Abstract
There is limited information on functional low vision (FLV) in Latin America, especially in individuals under 50 years of age. In the present study, we retrospectively evaluated the medical records of 1393 consecutive subjects seen at a Brazilian tertiary rehabilitation service, from February 2009 to June 2016. We collected sociodemographic, clinical data, and information on optical aids and spectacle prescription. Subjects were divided into three age groups: 0 to 14 years old (children), 15 to 49 years old (young adults), and 50 years or older (older adults). The main etiologies leading to FLV in children were cerebral visual impairment (27.9%), ocular toxoplasmosis (8.2%), and retinopathy of prematurity (7.8%). In young adults, retinitis pigmentosa (7.4%) and cone/rod dystrophy (6.5%) were the most frequent, while in older adults, age-related macular degeneration (25.3%) and diabetic retinopathy (18.0%) were the leading causes. Our results indicate that preventable diseases are important causes of FLV in children in the area, and proper prenatal care could reduce their burden. The increasing life expectancy in Latin America and the diabetes epidemic are likely to increase the demand for affordable, people-centered rehabilitation centers, and their integration into health services should be planned accordingly.
Highlights
There is limited information on functional low vision (FLV) in Latin America, especially in individuals under 50 years of age
252 (11.6%) did not attend the appointment, 442 were excluded due to best-corrected visual acuity (BCVA) equal or better to 6/18, 47 with no light perception in both eyes, and 34 were excluded due to incomplete ophthalmological evaluation, leaving 1393 subjects included for analysis (Fig. 1)
In this study of a large series of 1393 subjects seen in a tertiary Brazilian rehabilitation service, we observed that most cases had diseases affecting the posterior segment (n = 768; 55.1%; retina and optic nerve combined, uveitis not included)
Summary
There is limited information on functional low vision (FLV) in Latin America, especially in individuals under 50 years of age. Despite the global decrease in the prevalence of blindness over the last d ecades[1], the number of individuals presenting functional low vision (FLV), defined as visual acuity (VA) of < 6/18 to ≥ light perception (LP) due to any untreatable c ause[2], is increasing[1], mostly due to population growth and aging[1] Treatable causes, such as uncorrected refractive errors and cataract, still contribute to the highest visual impairment burden globally and in Latin America[1,2,3]. Those with functional low vision need perennial, multidisciplinary rehabilitation assistance, often with the need for expensive optical aids. Spectacles, optical aids, and walking sticks are prescribed
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