Abstract
Background: The university-based low vision clinic is one of the few low vision clinics in South Africa.Aim: To describe demographic and clinical profiles of patients who attended this clinic from 2010 to 2017.Setting: The university low vision clinic, South Africa.Methods: The record cards of all patients seen at the low vision clinic over 8 years were examined and the following information was extracted: age, gender, presenting visual acuity (VA), VA following low vision assessment, cause of visual impairment and types of low vision devices recommended.Results: A total of 621 patients were examined, comprising 45.1% males and 55.9% females aged 36.0 ± 18.2 years (range: 4–93 years). Many of these patients (33.7%) had presenting VA worse than 1.3 logarithm of the Minimum Angle of Resolution (logMAR) ( 6/120) at 4 m in the better eye, and 196 (31.6%) had presenting VA of worse than 1.3 logMAR at near distance. Following optical low vision assessment, 62.4% had distance VA of 0.9 LogMAR (6/48) to −0.2 logMAR (6/3.8) and 58.4% had near VA of 0.9 logMAR (6/48) to −0.2 logMAR (6/3.8). Albinism (22.7%), unknown causes (18.2%), cataract (15.5%) and macular diseases (12.2%) were the most common causes of low vision. Amblyopia (80.7%) was the most common cause of low vision in patients aged 20 years and younger, followed by albinism (68.1%) and corneal diseases (41%). Cataract (78.1%), macular diseases (64.4%) and glaucoma (55.9%) were the most common causes of low vision in patients aged more than 60 years. Telescopes (33.8%) were the most commonly recommended form of intervention, followed by magnifiers (29.6%) and protective measures (24.5%).Conclusion: Albinism, cataract and macular diseases are the predominant causes of low vision in patients attending this low vision clinic. There was a significant improvement in VA after low-vision assessment, particularly for patients with presenting VA of better than 1.3 logMAR (6/120).
Highlights
The new definition emanated from the fact that the ICD-10 categories of visual loss do not allow refractive errors to be assessed as a cause of visual impairment (VI)
The results showed that cataract (43%) and glaucoma (42%) were the commonest causes of blindness in their study population
A total of 621 cards of the patients seen at the low vision clinic were reviewed
Summary
The World Health Organization (WHO) defines low vision as ‘visual acuity [VA] less than 6/18 and equal to or better than 3/60 in the better eye with [the] best correction’ and a person with low vision as:[O]ne who has impairment even after treatment and/or standard refractive correction, and has a visual acuity of less than 6/18 to light perception, or a visual field less than 10 degrees from the point of fixation, but who uses, or is potentially able to use, vision for the planning and/or execution of a task for which vision is essential.[1]The WHO International Classification of Diseases (ICD)-10 categories of visual loss define low vision as ‘a corrected visual acuity (VA) in the better eye of 6/18 down to and including 3/60’.2 This definition includes all individuals regardless of the cause of visual loss. The WHO International Classification of Diseases (ICD)-10 categories of visual loss define low vision as ‘a corrected visual acuity (VA) in the better eye of 6/18 down to and including 3/60’.2. This definition includes all individuals regardless of the cause of visual loss. The WHO recently suggested that ‘presenting visual acuity’ (VA tested with distance spectacles if usually worn), as well as uncorrected VA, be used in all population-based surveys.[2] The new definition emanated from the fact that the ICD-10 categories of visual loss do not allow refractive errors to be assessed as a cause of visual impairment (VI). The university-based low vision clinic is one of the few low vision clinics in South Africa
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