Efficacy of low-vision devices in elderly population with age-related macular degeneration

Purpose: Age?related macular degeneration (AMD) is a common cause of blindness, residual damage to macular area in spite of treatment necessitates visual rehabilitation by means of low?vision aids (LVAs). Methods: Thirty patients suffering from different stages of AMD requiring LVAs were included in this prospective study. Patients with nonprogressive, adequately treated AMD were enrolled over a 12?month period, prescribed requisite LVAs and followed?up for a minimum 1?month period. Before and after provision of LVAs, near work efficiencies were evaluated by calculating reading speed as words per minute (wpm) under both photopic and mesopic light conditions, and impact of poor vision on activities of daily living (ADL) was quantified by modified standard questionnaire based on Nhung X et al. questionnaire. Results: Of the 30 patients mean studied with mean age of 68 ± 10 years, 20 patients (66.7%) had dry AMD in better eye and 10 (33.3%) had wet AMD. Post?LVA, near visual acuity improved significantly and all cases were able to read some letters on near vision chart with an average improvement of 2.4 ± 0.96 lines. The different LVAs prescribed were high plus reading spectacles (up to 10 D) in 23.3%, hand?held magnifiers in 53.3%, base in prisms in 10%, stand held magnifiers in 6.7%, and bar and dome magnifiers in 3.3%. Conclusion: LVAs are effective in visual rehabilitation in patients with AMD. Self?reported reduction in visual dependency and improvement in vision?related quality of life post use of aids corroborated perceived benefit.

Need of optical aids for schools for blind students in Pune and Nasik districts and compliance of their use

Purpose: To assess the need for spectacles and low?vision aids (LVA) in students attending schools for the blind and study their compliance with use. Methods: Comprehensive ocular evaluation was performed using a hand?held slit lamp and ophthalmoscope. Vision acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart for distance, as well as for near. Spectacles and LVAs were dispensed after refraction and LVA trial. Follow?up was performed to assess the vision using the LV Prasad Functional Vision Questionnaire (LVP?FVQ) along with compliance with use after 6 months. Results: Of the 456 students examined from six schools, 188 (41.2%) were female; 147 (32.2%) were <10 years of age. In all, 362 (79.4%) were blind since birth. The students dispensed only LVAs were 25 (5.5%), only spectacles were 55 (12.1%), and both spectacle and LVAs were 10 (2.2%). The vision improved using LVAs in 26 (5.7%) and using spectacles in 64 (9.6%). There was a significant improvement in LVP?FVQ scores (P < 0.001). Also, 68/90 students were available for follow?up, of whom 43 (63.2%) were compliant to use. Causes of not wearing spectacles or LVA in 25 were left somewhere or lost 13 (52%), broken 3 (12%), uncomfortable to use 6 (24%), not interested to use 2 (8%), and got operated 1 (4%). Conclusion: Although the dispensing of LVA and spectacles improved the visual acuity and vision function of 90/456 (19.7%) students, nearly a third were not using them after 6 months. Efforts need to be taken to improve the compliance of use

Effectiveness of low vision aids in vision rehabilitation and improvement of reading speed in people with age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To assess the effectiveness of low vision devices in visual rehabilitation of people with age-related macular degeneration(AMD).<p>METHODS: Forty-four consecutive people with AMD were assessed in low vision clinic. Data about uncorrected and best corrected visual acuity, refractive errors, types of low vision aids(LVAs)and reading speed prior and with low vision devices were collected and analyzed.<p>RESULTS: Among 44 people with mean age 73±10.8 years suffering from AMD, 36(82%)were male. 29(67%)participants had distance visual acuity(DVA)of 1.0-1.6 LogMAR in the better-seeing eyes while 36(82%)had near visual acuity(NVA)less than 3.2 m. Mean improvement in DVA with low vision devices was 0.67±0.27 LogMAR(<i>P</i>=0.000). With LVAs 42(95%)participants achieved NVA of 1 m or better whereas only two(4.5%)participants had NVA of 1 m without LVAs. With the provision of adequate LVAs, mean reading speed was improved from 2.9±4.78 words per minute(wpm)to 71.31±29.96 wpm among the group of participants who could read(<i>P</i><0.001). Monocular telescopes were prescribed to 15 participants for distance vision and high plus monocular lenses in spectacle were the most common aid for reading.<p>CONCLUSION: LVAs can play an effective role in vision rehabilitation of people with AMD and in improvement of reading abilities. Referral to low vision care services must be considered for people with AMD.

Evaluación oftalmológica en niños derivados a un proyecto de rehabilitación en baja visión de un organismo de apoyo social / Ophthalmological evaluation in children referred to a low-vision rehabilitation project of a social assistance agency

INTRODUCCIÓN: Un niño con baja visión (BV) rehabilitado puede tener una educación integral. Objetivo: Estudiar el perfil de los escolares derivados para evaluación a un Proyecto de Rehabilitación en un organismo de apoyo social. PACIENTES Y MÉTODO: Estudio transversal descriptivo de beneficiarios evaluados entre septiembre 2015 y septiembre 2016 en JUNAEB. Se consideró diagnóstico de derivación, agudeza visual monocular (AV) con corrección óptica para lejos (cartillas Feinbloom) y cerca (cartillas Zeiss). Se clasificaron según AV y perimetría. Se consideró éxito de tratamiento lograr AV > 0,4 para le jos y/o cerca con ayuda óptica. RESULTADOS: Se evaluaron 278 escolares. 153 (55%) fueron hombres, 121(43,5%) entre 10 a 14 años. Catarata congénita bilateral, distrofias retinales, alta miopía, atrofia óptica y nistagmus congénito fueron las patologías más frecuentes. 224 (80,6%) se habilitaron con ayudas. 85 (37,9%) presentaron BV moderada y 63 (28,6%) BV severa. 122 (54,5%) presentaban perimetría normal, 68 (30,4%) campo visual (CV) tubular, 19 (8,5%) defecto sectorial del CV y 15 (6,7%) compromiso central del CV. 198 (88,4%) escolares lograron éxito visual de lejos y todos lograron éxito visual de cerca. 48 (17,2%) escolares no pudieron ser rehabilitados, estando asocia dos a una afección neuroftalmológica (41,7%), alto error refractivo (16,6%) o glaucoma congénito (10,4%). 6 (2,2%) casos mejoraron su AV con nueva corrección óptica. CONCLUSIÓN: El éxito obtenido demuestra la necesidad de habilitar visualmente a escolares con BV. Nuestro desafío es mantener este programa y educar al oftalmólogo prestador para una derivación oportuna.

INTRODUCTION: A low-vision (LV) rehabilitated child can receive comprehensive education. OBJECTIVE: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. PATIENTS AND METHODS and Method: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. RESULTS: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. CONCLUSION: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Etiology of 100 patients with visual disability in Chongqing City and analysis on fitting effect of optical aids / 重庆医学

Objective To investigate the causes of visual disability and to evaluate the curative effect of visual disability aids test paired for improving the visual function in the patients with visual disability.Methods By adopting the visual acuity disability rating standards in the 2006 second national disabled sampling survey,100 patients with visual disability undergoing fitting visual aids in the ophthalmology department of the Second Affiliated Hospital of Chongqing Medical University were selected.The causes of visual disability were identified by means of ophthalmological examinatiom at the same time wearing far or near low vision aids observed the improvement degree of eyesight.Results The first cause of visual disability was retinal disease(25.00％).In wearing the distant visual aids,the off-blindness rate was 94.59 ％ and the off-disability rate was 82.43 ％;after wearing the near visual aids,the cases of near visual acuity≥0.50 accounted for 92.31％.Conclusion Retinopathy is a leading cause of adult vision disability;the aids for visual disability in the patients with visual rehabilitation have remarkable curative effect,and can improve the quality of life in the patients with visual disability.

Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital.

Context: In India, where the heavy burden of visual impairment exists, low vision services are scarce and under‑utilized. Aims: Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India. Subjects and Methods: The low vision quality of life (LVQOL) questionnaire measures vision‑related quality of life through 25 questions on a Likert scale of 0–5 that pertain to (1) mobility, distance vision, and lighting; (2) psychological adjustment; (3) reading and fine work; and (4) activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs) were prescribed at the discretion of the low vision specialist. 1‑month later, the same questionnaire was administered over the phone. Results: About 44 of 55 low vision patients completed baseline and follow‑up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points). After the low vision clinic visit, the low vision group demonstrated a 4.55‑point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001). Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24) experienced an even larger increase than those who did not (n = 20) (8.89 points, P < 0.001). Conclusion: Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

Community rehabilitation of disabled with a focus on blind persons: Indian perspective.

India, the largest democratic country in the world, is marching ahead strongly on the growth and developmental front and is poised to be the leader in the market economy. This role creates and increases far greater responsibilities on us in ensuring that the benefit of the developmental cycle reaches each and every citizen of this country, including the able and the disabled ones. It has been enshrined in the Constitution of India to ensure equality, freedom, justice, and dignity of all individuals and implicitly mandates an inclusive society. With increase in consideration of quality parameters in all spheres of life including availability, access, and provision of comprehensive services to the disabled, it is pertinent to have a look on the contribution of government in keeping the aspiration and commitment towards common people. The article attempts to review the concept of rehabilitation for the disabled keeping a focus on the blind person, and list out the activities, programs/schemes, institutional structure and initiatives taken by the Government of India (GOI) for the same and the incentives/benefits extended to blind persons. The article concludes by reiterating the importance of individual need assessment and mentioning new initiatives proposed on Low Vision services in the approved 11th plan under National Programme for Control of Blindness (NPCB). The source of information has been annual reports, notification and the approved 11th five-year plan of GOI, articles published with key words like rehabilitation, disability, assistive devices, low vision aids, and/or blind person through the mode of Internet. Annexure provides a list of selected institutions in the country offering Low Vision services compiled from various sources through personal communication and an approved list of training institutes under NPCB, GOI offering Low Vision training.

Low vision AIDS provision for visually impaired Egyptian patients - a clinical outcome

Purpose: To evaluate a low vision rehabilitation service implemented for heterogeneously diverse group of Egyptian patients with vision loss in terms of improving their visual performance and fulfilling their visual needs. Methods: Fifty patients with low vision were included in a prospective study. History taking; ophthalmic examination and evaluation of the visual functions were performed for all patients. The required magnification was calculated; and subsequently a low vision aid was chosen after counseling with patients. Low vision aids were tried in office; followedby a period of training before patients received their own low vision aids. Follow up was done for 6 months. Results: All patients who were referred to the low vision unit were not satisfied with their current spectacles or low vision aids. After training and prescription of suitable LVAs; the improvement in distance and near visual acuity wasstatistically significant (p0.001). Fifty-six per cent of the patients (nof the patients (n=27) could discern N8 print size or better. The most commonly used aids were high powered near adds. Despite the complaints about the appearance and use of LVAs; 76of the patients reported being moderately to highly-satisfied with their aids. Conclusions: The significant improvement in the visual performance of patients with low vision after the prescriptionand training on the use of LVAs; associated with patients' satisfaction; confirms the importance of expanding low vision rehabilitative services and increasing the public awareness of its existence and benefits

Clinical Analysis of 350 Low Vision Patients

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.

Clinical Analysis of Low Vision Patients

We retrospectively evaluated the 130 low vision patients on the basis of medical recordings. Men(58.5%) were more than women. The patients in teen-age(11-20yr) were most common(23.9%). Etiologies were aphakia due to congenital cataract(21.5%), macular degeneration(15.4%), and optic atrophy(13.8%) in that order. Low vision aids were prescribed for rehabilitation of the low vision. High-power plus glasses(25.4%), magnifiers(24.6%), and telemicroscope(7.9%) were low vision aids commonly prescribed for near vision, while hand-held telescope(23.8%) was the most popular for distance vision aids. High-power plus glasses were actually worn by 31 of 32 patients prescribed for them.

Clinical Analysis of 100 Low Vision Patients

One-hundred patients with low vison caused by various ophthalmic pathologies were evaluated retrospectively. Ophtic atrophy was the most common etiology for low vision. For the low vision patients, hand-help magnifiers, stand magnifiers, telecopes and spectacle-mounted magnifiers were used as optical low vision aid(LVA)s. Typoscopes, visors, absorptive lenses, reading stands were used as non-optical LVAs. Closed circuit television was used as an electrical LVA. Majority of patients(82%) benefited from being prescribed low vision aids Therefore, it was suggested that all patients having low vision should receive a low vision assessment.

Visual Rehabilitation of Optic Atrophy Patients with Low Vision Aids

In oder to evaluate the efficacy of low vision aids in patients with optic atrophy, we analyzed sex, age distribution, preexisting conditions, visual acuities before and after low vision aids use. The sorts and magnifications of prescribed low vision aids were studied in patients with optic nerve atrophy whose visual acuities were not corrected with conventional glasses or contact lens. Our results indicate that distant and near visual acuities with low vision aids were significantly improved in patients with optic atrophy(p<0.01, paired ttest). We think that low vision aids are required to rehabilitate the visually impaired patients caused by optic atrophy because of high probability of visual rehabilitation.