A holistic approach to low vision rehabilitation needed

A more holistic approach to patient referral and rehabilitation provision for people with low vision is required, according to a report published in the February issue of the British Journal of Ophthalmology.

P. M O'Connor and colleagues from the Centre for Eye Research Australia, University of Melbourne and Vision CRC, Sydney, Australia conducted a study to determine the independent predictors of rehabilitation needs for people with low vision using the Impact of Vision Impairment questionnaire (IVI).

A total of 477 patients attending low vision clinics completed the IVI and provided personal and clinical information such as co-morbidities and visual acuity (VA). Rasch analysis was used to generate person measures for the IVI total and three domain scores. Rehabilitation needs were based on mild, moderate or severe levels of restriction in participation as determined by the lower, moderate and higher tertiles of persons' measures. Logistic regression analyses were used to determine independent predictors of rehabilitation needs.

The majority of patients (74%) had moderate or severe vision loss and 43% had age-related macular degeneration (AMD). The results demonstrated that women, shorter duration of vision impairment, the presence of AMD, worse VA, a greater impact of co-morbidities on daily living and reliance on family or friends were univariately associated with poorer IVI scores (p<0.05). In all regression models, VA, the impact of co-morbidities on daily living and dependence on family or friends emerged as the three strongest independent predictors of rehabilitation needs.

The study concluded that, in addition to vision, clinicians should also consider issues relating to dependency when assessing rehabilitation needs.