Assessing the effectiveness of low vision rehabilitation in children: an observational study.

Abstract

To evaluate the change in visual functioning (VF) using the L. V. Prasad-Functional Vision Questionnaire II (LVP-FVQ II) following multidisciplinary low vision rehabilitation (LVR) services in children with low vision (LV). Children with LV referred for the first time to the Centre for Sight Enhancement were administered the LVP-FVQ II at baseline and at 3 to 4 months' follow-up to assess the outcomes of LVR. Participants' responses to the LVP-FVQ II at baseline and follow-up were transformed into interval-level estimates of VF using Rasch analysis. Cohen's d values (effect size) were used to estimate the magnitude of change in VF. A total of 183 participants completed the rehabilitation (mean age, 11.9 years; male, 57%). More than one-half of the participants had retinal disorders (55%) and most were moderately visually impaired (<20/60-20/200, 76.5%). Using the LVP-FVQ II, significant improvement in VF after rehabilitation was recorded (P < 0.0001) and the increase in VF (SD) was 1.20 (1.82) logits. Using Cohen's d, the magnitude of the improvement in LVR intervention at follow-up was found to be 0.75, indicating nearly large treatment effect. Ours is the first study to provide strong evidence that LVR services result in nearly large and significant improvements in the overall VF in children with LV, regardless of the cause of LV. These results should encourage eye care professionals to refer children with LV to LVR services. Further investigation is needed to determine if the improvement in VF can be sustained over a longer duration (>4 months).