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PubMed1999

[At home utilization of low-vision aids by the visually impaired].

BACKGROUND: The increase of life expectancy causes a rising number of partially sighted. Therefore our Department of Ophthalmology has founded a laboratory for partially sighted 7 years ago. To optimize patient care, the results were now reinvestigated. MATERIALS AND METHODS: For the present study, 125 patients were selected by geographical aspects (home nearby clinic) from the lab's pool. After a 3 month minimum period of using the low-vision aid (LVA) patients were visited at their homes. Near visual acuity, distance visual acuity, magnification, and contrast sensitivity were studied under domestic and optimized conditions of illumination. Patients were interviewed in detail to investigate their habits of LVA use. RESULTS: An overall number of 94 patients (66 females and 28 males) could be evaluated. The most patients were between 80 and 84 years old. Vision impairment was attributable mostly to macular degeneration (55%) and diabetic retinopathy (21%). Visual acuity and contrast sensitivity decreased during the period of investigation. 79% of the patients had a unsatisfactory domestic illumination (< 1000 lx). Only 23% of the patients used their LVA at a fixed location. Main field of using LVA was reading (68%). The LVA were rarely used for writing and other fields of practice. 76% of LVA were used daily, more than 50% for a maximal duration of 1 h/d. Magnifiers were preferably used for short-time activities. Closed circuit television systems (CCTV) had a very good acceptance. Telescopes were characterized by a very high rate of rejection. The number of non-used LVA was approximately a fifth. Reasons were decreased visual acuity, impractical handling, missing introduction by delivering optician (54%) as well as unsatisfactory illumination. CONCLUSIONS: Improved patient care can be obtained by regular check-up visits (6 months), enhanced illumination, low-vision training, home visits, multi-disciplinary care and modified prescription of LVA.

Aged↗
PubMed2000

Spectral filters in low-vision correction.

Coloured filters are used to protect the lens, retina and other ocular tissues against the hazard of light damage and to improve the quality of vision mainly in cases of ocular media opacities. Four types of yellow, amber and orange filters have been designed as tinted glasses, shields and colour covering of spectacles. They were tested on 15 adult patients with partial cataract and on 80 children with congenital pathology (i.e. macular hypoplasia, albinism, aphakia after congenital cataract). The majority of the children had nystagmus. The filters with particular spectral characteristics provide reduction of light intensity in the light-damaging range by at least a factor of five. Optimal filters were selected by examination of visual acuity, contrast frequency sensitivity, glare sensitivity and subjective selection by the patients. The effects of filters were: 11-43% increase in corrected visual acuity, 27-34% increase in contrast sensitivity function (CSF) for all frequencies and a marked reduction in glare sensitivity. All patients reported subjective improvement including reduction of photophobia, eye-strain and eye discomfort. It is concluded that coloured filters are able to contribute substantially to rehabilitation of low-vision patients.

Adolescent↗
PubMed2004

Blindness, low vision, and other handicaps as risk factors attached to institutional residence.

AIMS: To estimate the risk of living in an institution and being visually impaired. METHODS: Two national surveys were pooled: (1) 2075 institutions (for children or adults with handicaps, old people, and psychiatric centres) were selected randomly, in 18 predefined strata, from the French health ministry files. From these institutions, 15 403 subjects were selected randomly and handicap was documented by interview in 14 603 (94.9%) of them; (2) level of handicap was documented in a randomised, stratified sample of 356 208 citizens living in the community; from this sample, 21 760 subjects were further selected at random and 16 945 people were interviewed. Data on handicaps (visual, auditory, speech, brain, visceral, motor, and other) and activities of daily living (ADL) were extracted. The odds ratio (OR) of living in an institution was estimated, using stepwise logistic regressions with age, geographical area, handicaps, and ADL as co-variables. RESULTS: Subjects in institutions, compared to those living at home, were, respectively, more often female (64.3% v 52.4%) and older (68.7 v 38.0 years); they more often had handicaps (ORs: speech, 6.59; brain, 10.17; motor, 8.86; visceral, 3.49; auditory, 2.66; other, 1.53); and were less often able to perform their ADL (46.2% v 97.1%) without assistance. Below 80 years, blind people were more often in institutions (ORs 0.239 to 0.306); whereas in older people the association was reversed (OR: 3.277). Low vision was always significantly associated with institutional residence (ORs from 0.262 to 0.752). CONCLUSION: Visual handicap was associated with institutional residence. The link persisted after adjustment for known confounding factors.

Activities of Daily Living↗
PubMed2004

[Prismatic treatment in low-vision rehabilitation of patients with age-related macular degeneration].

PURPOSE: To evaluate visual improvement in an age-related macular degeneration (ARMD) population with bilateral central scotomas, after a 3- to 6-month prismatic treatment. PATIENTS AND METHODS: Prisms prescribed for both eyes were oriented according to eccentric fixation. Criteria were visual acuity (VA), reading ability, contrast sensitivity subjective visual comfort, prism wearing frequency and autonomy level. RESULTS: Thirty-one patients (23 women, 8 men) 65-95 years old (mean, 78 years) were selected. Mean long distance VA remained stable (0.249 at inclusion and 0.261 after prismatic treatment); long distance VA was unchanged for 51.6% of patients, improved by at least one line for 35.5% and decreased for 12.9%. Reading ability was slightly improved (average of 1 line), as was short distance VA (P14 at inclusion, P12 after prismatic treatment); reading ability was unchanged for 45.2% of patients, improved by at least one line for 38.7%, and decreased for 16.1%. Contrast sensitivity was improved for all levels: to 98% of contrasts (mean at inclusion 0.248 and 0.280 after prismatic treatment), to 50% of contrasts (0.214 at inclusion and 0.238 after prismatic treatment) and to 25% of contrasts (0.157 at inclusion and 0.185 after prismatic treatment). Visual comfort improved immediately after prismatic treatment for 90.3% of patients; 80.6% of patients wore their prismatic correction regularly. DISCUSSION AND CONCLUSION: Prismatic treatment in this population mainly improves contrast sensitivity and visual comfort. It provides patients with better initiation and stabilization of their eccentric viewing. Most of the time, prismatic treatment must be associated with low-vision rehabilitation.

Aged↗
PubMed1976

A low-vision clinic at a home for the aged.

The objective of a low-vision clinic developed at the Jewish Home and Hospital for Aged was to improve the visual capabilities of the residents who were not helped by the regular eye clinics. Eighty-three patients (72 women, 11 men) were examined the first year. Ages ranged from 71 to 101 years. The causes of poor vision were mainly senile macular degeneration, cataract formation, chronic glaucoma, severe myopia, aphakia, and combinations of these diseases. Vision ranged from 10/50 at 10 feet (20/100 at 20 feet) in the better eye, to only the ability to distinguish hand movements or to perceive light. With the use of visual aids such as distance or reading glasses and various forms of magnifying glasses, some improvement occurred in 61 of the 83 patients. The follow-up examination was within one year in most cases. It was concluded that in order to examine and treat such patients properly, much more time and patience were required than is usually possible in a regular eye clinic. This involved the help of more social workers and volunteer assistants. Nevertheless, the results were worthwhile for this type of patient.

Aged↗
PubMed1980

Low vision correction in retinitis pigmentosa and associated diseases.

Retinitis pigmentosa was considered unfavorable for low vision corrections before it was recognized that the term retinitis pigmentosa as frequently used referred to a group of disease entities including Leber's congenital amaurosis, centro-peripheral dystrophy, typical retinitis pigmentosa and Usher's syndrome. The success rate for use of optical aids was Leber's congenital amaurosis 66%, centro-peripheral dystrophy 75%, typical retinitis pigmentosa 95%. This data shows that the poor success rate is not due to the constricted visual field but to the combined central and peripheral visual impairment. The type of aids most commonly prescribed were spectacle corrections, bifocals, hand magnifiers and the Visolett (paperweight type magnifier). The Visolett (paperweight type magnifier) has proven to be the most suitable non-spectacle magnifier used by itself, or in addition to a spectacle magnifier. Telescopic spectacles were rarely found to be of any value. The data showed that the correction of these diseases consisted of a refraction and strong reading addition in 65% of the patients.

Adolescent↗
PubMed1987

Factors affecting the successful use of low-vision aids.

Telephone interviews were conducted with 100 partially sighted patients who had been using low-vision aids for at least 6 months. Only "near-vision" aids were examined. The patients were asked how often they used the aid(s), how satisfied they were with it and whether they had any specific complaints about it. There were no differences in the responses between head-borne and hand-held optical aids. The preferred range of dioptric power was 11 to 20 D.

Audiovisual Aids↗
PubMed1986

Low vision aids--evaluation in a general eye department.

A review was undertaken of all patients referred for Low Vision Aid (LVA) assessment in the Wandsworth Health Authority over eighteen months. The majority of referrals (72 per cent) could have near visual acuity improved and were prescribed an LVA. Of those prescribed only 23 per cent found the LVA useful at home. Fifty-three per cent of patients preferred a high reading addition or hand magnifier to the prescribed LVA. The most helpful indications to predict success in using an LVA were found to be age of the patient, the type of eye disease and the strength of magnification required.

Age Factors↗
PubMed1981

A comparative study of low-vision patients: Their ocular disease and preference for one specific series of light transmission filters.

One hundred low-vision patients who complained of sensitivity to light were permitted to select any one of five filters (Recreational Innovations Co.) The results show that patients with certain types of pathology prefer to use specific filters to control the light reaching their eyes. Patients with albinism chose amber filters. Patients with glaucoma of diabetes both selected the same filter. Most patients with retinitis pigmentosa found most help from a filter which allowed only 2% light transmission.

Adolescent↗
PubMed1982

Bioptic low vision aid: a simple approach.

This report describes the design of a variable focus telescopic system for a low vision patient who wanted to be able to see at numerous fixed working distances. A simple and effective means of mounting the telescope onto an existing spectacle lens is described. The discussion presents an analysis of the optical principles used and a formula for determining the equivalent power of a nearpoint telescope.

Adult↗
PubMed1983

Federal low vision services reimbursement mechanisms.

This paper is a synopsis of the present federal legislative programs that offer reimbursement for low vision services. The programs are reviewed with specific attention given to 1) The Social Security Act, 2) the Education of the Handicapped Act, 3) the Rehabilitation Act, and 4) the Veteran's and Uniformed Services Act. A comparison of these programs is presented along with a brief discussion about the effectiveness of these programs to meet our present and future needs.

Adolescent↗
PubMed1977

The prism loupe used as a low-vision aid and in ocular surgery.

The prism-magnifier developed and constructed by Biessels has been used as a low-vision aid since 1971. It has been derived from the Carl Zeiss (W. Germany) 8 x 20 mini prism-binoculars. The system has several advantages. The prism-magnifier also enables the eye surgeon to perform microsurgery without the disadvantages of a stand-microscope.

Microsurgery↗
PubMed2004

Effect of light filters on reading speed in normal and low vision due to age-related macular degeneration.

PURPOSE: To investigate the effects of light filters on reading speed in normal and low vision due to age-related macular degeneration (AMD). METHODS: Reading speed was determined for 12 subjects with normal vision and 12 subjects with non-exudative AMD using stationary lowercase nonsensical print in Times Roman font and four light filters; a yellow Corning Photochromic Filter (CPF) 450, a grey neural density (ND) filter, an individual filter obtained using the Intuitive Colorimeter and a clear filter. RESULTS: There was no statistically significant light filter effect on reading speed for the normal subjects. The AMD group demonstrated a statistically significant 5% average improvement in reading speed with the CPF450 compared with the other filters although some AMD subjects had improvements of 10-15%. CONCLUSIONS: Light filters obtained using the Intuitive Colorimeter(R) performed poorly when compared with the CPF450, ND and clear filters for both the study groups. For the AMD group, average reading speed was statistically greater with the CPF450 than the other filters, however it is questionable whether the improvement (5%) would be clinically significant. As some of the subjects with AMD had greater improvements with the CPF450 we advocate clinical assessment of light filters using existing protocols on an individual basis.

Aged↗
PubMed1990

[Low vision services in Switzerland. The Lausanne example].

The results of an inquiry conducted at 5 university eye hospitals and 9 regional centers in Switzerland, concerning services for low-vision patients, are presented. Most of the services can help these visually handicapped people, but the type of care provided varies considerably from center to center. The authors briefly review the patients examined in Lausanne with regard to diagnosis, age, and the visual acuity of the better eye.

Adolescent↗
PubMed1981

Low vision care--two case reports.

Two patients are discussed and their similarities and differences are noted. Both lost an eye as a result of military service. One had low vision in the remaining eye because of a retinal problem with generally clear media. The other had an essentially normally functioning retina but light transmission was compromised because of a developing cataract. It was demonstrated that visually impaired or legally blind persons can be helped and they do not always need sophisticated devices to achieve useful vision. I described the devices prescribed and the advice given.

Angioid Streaks↗