Cause Of Low Vision Research Articles

Prevalence, causes, magnitude and risk factors of visual impairment and blindness in Sri Lanka

Introduction There is paucity of data on the epidemiology of visual impairment in Sri Lanka. Objectives Estimate the prevalence and determine causes and risk factors of visual impairment among adults aged ≥40 years in Sri Lanka. Methods Multistage, stratified, cluster random sampling was used to select a nationally representative sample aged ≥40 years. All participants underwent vision testing, autorefraction and a basic eye examination. Participants with a presenting acuity of Results 5,779 of those enumerated (6,713) were examined (response rate 86.1%). The prevalence of blindness was 1.7% (95% confidence interval [CI]: 1.3-1.99%) and low vision was 17% (95% CI: 16.0-18.0%). Cataract (66.7%) and uncorrected refractive errors (12.5%) were the commonest causes of blindness. Uncorrected refractive errors (62.4%) and cataract (24.2%) were the commonest causes of low vision. Blindness was significantly higher in older age groups (OR 132.4: 95% Cl 11.7-149.3), those residing in the North Central (OR-12.5), North (OR-12.0), North West (OR-7.3), Eastern (OR-6.7), Western (OR-5.3) and Uva provinces (OR-5.3) compared to the Southern, and in those educated up to and including secondary school (OR 2.3: 95% CI 1.5- 3.17). Gender and socio-economic status were not significant after adjusting. Conclusions The prevalence of blindness in Sri Lanka is lower than in other South Asian countries and most causes are avoidable. Access to eye care needs to improve amongst the aged, those less educated and those in provinces with higher blindness risk.

Game accessibility guidelines for people with sequelae from macular chorioretinitis

Macular chorioretinitis is an ocular inflammation that may cause the permanent loss of the central vision. Researches indicate that the formation of macular scars, the potential sequela of that inflammation, is the leading cause of low vision in children. As we found no game accessibility guidelines in the literature that were specific to users with central vision loss in a preliminary review, this study thus aimed at surveying guidelines targeted at players with low vision. They were extracted through a systematic literature review conducted on digital libraries. There were some known guidelines that were not in the results of the systematic literature review and therefore we made a manual selection of other relevant sources. We also proposed a new guideline related to the sharpness of images because it was deemed important to improve game accessibility to the public concerned and it had not been presented in the literature. In total, we identified 25 general game accessibility guidelines for people with low vision, plus the one we proposed, and 20 of them were considered applicable to people with macular scars. Afterwards, based on classifications available in the literature and on the experience of the authors as developers, we assessed the feasibility of each guideline according to their impact, reach and an estimation of their implementation cost. The survey also confirmed that no guideline existed that was specific to players with central vision loss. In order to evaluate the new guideline and one of those identified in the literature from the player perspective, we developed a game prototype which implemented both. A qualitative analysis conducted with the game prototype indicated that the evaluated guidelines are applicable to the public concerned. We expect the results of this research to serve as a step towards determining how to make games more accessible to players with sequelae from macular chorioretinitis.

Reading aids for adults with low vision.

Background The purpose of low-vision rehabilitation is to allow people to resume or to continue to perform daily living tasks, with reading being one of the most important. This is achieved by providing appropriate optical devices and special training in the use of residual-vision and low-vision aids, which range from simple optical magnifiers to high-magnification video magnifiers. Objectives To assess the effects of reading aids for adults with low vision. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 1), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to January 2013), EMBASE (January 1980 to January 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2013), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov/) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 31 January 2013. We searched the reference lists of relevant articles and used the Science Citation Index to find articles that cited the included studies and contacted investigators and manufacturers of low-vision aids. We handsearched the British Journal of Visual Impairment from 1983 to 1999 and the Journal of Visual Impairment and Blindness from 1976 to 1991. Selection criteria This review includes randomised and quasi-randomised trials in which any device or aid used for reading had been compared to another device or aid in people aged 16 or over with low vision as defined by the study investigators. Data collection and analysis At least two authors independently assessed trial quality and extracted data. Main results We included nine small studies with a cross-over-like design (181 people overall) and one study with three parallel arms (243 participants) in the review. All studies reported the primary outcome, results for reading speed. Two studies including 92 participants found moderate- or low-quality evidence suggesting that reading speed is higher with stand-mounted electronic devices or electronic devices with the camera mounted in a ‘mouse’ than with optical magnifiers, which in these trials were generally stand-mounted or, less frequently, hand-held magnifiers or microscopic lenses. In another study of 20 participants there was moderate-quality evidence that optical devices are better than head-mounted electronic devices (four types). There was low-quality evidence from three studies (93 participants) that reading using head-mounted electronic devices is slower than with stand-based electronic devices. The technology of electronic devices may have changed and improved since these studies were conducted. One study suggested no difference between a diffractive spectacle-mounted magnifier and either refractive (15 participants) or aplanatic (15 participants) magnifiers. One study of 10 people suggested that several overlay coloured filters were no better and possibly worse than a clear filter. A parallel-arm study including 243 participants with age-related macular degeneration found that custom or standard prism spectacles were no different from conventional reading spectacles, although the data did not allow precise estimates of performance to be made. Authors' conclusions There is insufficient evidence on the effect of different types of low-vision aids on reading performance. It would be necessary to investigate which patient characteristics predict performance with different devices, including costly electronic devices. Better-quality research should also focus on assessing sustained long-term use of each device. Authors of studies testing several devices on the same person should consider design and reporting issues related to their sequential presentation and to the cross-over-like study design.

Clinical characteristics and causes of visual impairment in a low vision clinic in northern Jordan

AimThe aim of the study was to identify causes of visual impairment among patients attending a low vision clinic in the north of Jordan and to study the relevant demographic characteristics of these patients.Subjects and methodsThe retrospective study was conducted through a review of clinical records of 135 patients who attended a low vision clinic in Irbid. Clinical characteristics of the patients were collected, including age, gender, primary cause of low vision, best corrected visual acuity, and current prescribed low vision aids. Descriptive statistics analysis using numbers and percentages were calculated to summarize categorical and nominal data.ResultsA total of 135 patients (61 [45.2%] females and 74 [54.8%] males) were recruited in the study. Mean age ± standard deviation for the study population was 24.53 ± 16.245 years; age range was 5–90 years. Of the study population, 26 patients (19.3%) had mild visual impairment, 61 patients (45.2%) had moderate visual impairment, 27 patients (20.0%) had severe visual impairment, and 21 patients (15.6%) were blind. The leading causes of visual impairment across all age groups were albinism (31.9%) and retinitis pigmentosa (RP) (18.5%). Albinism also accounted for the leading cause of visual impairment among the pediatric age group (0–15 years) while albinism, RP, and keratoconus were the primary causes of visual impairment for older patients. A total of 59 patients (43.7%) were given low vision aids either for near or distance. The only prescribed low vision aids for distances were telescopes. For near, spectacle-type low vision aid was the most commonly prescribed low vision aids.ConclusionLow vision services in Jordan are still very limited. A national strategy programme to increase awareness of low vision services should be implemented, and health care policies should be enforced to cover low vision aids through the national medical insurance.

Prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study

BackgroundThis study aims to explore the prevalence and causes of low vision and blindness focused on retinal disease in a population above 60 years in Nepal.MethodsTwo thousand one hundred subjects were enrolled in a population-based cross-sectional study. History, presenting and best corrected visual acuity after subjective refraction, anterior and posterior segment examinations was obtained in detail.ResultsAmong the total subjects, 1860 (88.57%) had complete information. Age varies from 60 to 95 (mean age: 69.64 ± 7.31) years. Low vision and blindness in both eyes at presentation was found in 984 (52.90%, 95% confidence interval (CI): 50.60–55.19) and 36 (1.94%, 95% CI: 1.35–2.66) subjects respectively. After best correction, bilateral low vision and blindness was found in 426 (22.92%, 95% CI: 21.01–24.88), and 30 (1.61%, 95% CI: 0.10–2.30) subjects respectively. As compared to 60–69 years old, risk of visual impairment was four times higher (95% CI:3.26–5.58) in the 70–79 year olds and 14 times higher (95% CI: 9.72–19.73) in the age group 80 years and above.Major causes of bilateral low vision were cataract (68.07%), followed by retinal disorders (28.64%), and for blindness; retinal disorders (46.66%), followed by cataract (43.33%). Illiteracy was significantly associated with visual impairment.ConclusionAmong the elderly population, prevalence of visual impairment was high. Refractive error, cataract and retinal disorders were the major cause of low vision. Screening the population at the age 60 years and above, focused on cataract and posterior segment diseases, providing glasses and timely referral can help reduce visual impairment.

Causes of low vision and blindness in a Turkish adult population: the Izmir eye study

Data from Turkey show that sense organ diseases were the second leading cause of years lost due to disability in 2015. However, there are no reliable data on either the baseline causative disorders of visual impairment or the burden of these disorders on the population in Izmir region. Izmir is the third most populated city of Turkey with a population of approximately 4.2 million. The purpose of this study was to define the baseline disorders causing low vision and blindness in accordance with World Health Organization criteria in an adult population in Izmir. We evaluated the ophthalmologic reports of 20 790 people in Izmir, Turkey. Age- and sex-specific causes of low vision and blindness were identified. Bilateral low vision and blindness was detected in 347 people, 172 males and 175 females. For those aged 18-50 years, retinal dystrophies (37%), congenital eye anomalies (14%) and myopic degenerations (13%) were the most common causes. For those aged 50+ years, age-related macular degeneration (21%) was the leading cause. Diabetic retinopathy (17%), corneal opacities (14%), cataract (12%) and glaucoma (9%) were also important. Sex was not a significant determinant. The specific causes of visual impairment vary greatly with age, however, unavoidable retinal pathologies were the predominant causes at all ages.

Profile of Low Vision Patients in a Resource-Poor Underserved Setting of a Developing Country

Objectives: To identify causes of low vision among the patients in the Eye clinic of University of Nigeria Teaching Hospital (UNTH). Methods: This was a cross-sectional study of all new consecutive low vision patients seen at the eye clinic of University of Nigeria Teaching Hospital-(UNTH) Ituku-Ozalla. All patients with low vision were evaluated by the researcher and the findings entered on a research protocol. Data were analyzed using descriptive statistics to generate frequency and percentage distributions and analytical statistics to test for significance of observed inter-group differences. In all comparisons, statistical significance was indicated by p

Reading performances of low vision children after using low vision aid

Introduction/Objective. The objectives of the paper are to assess the causes of low vision (LV) in pediatric population in Montenegro and to evaluate the influence of low vision aids (LVA) on reading performance regarding the speed of reading and the understanding of the read text. Methods. A prospective study was conducted on 40 ?treatable? LV children what represent all registered LV children in Montenegro. All participants read the same text before and after using LVA. Reading rate was calculated as the number of words read per minute. Functional speed of reading was calculated as the ratio of the rate of reading and the understanding of the read text multiplied by 100. Results. The study comprised 40 LV children with the mean age of 12.60 ? 4.06 years (20 boys and 20 girls). The most common cause of LV in children were premature retinopathy (10/40 or 25%), retinitis pigmentosa (8/40 or 20%), optic nerve anomaly (5/40 or 13%), degenerative myopia (4/40 or 10%), macular dysgenesis (4/40 or 10%), Stargardt disease (3/40 or 7%), optic nerve atrophy (2/40 or 5%), and albinism (2/40 or 5%). Nystagmus was found in 11 LV children or 28% of the group. LVA were prescribed to all of them. Reading speed before vs. after LVA use was 36.58 ? 35.60 vs. 73.83 ? 27.05 words/minute (p < 0.001), while functional reading was 26.00 ? 30.43 vs. 59.41 ? 29.34 (p < 0.001). Conclusion. LV children demonstrate a significant improvement in reading performance by using LVA.

Are children with low vision adapted to the visual environment in classrooms of mainstream schools?

Purpose:The study aimed to evaluate the classroom environment of children with low vision and provide recommendations to reduce visual stress, with focus on mainstream schooling.Methods:The medical records of 110 children (5–17 years) seen in low vision clinic during 1 year period (2015) at a tertiary care center in south India were extracted. The visual function levels of children were compared to the details of their classroom environment. The study evaluated and recommended the chalkboard visual task size and viewing distance required for children with mild, moderate, and severe visual impairment (VI).Results:The major causes of low vision based on the site of abnormality and etiology were retinal (80%) and hereditary (67%) conditions, respectively, in children with mild (n = 18), moderate (n = 72), and severe (n = 20) VI. Many of the children (72%) had difficulty in viewing chalkboard and common strategies used for better visibility included copying from friends (47%) and going closer to chalkboard (42%). To view the chalkboard with reduced visual stress, a child with mild VI can be seated at a maximum distance of 4.3 m from the chalkboard, with the minimum size of visual task (height of lowercase letter writing on chalkboard) recommended to be 3 cm. For 3/60–6/60 range, the maximum viewing distance with the visual task size of 4 cm is recommended to be 85 cm to 1.7 m.Conclusion:Simple modifications of the visual task size and seating arrangements can aid children with low vision with better visibility of chalkboard and reduced visual stress to manage in mainstream schools.

Frequency of Cataract in Iran: A Meta-Analysis and Systematic Review.

PURPOSE:Cataract is the leading cause of blindness and the second cause of low vision in the world. In the world, Asia has the highest number of blind population. The aim of the present systematic review and meta-analysis was to assess the frequency of clinical cataracts in Iran.MATERIALS AND METHODS:The frequency of clinical cataract was defined based on the international criteria and the measured outcome of the disease. Study selection, data extraction, and quality assessment were performed by two independent reviewers. We explored PubMed, Google Scholar, ISI Web of Science, and national databases (scientific information database, Magiran) to evaluate the clinical cataract of cataract in the Iranian populations from 1995 to July 2017. Statistical analysis was performed using STATA 14.0 software.RESULTS:Of 283 studies, 27 studies utilized meta-analysis. In 2017, the pooled overall frequency of clinical cataract in 59668 people was 9.27% (95% confidence interval [CI]: 8.09, 10.45, I2 = 98.82%). Based on subgroup analysis, in the random effect method, the frequency of clinical cataract in males and females were 8.03% (CI: 6.78, 9.28) and 8.32% (CI: 7.08, 9.55), respectively.CONCLUSION:Regarding the high frequency of clinical cataract in Iran, it seems that paying attention to the results of the current study and the application of international policy plans may contribute to better cataract control in Iran.

THE SURGERY OF CATARACT AS A MEDICAL SOCIAL PROBLEM

The cataract is one of leading causes of low vision and blindness in the world. It is well known that a significant decreasing of vision or its total loss result in deterioration of quality of life, including total or partial loss of working capacity. On the basis of official statistics data, a study was carried out шт the course of which costs of inputs to cataract treatment and dependence of disability on quality of visual functions were established.

Causes and Three-year Incidence of Irreversible Visual Impairment in Jing-An District, Shanghai, China from 2010-2015

BackgroundThe registry system can be used to observe the distribution trend of diseases and analyze the related data to provide useful information in a way that enables the government to take appropriate interventional measures. The purpose of this study was to determine the causes and three-year incidence of newly registered disabled patients who were blind or had low vision in Jing-An District, Shanghai, China from 2010 to 2015.MethodsData from the registration system of visual disability in Jing-An District, Shanghai from 2010 to 2015 were collected and analyzed. In this registry, the only person with permanent visual impairment (VI) was identified as being a certified visually impaired person. The main causes of visual disability were obtained, the three-year incidence of visual disability was calculated, and the relationships between blindness or low vision and age, as well as those between blindness or low vision and gender, were analyzed.ResultsSix-hundred and forty-six newly certified people with VI were registered, including 206 blind patients and 440 low vision patients. The major causes of blindness were myopia macular degeneration (MMD, 23.30%), glaucoma (20.39%), and age-related macular degeneration (AMD, 17.96%). The three leading causes of low vision were MMD (58.86%), AMD (16.36%), and diabetic retinopathy (DR, 7.27%). DR (16.0%) was the first leading cause of blindness and the second leading cause of VI in patients aged 30–59 yrs. from 2010 to 2015. The three-year incidences of blindness in 2010–2012 and 2013–2015(P = 0.43), which remained stable throughout this time period, were 32.74/100000 and 36.51/100000, respectively. However, the three-year incidence of low vision was 64.51/100000 in 2010–2012 and 83.58/100000 in 2013–2015(P = 0.007), which shows that the incidence increased significantly due to the increase of patients with low vision caused by MMD and DR (P = 0.003 and P = 0.01, respectively).ConclusionsMMD, glaucoma, and AMD were the main causes of blindness, while DR was becoming a major cause of VI, especially in working-age people of Jing-An District, Shanghai, China.

Analysis on the efficacy of cataract surgery during the international aid to African "Brightness Action"

Objective To analyze the safety and efficacy of cataract surgery during the international aid to African Brightness Action . Methods The data of 280 eyes of 240 cases with cataract were collected during international aid to Cameroon Brightness Action from May 2016 to Jun. 2016. They underwent phacoemulsification or small incision cataract extraction and intraocular lens implantation. Results Followed up for 3 to 6 months, no endophthalmia, bullous keratopathy or other serious complication occurred after surgery. No cystoids macular edema, retinal detachment or secondary opacification of the posterior capsule happened. At 1-3 days postoperatively, the visual recovery rate was 98.21% and the visual acuity recovered from disability occupyed for 83.93%. The visual acuity at 1-3 days after surgery was ≥0.5 in 203 eyes (72.50%). At the end of the follow-up, the visual acuity was ≥0.5 in 266 eyes(95.00%), 0.05-0.25 in 8 eyes (2.97%). The main cause of low vision after surgery was ocular fundus disease. Conclusion The operation of large-scale cataract rescue operation during the international aid to Brightness Action is effective, the treatment is selected by phacoemulsification and small incision manual operation, the safety is reliable. Key words: Cataract; Brightness Action international aid to Africa; Phacoemulsificstion; Small incision extracapsular cataract extraction; Intraocular lens implantation

Protective Effects of Dietary Flavonoids in Diabetic Induced Retinal Neurodegeneration.

Diabetic retinopathy is one of the serious complications of diabetes and the leading cause of decreased vision and blindness worldwide. Neurodegeneration has been recognized as initiating factor in causing the retinal damage, which leads to micro-vascular damage in diabetic retinopathy. Diabetes-induced oxidative stress is believed to be the key factor that damages neurons in the diabetic retina. Various therapeutic approaches for effective attenuation of increased oxidative stress by antioxidants have emerged. One such approach is to utilize dietary flavonoids, which have been found to possess powerful antioxidant activity. Some of the naturally occurring flavones possess anti-diabetic effects by enhancing insulin sensitivity and reducing plasma glucose levels in diabetic animal models. Considering the importance of developing new antioxidant compounds and the relevance of their applications in the treatment of diabetes and its complications, in this review article, we discuss and highlight various neuroprotective mechanisms of flavonoids in the diabetic retina. Dietary supplementation of flavonoids to diabetics may reduce oxidative stress, which in turn might ameliorate apoptosis and the levels of neurotrophic factors in the diabetic retina. This approach will elucidate a novel strategy for preventing and treating diabetic retinoneuropathy the leading cause of low vision and blindness.

Prevalence and causes of low vision and blindness in a Chinese population with type 2 diabetes: the Dongguan Eye Study

To assess the prevalence and causes of low vision and blindness in type 2 diabetes patients, a population-based cross-sectional study including 8952 rural-dwelling residents aged 40 years or older from Hengli Town in Southern China was conducted. Participants underwent standard interviews, physical measurements, laboratory tests, and comprehensive eye examinations. Low vision and blindness were defined based on WHO criteria. Visual acuity data were available for 1348 (89.9%) of the 1500 subjects with type 2 diabetes. Age-standardized prevalence of bilateral low vision and blindness assessed in the better-seeing eye was 2.9% (95% confidence interval [CI]: 2.0–3.8) and 0.7% (95% CI: 0.2–1.1) based on best-corrected visual acuity (BCVA). Cataracts were the primary cause of low vision and blindness. Visual impairment was associated with age (odds ratio [OR]: 3.73, 95% CI: 2.39–5.83), education level (OR: 3.21, 95% CI: 1.63–6.29), duration of diabetes (OR: 1.14, 95% CI: 1.04–1.25) and body mass index (OR: 0.86, 95% CI: 0.77–0.95). Our data suggest that approximately 70% of visual impairment in this diabetic population could be eliminated with appropriate cataract surgery or spectacle correction. Greater consideration should be given to older type 2 diabetes patients with a level of lower education.

Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases.

Macular disease is the leading cause of low vision in the Western world. Drusen and pigmentary irregularities are common among the rural Northern Indian population. The disease process leads to loss of central vision, metamorphopsia, macropsia or micropsia and colour vision defect. To study the retinal sensitivity changes in macular diseases using microperimetry. It was an observational study, conducted in the Department of Ophthalmology at a rural tertiary care hospital. This study was started from December 2014 until June 2016, in all patients with macular disease above the age of 20 years attending the outpatient department. Microperimetry was done for 84 eyes of 52 patients with macular disease. Mean retinal Sensitivity (MS) and fixation stability was evaluated. The statistical analysis of mean retinal sensitivity, central 2° and 4° fixation was done by calculating the mean and standard deviation using 95% confidence interval. The range of age was between 20-81 years. Majority were 32 males (62%) and 20 females (38%). Out of the 84 eyes studied, majority of the macular disease were Age-Related Macular Degeneration (AMD) (50%). Rest 50% were other macular diseases. The mean retinal sensitivity (dB) shown by microperimetry was 10.83 in AMD, 9.12 in Cystoid Macular Oedema (CME), 10.34 in Epiretinal Membrane (ERM), 10.74 in Pigment Epithelial Detachment (PED), 8.96 in Central Serous Chorioretinopathy (CSCR), 6.43 in macular dystrophy, 7.15 in Lamellar Hole (LMH), 9.8 in Pseudomacular Hole (PMH), 3 in geographic atrophy, 11.1 in macular telangiectasia, 5.6 in Berlin oedema, 12.3 in macular scar and 15.2 in haemorrhage in macula. The study showed 64% of the eyes had stable 2° central fixation, 35% had relatively unstable fixation and 1% had unstable fixation. No significant correlation between retinal sensitivity and retinal thickness in AMD was found. This study shows that microperimetry can be a useful tool for objective evaluation of macular function and progression of the disease.

Optic nerve pathology in the structure of diagnostic errors inpatients referred for cataract surgery

to study the frequency of misdiagnosis of cataract in patients with optic nerve pathology or amblyopia and to identify its main causes. The study enrolled 381 patients (381 eyes) wrongly diagnosed with cataract. A standard set of eye tests was performed. In-depth examination of the macular area was done through biomicroscopy with contactless aspheric lenses of 60 and 90 D. Part of the patients underwent optical coherence tomography and static perimetry as well as examination of electrical sensitivity threshold and electrical lability of the optic nerve. In 190 patients (190 eyes - 49.9%), the true cause of central vision impairment was optic nerve pathology associated with its partial atrophy of different origins: vascular (77.8%) or post-traumatic (22.2%). Glaucomatous atrophy of the optic nerve was found in 175 patients within the age range from 57 to 70 years (175 eyes - 45.9%). These were newly diagnosed cases of advanced open-angle glaucoma. In 16 eyes (4.2%), the true cause of low vision appeared to be amblyopia of some type: strabismic (9 eyes - 56.3%), refractive (4 eyes - 25%), or mixed (3 eyes - 18.7%). The main diagnostic errors of attending ophthalmologists were the following: underestimation of the discrepancy between low visual functions and small degree of lens opacity as well as the neglect of careful examination of the fundus (specifically, the optic disc and macula), additional perimetry, thorough history taking, and cover-testing for suspected amblyopia.

An update on the characteristics of patients attending the Kooyong Low Vision Clinic

BackgroundSince 1972, the Australian College of Optometry has worked in partnership with Vision Australia to provide multidisciplinary low‐vision care at the Kooyong Low Vision Clinic. In 1999, Wolffsohn and Cochrane reported on the demographic characteristics of patients attending Kooyong. Sixteen years on, the aim of this study is to review the demographics of the Kooyong patient cohort and prescribing patterns.MethodsRecords of all new patients (n = 155) attending the Kooyong Low Vision Clinic for optometry services between April and September 2012 were retrospectively reviewed.ResultsMedian age was 84.3 years (range 7.7 to 98.1 years) with 59 per cent female. The majority of patients presented with late‐onset degenerative pathology, 49 per cent with a primary diagnosis of age‐related macular degeneration. Many (47.1 per cent) lived with their families. Mean distance visual acuity was 0.57 ± 0.47 logMAR or approximately 6/24. The median spectacle‐corrected near visual acuity was N8 (range N3 to worse than N80). Fifty patients (32.3 per cent) were prescribed new spectacles, 51 (32.9 per cent) low vision aids and five (8.3 per cent) were prescribed electronic magnification devices. Almost two‐thirds (63.9 per cent) were referred for occupational therapy management and 12.3 per cent for orientation and mobility services.ConclusionsThe profile of patients presenting for low‐vision services at Kooyong is broadly similar to that identified in 1999. Outcomes appear to be similar, aside from an expected increase in electronic devices and technological solutions; however, the nature of services is changing, as treatments for ocular diseases advance and assistive technology develops and becomes more accessible. Alongside the aging population and age‐related ocular disease being the predominant cause of low vision in Australia, the health‐funding landscape is becoming more restrictive. The challenge for the future will be to provide timely, high‐quality care in an economically efficient model.

Treatment of Amblyopia and Amblyopia Risk Factors Based on Current Evidence

ABSTRACTPurpose: Amblyopia is a leading cause of low vision and warrants timely management during childhood. We performed a literature review of the management of amblyopia and potential risk factors for amblyopia. Methods: Literature review of the management of amblyopia and risk factors for amblyopia. Results: Common amblyopia risk factors include anisometropic or high refractive error, strabismus, cataract, and ptosis. Often a conservative approach with spectacles is enough to prevent amblyopia. However, surgery may be necessary to clear the visual axis or align the eyes. Conclusion: Amblyopia risk factors should be managed early. Though amblyopia treatment is more likely to be successful at a younger age, those who are older but treatment-naïve may still respond to treatment. Promoting binocular or dichoptic experiences may be the future direction of amblyopia management.

Low Vision Rehabilitation in Older Adults.

Objectives:To evaluate the diagnosis distribution, low vision rehabilitation methods and utilization of low vision rehabilitation in partially sighted persons over 65 years old.Materials and Methods:One hundred thirty-nine partially sighted geriatric patients aged 65 years or older were enrolled to the study between May 2012 and September 2013. Patients’ age, gender and the distribution of diagnosis were recorded. The visual acuity of the patients both for near and distance were examined with and without low vision devices and the methods of low vision rehabilitation were evaluated.Results:The mean age of the patients was 79.7 years and the median age was 80 years. Ninety-six (69.1%) of the patients were male and 43 (30.9%) were female. According to the distribution of diagnosis, the most frequent diagnosis was senile macular degeneration for both presenile and senile age groups. The mean best corrected visual acuity for distance was 0.92±0.37 logMAR and 4.75±3.47 M for near. The most frequently used low vision rehabilitation methods were telescopic glasses (59.0%) for distance and hyperocular glasses (66.9%) for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids.Conclusion:The causes of low vision in presenile and senile patients in our study were similar to those of patients from developed countries. A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted geriatric patients. It is important to guide them to low vision rehabilitation.