Comparison of patient satisfaction with services of Vision Centers in rural areas of Andhra Pradesh, India.

Aim: To compare the satisfaction of patients with the services of Vision Center services (primary eye care) in large village (s) and small village (s) in rural settings in Andhra Pradesh state, India. Materials and Methods: We have administered standard questionnaires to randomly selected patients to assess patient satisfaction when assessing Vision Center Services. We used the Chi-square (P <0.05) to explore differences in satisfaction of patients with Vision Center services located in the large village (s) and small village (s) rural settings. Results: Vision Center patients at the large village (s) expressed higher levels of satisfaction (median 78%) than patients treated at the Vision Center at small village (s) (median 69%). The difference was statistically significant (Chi square P value ranging from <0.001 to 0.03) for all the items except two – ‘easy to identify vision center location’ and ‘spectacles dispensing time’ as compared to other (privately run optometry) facilities (Chi square P value=0.498 and 0.993 respectively). The location of the Vision Center, convenience of journey, ophthalmic technician’s behavior with patients, are some of the most important factors that determined the patient perception about Vision Center services. Conclusion: The overall satisfaction levels of the Vision Center experience at 78% and 69% were good. However, continual improvement is to be made in service time, staff performance, cost and quality of vision care, especially at more remote primary eye Care Centers.

Vision function and quality of life outcomes after low vision rehabilitation in patients with age-related macular degeneration at a tertiary eye care center

To report vision function [VF] and quality of life [QOL] outcomes after low vision rehabilitation in patients with age-related macular degeneration [AMD]. A questionnaire developed and validated to assess VF and QOL in cataract patients in south India was administered to 50 patients with AMD before and after providing low vision care between October 1, 1997, and May 31, 2003. The outcome measures included overall changes in VF and QOL after low vision rehabilitation. Rasch analysis was performed on pre and post rehabilitation responses to the QOL and VF instruments using Winsteps package. Visual function: The items that were most difficult were reading, writing, needlework, sorting stones from food grains, recognizing faces and light adaptation. Difficulties with these functions reduced significantly after rehabilitation. Quality of Life: The items that were most difficult were banking, using public transport, and psychological well-being. Following rehabilitation the visual functioning for banking, daily living skills, and ease of dialing the telephone increased significantly though the visual functioning/satisfaction for the item related to mobility and psychological well-being either remained the same or worsened. The average perceived visual functioning and QOL improved significantly after rehabilitation [p<0.001]. The improvement in visual function [reading, writing, and recognizing faces] and improvement in quality of life [banking, daily living skills, and dialing the telephone] following rehabilitation point to the advantage of low vision rehabilitation in patients with age-related macular degeneration