65; mean age 73 years; 70% female) had a median visual acuity (VA) of 20/30 in the better eye. Most participants were diagnosed (41.5%) and experienced functional deficits (53.8%), such as reading, driving, or recognizing faces, within the last 1-5 years. Participants reporting VI in both eyes (60%) were more likely to report a longer duration of functional deficits (ptrend=0.03). Worse VA nor VI in both eyes were not associated with emotional health concerns or reliance on others for support. Half (53.8%) reported anxiety or depression related to VI; 70.8% required additional support with function. Despite levels of anxiety and depression, few participants (16%) self-identified a need for additional education, or support groups. Half (50.8%) reported that their eyecare provider adequately inquired about emotional status and one-third (33.8%) tended to normalize chronic eye disease, VI and functional loss as an expected outcome of ageing or family history.

Conclusions : A framework for older adults with chronic eye disease and on average mild VI should include identifying and discussing functional and emotional health concerns to determine individual need. Despite high levels of anxiety, depression, and visual function deficits there was limited interest in pursuing supportive services. However, inquiry regarding emotional health by eyecare providers was important to patients.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Fig 1. Select correlations

Fig 1. Select correlations

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