Profile of the Australian College of Optometry low vision clinic.

BACKGROUND: The number of Australians living with vision impairment or blindness is expected to increase substantially due to the ageing population and prevalence of age-related eye disease. In response, the Australian College of Optometry (ACO) commenced a low vision clinic in 2013. The ACO is a not-for-profit organisation providing eye-care services to more than 60,000 Victorians per year experiencing economic or social disadvantage. Consultation fees are bulk-billed to the Australian national health care scheme - Medicare - while spectacles and visual aids are subsidised through the state government-funded Victorian Eyecare Service. The aim of this study was to determine the profile and prescribing patterns of the new optometry-led low vision clinic, and report the findings of a short-term loan magnifier pilot study. METHODS: A retrospective audit of 270 patient records was conducted. Additionally, a short-term loan magnifier program was pilot tested to ascertain the demand for, and benefits of, such a program among this cohort. RESULTS: The median age was 77 years (interquartile range 64 to 85 years), with 52 per cent being female. The main cause of vision impairment was age-related macular degeneration (40 per cent). At least one-third primarily spoke a language other than English. The majority (75 per cent) were referred by the optometrist to the onsite consultant occupational therapist for immediate assistance with activities of daily living and onward referral for additional comprehensive services, as required. Of the 49 participants who completed the loan magnifier study, only nine exchanged the magnifier/s initially prescribed. CONCLUSIONS: The ACO has established a low vision service within a large optometry clinic for people experiencing social and economic disadvantage. Where a program of subsidised low-cost magnifiers is available, there is little benefit to short-term loans of magnifiers. Providing basic affordable low vision aids and rehabilitation within a large primary care optometry setting can facilitate acceptability and uptake of low vision services that increase quality of life.

An update on the characteristics of patients attending the Kooyong Low Vision Clinic.

BACKGROUND: Since 1972, the Australian College of Optometry has worked in partnership with Vision Australia to provide multidisciplinary low-vision care at the Kooyong Low Vision Clinic. In 1999, Wolffsohn and Cochrane reported on the demographic characteristics of patients attending Kooyong. Sixteen years on, the aim of this study is to review the demographics of the Kooyong patient cohort and prescribing patterns. METHODS: Records of all new patients (n = 155) attending the Kooyong Low Vision Clinic for optometry services between April and September 2012 were retrospectively reviewed. RESULTS: Median age was 84.3 years (range 7.7 to 98.1 years) with 59 per cent female. The majority of patients presented with late-onset degenerative pathology, 49 per cent with a primary diagnosis of age-related macular degeneration. Many (47.1 per cent) lived with their families. Mean distance visual acuity was 0.57 ± 0.47 logMAR or approximately 6/24. The median spectacle-corrected near visual acuity was N8 (range N3 to worse than N80). Fifty patients (32.3 per cent) were prescribed new spectacles, 51 (32.9 per cent) low vision aids and five (8.3 per cent) were prescribed electronic magnification devices. Almost two-thirds (63.9 per cent) were referred for occupational therapy management and 12.3 per cent for orientation and mobility services. CONCLUSIONS: The profile of patients presenting for low-vision services at Kooyong is broadly similar to that identified in 1999. Outcomes appear to be similar, aside from an expected increase in electronic devices and technological solutions; however, the nature of services is changing, as treatments for ocular diseases advance and assistive technology develops and becomes more accessible. Alongside the aging population and age-related ocular disease being the predominant cause of low vision in Australia, the health-funding landscape is becoming more restrictive. The challenge for the future will be to provide timely, high-quality care in an economically efficient model.