Vision Rehabilitation Research Articles

Comparison of the effects of telescopic glasses and filtered glasses on functional vision rehabilitation outcomes in patients with retinitis pigmentosa

Comparison of the effects of telescopic glasses and filtered glasses on functional vision rehabilitation outcomes in patients with retinitis pigmentosa

Low vision in school-age children in Menoufia Governorate

Purpose To assess the causes and management of low vision in school-age children in Menoufia Governorate. Patients and methods This prospective study was made among 140 children with vision impairment aged from 6 to 18 years who came to the low-vision clinic of the Department of Ophthalmology of Menoufia University Hospitals with visual acuity less than 6/18 in the better eye best correction. A complete history was obtained. Complete examination of the anterior and posterior segments was done. Strabismus existence was determined. Refractive errors were measured. Before and after using low-vision aids, near and far visual acuity was measured. Results The mean age of patients was 11.94±3.61 years; 76 (54.29%) of the children were males and 64 (45.71%) of the children were females. According to the distribution of the diagnoses, hereditary fundus dystrophies were the most prevalent diagnosis among the children, accounting for 28.57% of diagnoses, followed by albinism (20%). The rehabilitation techniques that were mostly used were telescopic glasses (54.29%) for distant vision, electronic magnifiers (31.43%), and optical magnifiers (20.0%) for near vision. Low-vision devices were shown to significantly improve both near and distant visual acuity. Conclusions Visual rehabilitation for school-age children with visual impairment can result in a considerable improvement in both distant and near vision. As a result, pediatricians and ophthalmologists must recommend vision rehabilitation for children with vision impairment.

Low vision rehabilitation program in patients with myopic macular degeneration: A case series

Aims/Purpose: Patients with pathologic myopia are at risk of developing myopic macular degeneration (MMD) that leads to vision loss and irreversible visual impairment. Working age and elderly populations are affected by loss of productivity and quality of life. Low vision services should offer specialized training programs to help patients to overcome the difficulties in daily living activities. The aim of this study was to describe the results of a low vision rehabilitation program (LVR) in patients with MMD.Methods: Five patients (8 eyes) with MMD were included in the LVR at an ophthalmology clinic in Portugal. The LVR had a length of 8 weeks and was divided into two phases. The first phase included the use of prisms for image relocation (IR) with eccentric viewing exercises to stabilize the preferred retinal locus. At the second phase, training with low vision aids was performed. Best corrected visual acuity (BCVA) for distance and near, contrast sensitivity (CS), reading speed (RS) and face recognition were compared pre and post rehabilitation.Results: Patients had MMD category 3 (patchy chorioretinal atrophy) and 4 (macular atrophy) in the best eye. Vision impairment varied between mild and severe. The IR prisms varied from 2 to 6 prism dioptres. Electronic devices were the most prescribed low vision aids. At the end of the LVR, the outcomes were good in all patients. BCVA increased by two to three lines, CS increased by two to four lines, RS increased by 40 to 60 words per minute and face recognition improved in all patients.Conclusions: The LVR was beneficial, improving visual function and functional vision outcomes in all patients. LVR programs seem to be effective in patients with pathologic myopia. Longitudinal studies are necessary to ascertain the long‐term efficacy of LVR.

Towards identifying gaps in employment integration of people living with vision impairment: A scoping review.

The high rate of unemployment among individuals with vision impairment remains a pressing issue, even with the implementation of disability laws and coordinated effort to foster inclusive workplace. Employment integration challenges persist for people with vision impairment due to inaccessible job markets and workplaces. To create new knowledge from previous studies related to employment among people with vision impairment and to understand what has been explored and identify the gaps in employment integration. A comprehensive search of six databases was conducted utilizing both index terms and keywords. The title and abstract of identified studies were screened, followed by a full-text screening using pre-set criteria. Only available peer-reviewed studies with a focus on employment and vision impairment were included, irrespective of location and publication year. Of 2264 studies screened, only 43 studies were eligible for review and data extraction. Using thematic analysis, 8 key themes emerged: social support, disability rights and service systems, transition strategies and challenges, career, employment integration, employment environment, adaptive potential, and employment sustainability. These studies considered the perspectives of people living with vision impairment, rehabilitation practice, and employers. Identified gaps include transition strategies, workplace participation, the perception of colleagues, and work evolution. The primary focus of studies was on the individual factors that impact workplace integration; work environment impact was not explored in depth. The need to examine the readiness of the work environment is also importance because environmental factors can be modified according to the functional needs of people with vision impairment.

REFRAMING AGING AND VISION LOSS AS A PUBLIC HEALTH IMPERATIVE

Abstract Severe vision impairment and blindness often have profound effects upon older people and those who care for and about them. Recent translational research reveals in the United States, 7.3% of older people report severe vision impairment or blindness. A recent study estimated that the population of people with vision impairment will increase by 118% by 2050. The greatest increases will be among the most senior, women, African Americans, and Hispanics. People with vision impairment report greater prevalence of chronic conditions, poorer health, and poorer quality of life than older people without vision impairment, and they are much more likely to experience multiple disabilities. These factors point to grave disparities in health equity. While the multiple studies have informed social, health, and economic disparities among older people with vision impairment at the national level, virtually nothing is known about the variability of the prevalence of vision impairment, chronic conditions, health-related quality of life, and disability at the state level. The geographic distribution of vision impairment varies among and within states. Often rural and poorer areas have a higher prevalence of vision impairment — areas that generally have a paucity of eye care providers, social support systems, and vision rehabilitation services. As aging issues are addressed at state and federal levels, vision loss and vision rehabilitation are frequently omitted from the conversations and plans (e.g., Master Plans on Aging and/or Age-Friendly Plans) and from policy instruments such as the Older Americans Act, which has no mention of vision or vision loss.

GROUP RESIDENTIAL TRAINING OF BLIND OLDER ADULTS OFFERED BY VISUALLY IMPAIRED AND SIGHTED PROFESSIONAL TRAINERS

Abstract VISIONS/Services for the Blind and Visually Impaired piloted a 6-day residential group training for 6 legally blind older adults ages 57-80, self identified as Caucasian or African-American. Assessments occurred in five core areas: personal, home, financial and meal management and communication skills. Mobility and family care skills were also assessed. One legally blind and one sighted professional instructor offered the training along with adaptive equipment and training on how to use it. Each participant received follow up visits in their home to measure how well they retained the skills taught and how well they were safely using them. Referrals were made to VISIONS occupational therapists to address other chronic health conditions, social workers for adjustment to blindness counseling or low vision optometrists for additional follow up. Offering intensive residential group training with peers resulted in documented improvement in ADL/IADL skills and increased social connections. Group training, even when participants had varied skill levels, education, age of onset of vision loss, and eye diseases, proved successful. One participant framed his completion certificate and hung it in his living room. The value of learning new skills with a peer group was confirmed as well as the willingness for older adults with legal blindness to attend a 6-day residential program. Providing group training helps to address the long waitlist for services with a national personnel shortage of nationally certified vision rehabilitation therapists to serve the growing older blind. population. Group training also effectively utilizes the limited government funding for training older blind adults.

Enhancing visual perceptual learning using transcranial electrical stimulation: Transcranial alternating current stimulation outperforms both transcranial direct current and random noise stimulation.

Diverse strategies can be employed to enhance visual skills, including visual perceptual learning (VPL) and transcranial electrical stimulation (tES). Combining VPL and tES is a popular method that holds promise for producing significant improvements in visual acuity within a short time frame. However, there is still a lack of comprehensive evaluation regarding the effects of combining different types of tES and VPL on enhancing visual function, especially with a larger sample size. In the present study, we recruited four groups of subjects (26 subjects each) to learn an orientation discrimination task with five daily training sessions. During training, the occipital region of each subject was stimulated by one type of tES-anodal transcranial direct current stimulation (tDCS), alternating current stimulation (tACS) at 10Hz, high-frequency random noise stimulation (tRNS), and sham tACS-while the subject performed the training task. We found that, compared with the sham stimulation, both the high-frequency tRNS and the 10-Hz tACS facilitated VPL efficiently in terms of learning rate and performance improvement, but there was little modulatory effect in the anodal tDCS condition. Remarkably, the 10-Hz tACS condition exhibited superior modulatory effects compared with the tRNS condition, demonstrating the strongest modulation among the most commonly used tES types for further enhancing vision when combined with VPL. Our results suggest that alpha oscillations play a vital role in VPL. Our study provides a practical guide for vision rehabilitation.

A Europe‐wide randomised controlled trial of hearing and vision rehabilitation in dementia: Additional findings from the SENSE‐Cog trial

AbstractBackgroundHearing and vision impairments are highly prevalent in people with dementia (PwD) and may have a negative impact on quality of life and other dementia‐related outcomes. Intervening to optimise sensory impairment and support sensory function may be a means of improving dementia‐related outcomes. The SENSE‐cog Trial evaluated whether a home‐based multi‐part ‘sensory support’ intervention (SSI) is effective in improving quality of life and other key outcomes in PwD (including hearing and/or vision problems), and their partners.MethodThis was a pan‐European, multi‐centre, observer blind, randomised controlled trial (RCT), of PwD with hearing and/or vision impairment and their partners. We evaluated a multi‐part complex intervention of hearing and vision rehabilitation tailored to each participant dyad, compared to care as usual (CAU). The intervention included at a minimum: assessment and correction of hearing and/or vision impairments; home‐based, therapist‐delivered sensory support (i.e., adherence with devices; improving the sensory environment (i.e., lighting), communication training, and signposting to other support agencies.ResultAcross 7 centres in the UK, Ireland, Greece, France and Cyprus, 291 participants with dementia were randomised from May 2018 to May 2021 to receive either ‘care as usual’, or a multi‐component sensory intervention (10 visits over 18 weeks). Mitigating strategies to adapt study procedure to the COVID‐19 pandemic were implemented. Significant difference in Quality of Life at 36 weeks was not seen; however, significant differences at 18 weeks were seen, with average DEMQoL scores being lower (poorer QoL) in the CAU group by between 2.6 and 2.7 units/ points at this time point, adjusted for covariates. The focus of this presentation will be on secondary outcomes including activities of daily living and functional ability (dementia‐ or sensory‐related) across the two groups. No serious adverse effects were related to the intervention; low grade adverse effects related to the intervention were reported by five participants only.ConclusionHearing and vision support and rehabilitation in PwD living at home is a potentially important means of improving the lived experience of dementia and may represent a critical step in the diagnostic and post‐diagnostic care pathway. However, effects may not be sustained over the longer term.

Automated Eye Tracking Enables Saccade Performance Evaluation of Patients with Concussion History.

Automated eye tracking could be used to evaluate saccade performance of patients with concussion history, providing quantitative insights about the degree of oculomotor impairment and potential vision rehabilitation strategies for this patient population. To evaluate the saccade performance of patients with concussion history based on automated eye-tracking test results. We conducted a retrospective study of patients with concussion history, primarily from sports participation, who underwent oculomotor testing based on an eye-tracking technology at the Duke Eye Center vision rehabilitation clinic between June 30, 2017, and January 10, 2022. Patients' saccade test results were reviewed, including saccade fixation and saccade speed/accuracy ratio. The outcomes were compared with age-matched normative population data derived from healthy individuals. Multiple linear regression analyses were performed to identify factors associated with saccade performance among patients with concussion history. On hundred fifteen patients with concussion history were included in the study. Patients with concussion, on average, had fewer fixations on self-paced horizontal and vertical saccade tests and lower horizontal and vertical saccade speed/accuracy ratios compared with normative ranges. Among patients with concussion history, multiple linear regression analyses showed that older age was associated with fewer fixations on horizontal and vertical saccade tests, whereas male sex was associated with more fixations on horizontal and vertical saccade tests (all P < .01). In addition, older age was associated with lower horizontal saccade speed/accuracy ratio, after adjusting for sex, number of concussion(s), and time from most recent concussion to oculomotor testing ( P < .001). Patients with concussion history had lower saccade performance based on eye tracking compared with healthy individuals. We additionally identified risk factors for lower saccade performance among patients with concussion history. These findings support the use of saccade test results as biomarkers for concussion and have implications for post-concussion rehabilitation strategies.

Leber Optic Neuropathy and Low Vision Rehabilitation: A Case Report

Leber’s Hereditary Optic Neuropathy (LHON) is a maternally inherited mitochondrial disease, characterized by point mutations in mitochondrial DNA and subsequent mitochondrial dysfunction; which leads to a bilateral and painless loss of central vision. Unfortunately at this time, there is no proven treatment to prevent or reverse this optic neuropathy. Therefore, individualized low vision rehabilitation services and assistive devices are essential to help people with LHON regain their independence and quality of life. We highlight through a case study the importance of psychic support as well as the impact of low vision rehabilitation on a young man with LHON.

Prevalence of dry eye disease in the low vision population at the University of Colorado

PurposeTo evaluate the prevalence of diagnosed dry eye syndrome, meibomian gland dysfunction, and blepharitis amongst the low vision population. MethodsA retrospective analysis was conducted on patients seen in the University of Colorado Low Vision Rehabilitation Service between the dates of 12/1/2017 and 12/1/2022. 74 ICD-10 codes were used to identify patients as having dry eye syndrome or not having dry eye syndrome. Data was further analyzed to determine the prevalence of blepharitis and meibomian gland dysfunction using 29 blepharitis and 9 meibomian gland dysfunction ICD-10 codes. Data were also analyzed to determine the age and sex of the patients with diagnosed dry eye syndrome. ResultsThe percentage of patients with a diagnosis of dry eye syndrome by an eyecare provider was 38.02 %. The prevalence of dry eye syndrome by age group was 3.57 % for 0–19 years, 14.35 % for 20–39 years, 29.07 % for 40–59 years, 43.79 % for 60–79 years, and 46.21 % for 80 and above. The prevalence of meibomian gland dysfunction and blepharitis was 11.90 % and 9.1 % respectively. Dry eye syndrome prevalence amongst males was 31.59 % and 42.47 % for females. ConclusionThis study demonstrates that dry eye syndrome in the low vision population is a significant co-morbidity occurring in over a third of patients in the University of Colorado Low Vision Rehabilitation Service. These findings are meaningful as ocular comfort should not be overlooked while managing complex visual needs.

80 Looking Beyond Visual Functioning in the Rehabilitation of Visual Complaints in People with Multiple Sclerosis: Integrating Low Vision and Neuropsychological Rehabilitation

Objective:The objective of the present study is to expand our understanding of visual complaints in people with multiple sclerosis (MS) with the aim of exploring potential rehabilitation approaches for treating visual complaints. Visual complaints are increasingly recognized as a core manifestation of MS. Up to 90% of people with MS report all kinds of visual complaints, such as blurry vision, double vision, being blinded by bright light, a reduced visual field and having trouble with depth perception. Since intact vision is quintessential to many activities of daily life, such as reading or car driving, these complaints affect independent participation to a great extent. The complaints cannot be fully explained by optical neuritis (a common symptom of MS) or other treatable visual or ophthalmological disorders. Moreover, there are no rehabilitation programs available for visual complaints in people with MS. However, the complaints are not yet understood well enough to develop effective rehabilitation strategies to reduce the impact of the visual complaints.Participants and Methods:Visual complaints were assessed using the Screening Visual Complaints questionnaire. 68 people with MS with visual complaints, and 37 with hardly any visual complaints received a standard visual function assessment and a neuropsychological assessment. Correlations between the visual complaints, visual functions and cognitive functions were calculated. In addition, correlations were calculated between several visual functions and a composite score of the neuropsychological assessment.Results:Only some specific visual measures related to visual complaints, with small to moderate effect sizes. While most specific cognitive functions did not show correlations, measures indicative of overall cognitive capacity in people with MS (such as motor speed) consistently correlated with different kinds of visual complaints. Additionally, visual functions that related to visual complaints also correlated with the composite score for cognitive functioning.Conclusions:Our study serendipitously showed that in developing or composing effective rehabilitation strategies for visual complaints, we should look beyond a person’s visual functioning: first, the overall cognitive capacity should be taken into account. Second, visual functioning and cognitive functioning are closely related. These results indicate that visual complaints may be a result of a general decline of the visual and/or cognitive system as one. When treating these complaints, low vision rehabilitation and neuropsychological rehabilitation strategies may be combined. Strategies should not focus on specific visual or cognitive functions, but at making the visual world more easily accessible, or more easily visible, to reduce the impact on the visual system and cognitive capacity. Strategies could range from applying more contrast in the environment to psycho-education. Future research should focus on developing rehabilitation programs and assessing their effectiveness in people with MS or with other types of non-acquired brain injuries.

Clinical Report: Clinician Feedback on the Magnetic Levator Prosthesis.

Stakeholder engagement has been identified by national health organizations as a crucial step to successful translation of new healthcare treatments. In this clinical report, clinician-stakeholder feedback is presented for the Magnetic Levator Prosthesis (MLP), a promising non-invasive spectacle device which restores eyelid motility with magnetic force. To evaluate MLP clinical need and translational barriers. Ten vision rehabilitation optometrists who attended an educational presentation on the MLP and participated in a hands-on workshop in the fitting of a patient were invited to complete an anonymous online survey. Ten multiple-choice items gathered data on estimated patient need, current approaches, main barriers for MLP, temporary versus chronic use, cost barriers, and need for insurance coverage. Open fields allowed for additional comments. Nine of 10 specialists completed the survey. Of those, 7 answered that they could potentially see at least 1-5 patients for ptosis management within a year. The most common ptosis management options reported were the ptosis crutch, taping the eyelid open, and Oxymetazoline drops, all with 6 responses each. Seven clinicians indicated that cost was a main concern. If cost-to-patient was not a barrier, all indicated they would be at least somewhat likely to try the MLP for: 1) temporary management of ptosis, 2) as a pre-surgical trial, and 3) for long term management of ptosis, with more selecting extremely likely and very likely than somewhat likely. Main comments were expressing enthusiasm for the technology and that it would be more appealing for patients if covered by insurance. This clinical report suggests the main barriers to clinical success of the MLP may be cost and insurance coverage, appearance of the device, and self-application. Possible solutions are cost-benefit analysis research, engineering efforts to reduce spectacle magnet size and improve the ease of eyelid magnet application.

Exploring the dynamics of architecture with the concept of affordance

ABSTRACT From an architectural perspective, the purpose of this paper is to explore the dynamic relations between individuals and the environments using the concept of affordance. In three different cases of architectural research, the concept of affordance is used as an analytical tool – yet demonstrating different scopes and outcomes. A post-occupancy evaluation of an office space in transformation; a lighting assessment and intervention in low vision rehabilitation situated in private home environments; and an urban event at an architecture festival involving the intervention of a sound- and scentscape. The three cases show that the concept of affordance can embrace and operationalize the human perception of the environment, pointing at descriptive, prescriptive, and exploratory possibilities in relation to architectural design and research. The concept of affordance enables rich descriptions and explorations of qualities of architecture, related to multisensorial, emotional, and social interactional aspects of humans and their environments.

Advanced Visualization Engineering for Vision Disorders: A Clinically Focused Guide to Current Technology and Future Applications.

Head-mounted visualization technology, often in the form of virtual, augmented, and mixed reality (VAMR), has revolutionized how visual disorders may be approached clinically. In this manuscript, we review the available literature on VAMR for visual disorders and provide a clinically oriented guide to how VAMR technology has been deployed for visual impairments. The chief areas of clinical investigation with VAMR are divided include (1) vision assessment, (2) vision simulation, and (3) vision rehabilitation. We discuss in-depth the current literature of these areas in VAMR and upcoming/future applications to combat the detrimental impact of visual impairment worldwide.

The Effect of Visual Impairment and Its Severity on Vision-Related and Health-Related Quality of Life in Jordan: A Comparative Cross-Sectional Study.

To assess the effect of visual impairment (VI), its severity, and ocular diseases on vision-related and health-related quality of life (QoL) in Jordan. A comparative, cross-sectional, hospital-based study was conducted among a group of 278 patients with VI aged ≥ 18 years, and age and sex-matched control group of 278 individuals with no VI. An interviewer administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) to all participants. All the mean VFQ-25 subscales scores, physical component scale (PCS) and the mental component scale (MCS) of the SF-12 were significantly lower in patients with VI compared to controls with no VI. The VFQ-25 subscales (except general health and ocular pain), PCS, and MCS scores significantly decreased with more severity of VI. In the adjusted multivariate analysis, lower level of education (p=0.013), male sex (p=0.016), and the presence of cerebrovascular disease (p=0.019) were significantly associated with lower VFQ-25 composite scores in visually impaired patients compared to controls. Ocular disease duration of >5 years and progressive VI were significantly associated with lower VFQ-25 composite scores (p= 0.026 and p<0.001) respectively, in patients with VI. Glaucoma had a significantly larger reduction in mean scores of all the VFQ-25 subscales, and the PCS of the SF-12 compared to all other ocular diseases. Both VI and increasing severity of impairment were associated with reduced vision-related and health-related quality of life in adult Jordanians. Glaucoma patients and less educated people were particularly affected. Routine assessment of QoL in visually impaired patients and improving referral protocols to vision rehabilitation services is recommended to improve the QoL in those patients.

Causes of Visual Impairment and Types of Low Vision Aids Prescribed in Low Vision Clinic, Sibu Hospital, Sarawak

This study was to determine the causes of visual impairment and to identify the low vision prescribing pattern among Low Vision Clinic (LVC) patients in the Sibu Hospital. This study was conducted retrospectively among 41 patients attending the LVC, Sibu Hospital. Patients’ demographic characteristics, causes of low vision and blindness, and types of low vision devices prescribed were recorded and analysed for 21 (52.5%) males and 19 (47.5%) females. The mean age was 39.38 ± 17.98 years. The main causes of visual impairment were retinal dystrophies in 12 cases (30.0%) followed by neurological causes in 9 cases (22.5%), glaucoma in 8 cases (20.0%), and acquired macular disorders in 4 cases (10.0%). A total of 27 low vision devices were dispensed, 85.2% (n = 23) were near devices and 14.8% (n = 4) were distance devices. The most frequently prescribed low vision devices (LVD) were video magnifiers (37.0%), followed by hand magnifiers (22.2%), spectacle magnifiers (14.8%), telescopes (14.8%) and stand magnifiers (11.1%). The main leading causes of visual impairment in LVC Sibu Hospital were retinal dystrophies. Video magnifiers were the most common type of low-vision device prescribed. A prompt comprehensive screening is urged for family members with retinal dystrophies to detect the diseases early and hence timely exposure to low vision care and rehabilitation. Familial counselling on inherited retinal diseases and better screening by primary eye care providers are required. Low vision services should be an integral part of the eye care systems in Malaysia.

Improving access to vision rehabilitation care: implementation of the South East Ontario Vision Rehabilitation Service

ObjectifExaminer l'effet de la création du service de réadaptation visuelle du sud-est de l'Ontario (SOVRS, pour South East Ontario Vision Rehabilitation Service), dont l'administration est centralisée, mais dont les services sont offerts à l’échelle régionale, sur l'accès aux soins de réadaptation visuelle. NatureÉtude d'observation pré- (n = 1196) et post-implantation (n = 414). ParticipantsPatients adressés à la clinique de réadaptation visuelle en milieu hospitalier du Centre des sciences de la santé de Kingston et à l'une des cliniques communautaires de réadaptation en déficience visuelle du sud-est de l'Ontario aux fins d'une évaluation en basse vision entre 2014 et 2019. MéthodesOn a comparé les indicateurs de l'accès aux soins (p. ex., le degré de ruralité du patient, la diversité des sources de références, la distance à parcourir, la durée du déplacement et le temps d'attente) avant et après l'implantation du SOVRS. RésultatsAprès la mise en route du SOVRS, on a noté une hausse significative (p < 0,001) du nombre de patients issus des zones rurales qui ont été examinés dans la collectivité. De même, la clinique de réadaptation visuelle en milieu hospitalier a enregistré une augmentation significative des patients qui lui ont été adressés de l'extérieur de Kingston (p < 0,001) et de la part de médecins autres que des spécialistes des soins oculaires (p < 0,001), ce qui se traduit, pour le patient, par une réduction significative de la distance à parcourir et de la durée du déplacement (p < 0,001) de même que par une baisse de 6 % du temps d'attente médian avant d'obtenir une évaluation en basse vision et une diminution significative du temps d'attente entre le moment où le patient a été adressé à la clinique et le premier rendez-vous disponible (p = 0,011). ConclusionLe SOVRS, modèle innovateur de prestation des soins en réadaptation visuelle, a effectivement amélioré la prestation de ce type de soins ainsi que l'accès à ces soins dans le sud-est de l'Ontario grâce à l'intégration des ressources et des services régionaux.

Near prescribing trends in two low vision rehabilitation clinics over a ten-year period

ABSTRACT Clinical relevance Optical magnification (OM), electronic magnification (EM), and assistive technology (AT) can be prescribed in low vision rehabilitation (LVR) clinics for near vision goals of patients. This study shows the prescription of OM has not decreased with increased availability of EM and AT. Background Near visual goals are a primary concern for patients with visual impairment. LVR providers can prescribe OM, EM and/or AT to help. With the rapid evolution and availability of EM and AT, we aim to evaluate if there have been changes in the prescription patterns of clinicians with respect to OM over time. We hypothesise that the increased availability of technology may result in declining prescriptions of OM and increasing prescription of EM and AT over time. Methods This retrospective study investigated near prescribing between 2008–2017 for 530 new patients to the LVR clinics. Examinations were performed by optometrists specialising in low vision. Near devices prescribed included OM and EM and AT. Results Most patients attending the LVR clinics were female, over 60 years old and had age related macular degeneration. Near visual goals were a primary concern of 97.2% of the patients. OM was most prescribed in the 0–19 and >60-year-old age groups. Within the 20–39-year-old age group there was the greatest number of both EM and AT prescriptions. OM was most prescribed in patients with visual acuity better than 6/60. EM and AT showed a trend of increasing prescription as visual acuity decreased. EM prescription peaked in <6/60 to 6/240 category while AT trended upwards from <6/21 to no light perception and peaked in patients with no light perception. Referral rates for additional rehabilitation services were 75.7%. Conclusions This study shows that the prescription of OM is not declining even as the prescription and the breadth of electronic magnification and assistive technology available is expanding. OM continues to be a viable option for patients, especially in the youngest and oldest cohorts.

Use of electronic devices by people attending vision rehabilitation services in Italy: A study based on the device and aids registry (D.A.Re).

To investigate the characteristics of electronic device users, specifically smartphones and tablets, in the Device & Aids Register (D.A.Re), from several low-vision rehabilitation services in Italy. We collected general and clinical information about ocular and systemic diseases, visual function, reading speed and Instrumental Activities of Daily Living (IADL) questionnaire score. Technological details of each optical and electronic device, (including screen size, touch-screen and OCR functions, text-to-speech function) were also collected. 1218 patients (752 females and 466 males) were included in our analysis, mean age 71.5 (±18.8) years. Users of electronic aids (n.237) were slightly younger (67 vs 72 years, p < 0.001) than non-users (n.981), had a worse reading speed (38 vs 65 words/minute), critical print size (43 vs 28 print size, p < 0.001), poorer visual acuity (VA)(1.0 logMAR or less: 30% non-users vs 73% users, p < 0.001) and more commonly visual field restriction within 10° (23% vs 14%, p = 0.001). A similar proportion of users and non-users were retired (about 70%) and about 16-17% were employed. The use of portable electronic devices (5″or less, p < 0.001; 6″ to 18″ screen size, p = 0.017) was associated with better IADL scores, and the use of stand devices with worse IADL score (p < 0.001); Furthermore, using smartphones and tablets (193 subjects) was strongly associated with better IADL scores. We found that using electronic devices, and especially smartphone and tablets, were associated with better vision-related quality of life in low-vision people attending rehabilitation services. While this association does not mean causality, these findings seemed robust to confounder adjustment.