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PubMed1991

Results obtained with low vision aids. A retrospective study.

In this retrospective study of 261 patients (181 female and 80 male) the results obtained in a special low vision clinic are described. The mean age of the patients was 73.5 years (range 16-95 years). Visual acuity of the best eye was less than or equal to 0.08 in 26 patients (10.0%); better than 0.08 but less than or equal to 0.25 in 130 (50%); 0.30 in 62 (23.8%) and better than 0.30 in 42 patients (16.1%). Persons with a visual acuity better than 0.30 either could not read normal print or had restricted visual fields. Main causes of visual impairment were macular degeneration (38.9%), diabetic retinopathy (16.1%), glaucoma (8.4%) and cataract (7.4%). Low vision aids could be prescribed for 208 persons (79.7%). Follow-up of an average of 12 months (range, 3-22 months) was carried out in 250 cases (96%). In this period 24 patients (9%) died. At least 161 persons (62%) used their aids regularly, i.e. 77% of the patients who were given a low vision aid.

Adolescent↗
PubMed2003

Prevalence and causes of blindness and visual impairment in Bangladeshi adults: results of the National Blindness and Low Vision Survey of Bangladesh.

AIM: To determine the age, sex, and cause specific prevalences of blindness and visual impairment in adults 30 years of age and older in Bangladesh. METHODS: A nationally representative sample of 12 782 adults 30 years of age and older was selected based on multistage, cluster random sampling with probability proportional to size procedures. The breakdown of the cluster sites was proportional to the rural/urban distribution of the national population. The examination protocol consisted of an interview, visual acuity (VA) testing, autorefraction, and optic disc examination on all subjects. Corrected VA retesting, cataract grading, and a dilated fundal examination were performed on all visually impaired subjects. The definitions of blindness (<3/60) and low vision (<6/12 to >or=3/60) were based on the presenting visual acuity in the better eye. The World Health Organization/Prevention of Blindness proforma and its classification system for identifying the main cause of low vision and blindness for each examined subject was used. RESULTS: In total, 11 624 eligible subjects were examined (90.9% response rate) across the 154 cluster sites. A total of 162 people were bilaterally blind (1.53% age standardised prevalence) while a further 1608 subjects (13.8%) had low vision (<6/12 VA) binocularly. Visual acuity was >6/12 in the "better eye" in the remaining 9854 subjects (84.8%); however, 748 of these people had low vision in the fellow eye. The main causes of low vision were cataract (74.2%), refractive error (18.7%), and macular degeneration (1.9%). Cataract was the predominant cause (79.6%) of bilateral blindness followed by uncorrected aphakia (6.2%) and macular degeneration (3.1%). CONCLUSIONS: There are an estimated 650 000 blind adults (95% CI 552 175 to 740 736) aged 30 and over in Bangladesh, the large majority of whom are suffering from operable cataract. This survey indicates the need for the development and implementation of a national plan for the delivery of effective eye care services, aimed principally at resolving the large cataract backlog and the inordinate burden of refractive error.

Adult↗
PubMed1995

Overview of technology for low vision.

This article provides an overview of technology resources and services to assist persons with low vision in maintaining independent function in the home, community, and educational and vocational settings. Case studies are provided to demonstrate the integration of technology into the lives of persons with low vision.

Computers↗
PubMed1988

Treatment of low vision in the progressive cone dystrophies.

Twenty-three patients suffering from the progressive cone dystrophies (PCD) were evaluated retrospectively, after they had undergone treatment for low vision. All patients were able to read 1 M or smaller print with magnification, despite poor central acuity. Eighteen (78%) patients achieved their primary rehabilitation goal, and 86% of the low vision devices prescribed were used at follow-up. Photosensitivity was reported by a large number of patients. Seven patients indicated that alleviating this problem was their primary rehabilitation goal. Eight (35%) found sun filters to be helpful. Our successful experience with patients with these disorders suggests that examination for, and trial of, low vision devices is warranted.

Adolescent↗
PubMed2000

Low vision in Nigerians with diabetes mellitus.

OBJECTIVES: To determine the prevalence and causes of low vision in diabetes mellitus patients in Nigeria. MATERIALS AND METHODS: All consecutive new patients seen at the Diabetic Eye Clinic, Nnamdi Azikiwe University Teaching Hospital Nnewi Nigeria, between March 1997 and September 1998 were the subjects of the study. Examination methods included interviewer-administered structured questionnaire, visual acuity test, external eye examination, refraction, tonometry, gonioscopy, binocular indirect ophthalmoscopy and slit lamp fundus examination with 78D non-contact lens. RESULTS: Of the 100 new patients examined, 47 (47%) did not know that diabetes could lead to visual loss; 53 (53%) had not been examined by any eye health worker. Eighteen patients (18%) were bilaterally blind and 26 (26%) had monocular blindness; visual impairment was present in the better eyes of 30 patients (30%), with 20 (20%) having bilateral visual impairment. Glaucoma, cataract, diabetic retinopathy, central retinal vein occlusion, age-related macular degeneration, and leukoma were the causes of blindness. Visual impairment was due to diabetic macular edema, ametropia, cataract, age-related macular degeneration, glaucoma, uveitis and branch retinal vein occlusion. CONCLUSION: The causes of low vision in the patients are treatable and visual defects from them are thus avoidable. It is recommended that (a) all diabetics be made aware that diabetic complications cause visual loss; (b) laser photocoagulation facilities be provided for treating diabetic retinopathy.

Adolescent↗
PubMed1997

[Recent progress in psychosensory rehabilitation of low vision. The third method for the prevention of blindness].

Functional strabism amblyopia is no more a problem: before 2 years old, they are cured in 95%. On the other and, low vision population beyond any medical or surgical treatment is increasing dramatically: over a million persons are concerned. Low vision is usually a consequence of age related macular degeneration related to the increase of life-span. Diabetic retinopathy, severe glaucoma, vitreoretinal disorders and chorioretinal diseases are also important blindness causes. Only a psychosensorial rehabilitation allow persons to see differently by developing functional vision thanks to the development of sensorial neurophysiology and cognitive psychology. This rehabilitation can only take place in well defined institution with a polyvalent team because such institution are so rare in France (4/33 Sweden) the authors ask National Academy of Medicine to beg public authority to create low vision rehabilitation center.

Blindness↗
PubMed1988

Low-vision aids in Stargardt's disease.

Fifteen patients with juvenile macular degeneration fitted with low-vision aids were followed up for a period of two to three years. About 80% of the patients equipped with visual aids used their devices successfully. It appears that in Stargardt's disease, low-vision aids are more useful than in other maculopathies.

Adolescent↗
PubMed1994

Prevalence and causes of blindness and low vision in the Casteldaccia Eye Study.

In a population-based survey performed on the middle-aged and elderly population of Casteldaccia, Sicily, we found that the prevalence of blindness was 0.47% and the prevalence of low vision 1.22%. Unilateral blindness affected 2.81% of the population and unilateral low vision 4.12%. Visual impairment was much more frequently seen in subjects aged 70 years or more than in younger persons. The main cause of visual impairment was cataract, followed by amblyopia, which was responsible for many cases of unilateral low vision.

Adult↗
PubMed1981

Assessing field defects of the low-vision patient.

Field losses are of particular significance to the low-vision patient, so it is incumbent upon the low-vision clinician to determine the degree, location, and extent of this field loss. Optometrists prefer to map the fields carefully for quantitative analysis, but if fatigue or debility prevent this a simplified technique is required. Devices and techniques are described which are shown to be effective.

Aged↗
PubMedDate not supplied

Low vision correction for high myopia.

High myopia is favorable for low vision corrections because the vision has usually been poor since childhood and the person has been able to read at close range, producing magnification. For near vision, in addition to bringing objects close, magnification is produced by high-add bifocals, trifocals, strong near vision spectacles and nonspectacle magnifiers. Hand magnifiers held at a distance from the eye are used with the spectacle correction. This paper describes the Visolett, used without correction or near vision correction, as the preferred non-spectacle magnifier because the reading area is self-illuminated, it doubles the approach magnification, rests on the paper, is simple to use, produces binocular vision, and attracts the least attention. Combination method of magnification consists in the use of the Visolett in addition to a spectacle magnifier, which doubles the magnification.

Contact Lenses↗
PubMed1991

Low-vision aids in Stargardt's disease.

The use of low-vision-aids (LVAs) to improve distance and near visual acuity was evaluated in 27 patients. Most of the patients had a useful distance vision with or without glasses, and 24 patients (89%) were prescribed a near visual aid successfully. The high success rate was attributed to young age, strong motivation and myopic refractive error of these patients. We recommend the trial of LVAs to patients with Stargardt's disease who have visual difficulties.

Eyeglasses↗
PubMedDate not supplied

Introduction of the Low Vision Evaluator (LoVE) for children.

PURPOSE: To determine whether the Low Vision Evaluator (LoVE) can grade the visual acuity of young children with light perception and hand movement acuity into finer acuity steps and at what age reliable measurements can be obtained. METHODS: Two hundred twenty children were tested with the LoVE. Each eye was tested separately, and each stimulus magnitude (intensity x duration) was presented three times. Three catch trials per eye also were presented. RESULTS: Scores ranged from -8 to -1 on variable-duration tests and from 22.5 to 37.5 dB on fixed-duration tests for four children with hand movement vision. Scores ranged from -12 to 0 on variable-duration tests and from 12.5 to 40 dB on fixed-duration tests for five children with light perception vision. Reliable measurements were obtained at different times on different days. Mean scores for children with counting finger vision or better were significantly better than scores for eyes with light perception and hand movement (P < .001 and P < .01, respectively). Reliability was less for children younger than age 4 years. CONCLUSIONS: The LoVE is capable of grading the visual function of children with light perception and hand movement vision into finer steps. Reliable measurements can be obtained for children age 4 years and older.

Child↗
PubMed2003

Orientation and mobility training for adults with low vision.

BACKGROUND: Orientation and mobility (O&M) training is provided to people who are visually impaired to help them maintain travel independence, teaching them new orientation and mobility skills to compensate for reduced visual information. OBJECTIVES: The objective of this review was to assess the effects of orientation and mobility training, with or without associated devices, for adults with low vision. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group trials register) (Issue 3 2002), MEDLINE (1966 to August 2002), EMBASE (1980 to September 2002) and LILACS (September 2002) and the reference lists of articles. SELECTION CRITERIA: We planned to include randomised or quasi-randomised trials comparing orientation and mobility training with no training in adults with low vision. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the search results for eligibility. MAIN RESULTS: No studies were found that satisfied the inclusion criteria. REVIEWER'S CONCLUSIONS: We could not find any controlled trials on the effects of orientation and mobility training for adults with low vision. As a premise to future trials, orientation and mobility instructors and scientists should reach a consensus and develop valid measures of mobility performance which are both reliable and meaningful to people with low vision.

Adult↗
PubMed1991

Comparison of reading speed in normal observers through different forms of equivalent power low vision devices.

Compensation at near for vision loss can be achieved using a variety of equivalent forms of low vision magnifiers. Each has inherent advantages and disadvantages in terms of field, working distance, etc. We compared the reading speed of 60 trained, normal observers with 4 commonly prescribed types of low vision devices of +12 D equivalent power (spectacles, hand magnifier, stand magnifier, and telemicroscope) to their normal reading speed. Although there was individual variance in performance, reading speed with all the devices was generally within 20% of normal reading speed. Implications are that in terms of differences in reading speed for normals, the form of the low vision device is not as significant as acquiring proficiency in the use of the selected device.

Adult↗
PubMed2006

Low vision rehabilitation services in Michigan viewed against the national backdrop.

The diagnosis and treatment (including low vision rehabilitation) of permanent vision impairment due to ocular disease and trauma are gaining increased emphasis around the world. In the United States, this emphasis is due to both changing demographics and emerging policies issued by the US Centers for Medicare and Medicaid Services (CMS). In this de facto report, we trace the evolution of low vision rehabilitation service in Michigan, highlighting the role of public appropriations initiated in the mid 1960s and continuing today. An array of state, private, nonprofit, and clinical services for vision rehabilitation in Michigan are described in the context of the historical roots, current roles, and future trends related to emerging policies and systems of care.

Delivery of Health Care↗
PubMed1995

How effective is an integrated approach to low vision rehabilitation? Two year follow up results from south Devon.

AIMS: A survey was undertaken to assess the effectiveness of an integrated approach to the provision of low visual aids (LVAs) in south Devon over a 2 year follow up period. This integrated approach includes the assessment of patient needs by low vision therapists, followed by the provision of suitable LVAs, with particular emphasis on training in their use. METHODS: A total of 125 patients were selected at random from the 445 patients seen in the low vision clinic at Torbay Hospital in the year 1991. These patients were sent questionnaires relating to the service over a 2 year period. Questionnaires from 111 patients were analysed at 1 year and 75 questionnaires together with 46 clinical reassessments, after 2 years. RESULTS: Using a similar questionnaire to one used in a previous study in the UK from a unit where LVA training was not provided, not only was a higher rate of satisfaction found with the services provided, but also the LVAs dispensed were used more frequently. The majority of the LVAs provided were of the simple, inexpensive variety and wastage was very low. CONCLUSIONS: It was concluded that this integrated approach to low vision rehabilitation with emphasis on training in the use of less complex LVAs exceeds the performance of other types of service that rely on the dispensing of more complex LVAs.

Adult↗
PubMed1999

Evaluating the outcomes of low vision rehabilitation.

The requirement for those providing healthcare to measure outcomes raises the fundamental question of how these should be measured. Both the scale of the low vision population and the different models of care proposed make it a pressing need to determine outcomes using valid and reliable measures. In this study we describe the development and piloting of a questionnaire designed to meet this requirement. The questionnaire was piloted on 56 subjects with age-related macular degeneration (ARMD). Test-retest reliability of the questionnaire was estimated using a further sample of 28 subjects with ARMD. Pilot testing confirmed the feasibility of administering the questionnaire to an elderly population with ARMD. A total of 87% of the sample reported using an LVA (65% on a daily basis), predominantly for a reading task. The number of tasks an LVA was used for, its frequency of use, length of continuous use and ease of use are significantly associated with the rating of an LVA as important/less important (P < 0.0001), but the acuity achieved with the device is not significantly associated with rated importance (P = 0.11), reinforcing doubt about the validity of visual function outcomes. The limitations of this pilot study and earlier case series in describing the outcomes of low vision care are discussed and a randomised controlled trial using a broad range of outcomes is proposed in order to fully describe the effectiveness of low vision rehabilitation and inform the debate about models of care.

Aged↗