Vision rehabilitation: recipients' perceived efficacy of rehabilitation.

OBJECTIVE/PURPOSE: This survey was conducted to determine the effect on activities of daily living of persons who report that they have received vision rehabilitation. DESIGN/METHODOLOGY: This study used a clinical sample to gather information from 417 patients. Of the 417, 105 reported receiving vision rehabilitation. The efficacy of rehabilitation was assessed by asking 20 questions about their activities of daily living prior to and after their rehabilitation. A retrospective pretest (post-then-pre) design was used. Paired t tests were conducted to evaluate the effect of rehabilitation. RESULTS: A significant difference was found for 13 of 20 questions. Difficulty reading ordinary prints in newspapers showed a large effect size (p=0.0005). Difficulty reading the small print in a telephone book showed a large effect size (p=0.0005). Difficulty doing work or hobbies that require one to see up close showed a moderate effect size (p=0.0005). Difficulty finding something on a crowded shelf showed a moderate effect size (p=0.0005). Difficulty figuring out whether bills received are accurate showed a moderate effect size (p=0.0005). Difficulty shaving, styling one's hair, or putting on makeup showed a small effect size (p=0.016). Difficulties seeing and enjoying programs on television showed a moderate effect size (p=0.0005). CONCLUSION: Patients with low vision who report having received vision rehabilitation show significant improvements in activities of daily living or specific types of functioning after rehabilitation. Improvement in both near and distance vision activities and in social activities indicates daily functioning was improved and that barriers to activities of daily living were removed.

Pain after epithelial removal by ethanol-assisted mechanical versus transepithelial excimer laser debridement.

PURPOSE: To compare subjective pain responses between two techniques of epithelial removal prior to photorefractive keratectomy (PRK) treatment: ethanol-soaked pledget with mechanical debridement of the epithelium versus excimer laser transepithelial ablation. METHODS: Nine patients underwent bilateral PRK. Each had the epithelium in one eye debrided by placing a pledget soaked in 20% ethanol on the cornea for 2 minutes followed by gentle scraping with a blade. The epithelium in the other eye was removed by transepithelial phototherapeutic keratectomy (PTK) treatment. For each eye, PRK was initiated immediately after removal of the epithelium. On postoperative day one, each patient was asked to rate the level of pain suffered over the last 24 hours on a scale of 0 (minimal) to 10 (maximal). Data were analyzed in a masked fashion. RESULTS: Postoperative day one average pain level in the ethanol-assisted mechanically debrided eyes was 3.0 +/- 2.5 and in the transepithelial PTK eyes was 6.8 +/- 1.8. The difference was statistically significant by Student's t-test (P < .01). All epithelial defects healed within 3 days with no clinically significant difference in healing time between the two techniques. CONCLUSION: In preparation for PRK, ethanol-assisted mechanical debridement of the epithelium caused significantly less postoperative pain than epithelial removal using the excimer laser.