Abstract
Purpose :
Acquired monocular vision loss (AMVL), or the loss of sight in one eye or the loss of an eye, leads to loss of stereopsis and peripheral vision. We sought to evaluate the low vision rehabilitation referral rate of patients with AMVL following open globe repair, enucleation, or evisceration at a tertiary academic medical center.
Methods :
A retrospective chart review was conducted for all adult patients who underwent open globe repair, enucleation or evisceration at University of Colorado from January 1, 2020 to October 31, 2022. Exclusion criteria were as follows: blindness in contralateral eye (BCVA ≤ 20/200), visual acuity recovery after open globe repair (BCVA > 20/200), reversible causes of vision loss (i.e. traumatic cataract), no documentation of post-operative visual acuity following globe repair. AMVL was considered acute for patients who had urgent surgeries, whereas patients who had scheduled outpatient surgeries were deemed to have chronic AMVL.
Results :
A total of 113 patients met study criteria. Average age was 55±19.9 years, and 70.8% were men. White patients accounted for 73% of the cohort, followed by Hispanic (14%) and Black (6%). AMVL was acute in 41% of patients. Average logMAR visual acuity of the contralateral eye was 0.16±0.20. Following their surgery, 7 patients were lost to follow-up. Of the remaining 106 patients, 10 (9%) were referred to low vision. Of these referrals, five were completed, with three patients subsequently completing at least one low vision occupational therapy session. It is worth noting that two patients were documented to have declined a low vision referral, and another nine patients had documentation by providers to consider a low vision referral but were never referred.
Conclusions :
While this study may have limited generalizability, the referral rate is consistent with published literature studying similar patient cohorts. It is possible that the low referral rate may be due to a perception that AMVL patients with relatively good visual acuity in the contralateral eye retain normal visual function. However, the loss of stereopsis and peripheral vision affects hand-eye coordination and mobility which in turn can limit successful completion of activities of daily living. Given that AMVL patients can benefit from low vision rehabilitation services, this study highlights the opportunity to routinely refer AMVL patients to low vision.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.