Quebec model for low vision rehabilitation.
The increase in longevity (and secondary morbidity) in the Quebec population adds social and financial pressure to society, as it does elsewhere in Canada and in many western countries. This article gives a brief history of the evolution of vision rehabilitation services in Quebec and describes how services are provided for people with low vision throughout the province. Although numerous groups, associations, centres, and resources are available to assist people with vision impairments, such as the Canadian National Institute for the Blind-Québec, the majority of visual rehabilitation services are provided by government-sponsored rehabilitation centres, namely the Centres régionaux de réadaptation en déficience physique that are located strategically throughout the province. Low vision clinical evaluations in these centres are shared by 36 optometrists throughout the province. Between 5 and 7 ophthalmologists are involved in low vision care, half in university-affiliated hospitals, primarily in Montreal. There may be delays of up to 6 months to be seen in a funded low vision clinic. Statistics obtained from la Régie de l'assurance maladie du Québec show that there are approximately 8,000 requests for low vision aids every year, and that 80% of clients retain at least some level of visual function. Services are covered by Medicare and low vision aids are provided at no cost, although ophthalmologists cannot prescribe low vision aids through the Medicare-funded system. We must ensure that the capacity of our system continues to provide adequately for clientele in the future.