Low vision aids provision in an urban setting in Germany between 2014 and 2017: a regional population based study with healthcare claims data.

PURPOSE: Little is known about the utilization of low vision services (LVS) in Germany. To understand which persons and how often these services would be utilized, this study aimed to investigate low vision aids (LVAs) provision in an urban setting and to describe user characteristics and trends in their characteristics. METHODS: A retrospective study based on a population-based healthcare claims database in Cologne (N = ~ 500,000), Germany. The study population comprised individuals, who were continuously insured at four large statutory health insurers and who redeemed a prescription for visual aids or aids for blindness between January 2014 and December 2017. We examined their socio-demographic and clinical characteristics. Trends in characteristics were examined with logistic and linear regression models over time. RESULTS: Out of ~ 500,000 persons, 781 unique individuals (~ 0.2%) redeemed an LVA prescription. They were mainly female (68.7%), 60 years or older (75.3%) and had macular degeneration (50.6%) and/or glaucoma (25.9%). In the working-age subgroup, 33.8% were employed. Visual aids were most often prescribed (74.1%) and of all types of LVAs, individuals most commonly redeemed a prescription for magnifiers (35.8%), screen readers (34.3%) and/or canes (17.1%). Of the entire study population, 75.4% received their prescription from an ophthalmologist, 5.3% from a general practitioner and 7.1% from other medical specialists. Significant trends in characteristics of individuals who redeemed an LVA prescription were not found. CONCLUSIONS: Between 2014 and 2017, 781 individuals in Cologne redeemed an LVA prescription. They had characteristics which mostly can be explained by the epidemiology of VI. Results indicate that individuals that redeemed LVAs have a magnification requirement of ≥ 1.5-fold and ≥ 6-fold. Furthermore, next to ophthalmologists, general practitioners and other medical specialists seem to play a role in LVA provision as well, which should be taken into account by policy makers when planning interventions for increasing LVS provision. Our findings provide a starting point to examine LVS provision in Germany.

Low vision aids and age are associated with Müller-Lyer illusion in congenital visually impaired children.

Background: The correlation between visual impairment and Müller-Lyer illusion is not yet elucidated. This study aimed to explore the connection between visual status, age, and the intensity of Müller-Lyer illusion in congenitally visually impaired and visually healthy children aged 4-17 years. Additionally, the developmental trends were compared. Methods: This cross-sectional study included 125 visually impaired children (age: 10.59 ± 4.05 years), among them, 53 had utilized low vision aids (LVAs) and 133 healthy controls (age: 11.33 ± 3.39 years). The participants were presented with Müller-Lyer illusion stimuli via binocular and engaged in a two-alternative forced choice task to quantify the illusion intensity. Pertinent factors including age, gender, residence, binocular distant best-corrected visual acuity and LVAs usage history, were assessed. Results: The visually impaired group exhibited significantly elevated illusion intensity compared to the healthy group (9.74 ± 2.89% vs. 5.42 ± 3.81%, p < 0.001), and visually impaired participants who had used LVAs exhibited significantly lower intensity compared to those had not (9.13 ± 3.00% vs. 10.19 ± 2.74%, p = 0.043). Multivariate generalized estimation equations revealed that visual impairment [odds ratio (OR) = 2.75, p < 0.001] and age (OR = 0.60, p < 0.001) were associated with illusion intensity in all participants, while history of LVAs usage (OR = 0.49, p = 0.045) and age (OR = 0.61, p < 0.001) were negatively correlated in visually impaired group. A significantly negative correlation was found between illusion intensity and age 4-17 years in the subgroups of visually impaired who had used LVAs (Y = -0.54X + 15.06, R2 = 0.56), who had not used (Y = -0.49X + 15.24, R2 = 0.51), and healthy controls (Y = -0.50X + 11.18, R2 = 0.21); all p-values were < 0.001. Conclusion: Children aged 4-17 years afflicted with congenital visual impairment exhibited a heightened intensity of Müller-Lyer illusion compared to visually normal counterparts, LVAs usage experience could reduce this higher intensity. The developmental trajectory of illusion intensity declined consistently with age across all three groups. The abnormal visual experiences during early-life may adversely affect integration in congenitally visually impaired children, and LVAs could facilitate this functional development.

Color perception on Ishihara plates with red lenses in subjects with low vision due to retinal diseases.

Purpose: This study aimed to evaluate color perception (CP) changes on Ishihara plates following red-tinted contact lenses in subjects with low vision (LV) from retinal diseases. Methods: A cross-sectional observational study without control involved 84 subjects, aged 20-70 years, having LV from retinal diseases to examine CP changes following wearing red-tinted contact lenses. The subjects viewed Ishihara plates, with each eye separately, before and after wearing red lenses in two categories: "plates 1-21" and "plates 22-25". Change in CP with the use of a red lens was the primary outcome measure. Results: There was a significant increase in the number of plates read in both categories, that is, plates 1-21 (P = 0.002) and plates 22-25 (P = 0.032), the latter being used to diagnose the red-green defects. Although 70 eyes could read both digits on plates 22-25 and appeared to have normal color vision (CV) at baseline, this number rose to 99 eyes following the use of red-tinted lenses. There was a significant change in the type of CP (red defect/green defect/normal/undefined defect) (P = 0.022) with the application of a red-tinted lens. Conclusions: The use of red-tinted lenses caused a significant increase in the number of plates read, increased the number of subjects who appeared normal on plates 22-25, and significantly changed CP of LV subjects. These lenses can be a valuable aid for LV subjects. Although Ishihara plates can diagnose only red-green defects, further studies on CV testing techniques that detect both red-green and blue-yellow CV defects are recommended.

Compliance With the Use of Low-Vision Aids in a Greek Population: An Explorative Study.

The aim of this study is to investigate the compliance with low-vision aids (LVAs) among patients with low vision (LV) in a Greek population. An explorative study was conducted in a sample of patients with LV attending our outpatient unit at the School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. Patients' demographics and daily visual demands were recorded, and they were administered with the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) at baseline. Participants were trained in the use of a wide range of LVAs before their prescription. Evaluation of the use of the LVAs was conducted at one year after the baseline using a structured phone survey. A total of 100 LV patients were included, with 68% of them being older than 65 years and 50 being males. The main cause of LV (57.0%) was age-related macular degeneration, and the mean VFQ-25 score at baseline was 49.2 (SD= 17.8). Overall, 75 patients had been prescribed LVAs, with 76.0% of these patients preferring an optical aid. The vast majority (98.7%) of these patients stated using the LVA one year after the baseline, and 62.1% of them reported using the aid often to very often. Significantly, 76% of these patients reported that their quality of life was positively affected by the use of the aid, and 97.3% would recommend the use of LVA to another individual with the same problem. Providing appropriate training before the prescription is of high significance to improve the rate of compliance with the use of LVAs. These results can be used to develop appropriate strategies in this field.

Assessing low vision care and the utilisation of optical low vision aids among patients with visual impairment in Taiwan.

PURPOSE: The aim of this study was to examine the quality of assessment and the utilisation of optical low vision aids (OLVAs) among people with visual impairment (VI) in Taiwan. METHODS: The study included 577 participants between 4 and 100 years of age (314 males and 263 females). All participants had been certified by the Ministry of the Interior of Taiwan, indicating that they had undergone a thorough and comprehensive low vision assessment, including evaluation of visual acuity (VA), contrast sensitivity, colour vision, visual fields and glare disability. Furthermore, all participants who consented to refraction had received prescriptions for OLVAs. RESULT: All participants were prescribed one or more OLVAs such as eyeglasses, tinted lenses, magnifiers, closed-circuit television magnifiers, telescopes, or screen magnifiers. Among the 577 individuals, 515 received correction for refractive errors, providing the best-corrected VA (BCVA). The improvement in VA was significant at both distance and near, improving from 1.29 ± 0.55 to 1.01 ± 0.52 logMAR (p < 0.001) and from 1.29 ± 0.56 to 1.01 ± 0.52 logMAR (p < 0.001), respectively. Eyeglasses were the primary OLVAs chosen by 333 participants (64.7%), while 53.3%-80.3% of participants combined eyeglasses with other OLVAs to enhance their visual performance. CONCLUSIONS: The most commonly used and effective OLVA was eyeglasses. Skilfully utilising appropriate refractive and VA measurements is crucial for determining the most suitable and beneficial OLVA for individuals with VI.

Efficacy of low-vision devices in elderly population with age-related macular degeneration.

Purpose: Age-related macular degeneration (AMD) is a common cause of blindness, residual damage to macular area in spite of treatment necessitates visual rehabilitation by means of low-vision aids (LVAs). Methods: Thirty patients suffering from different stages of AMD requiring LVAs were included in this prospective study. Patients with nonprogressive, adequately treated AMD were enrolled over a 12-month period, prescribed requisite LVAs and followed-up for a minimum 1-month period. Before and after provision of LVAs, near work efficiencies were evaluated by calculating reading speed as words per minute (wpm) under both photopic and mesopic light conditions, and impact of poor vision on activities of daily living (ADL) was quantified by modified standard questionnaire based on Nhung X et al. questionnaire. Results: Of the 30 patients mean studied with mean age of 68 ± 10 years, 20 patients (66.7%) had dry AMD in better eye and 10 (33.3%) had wet AMD. Post-LVA, near visual acuity improved significantly and all cases were able to read some letters on near vision chart with an average improvement of 2.4 ± 0.96 lines. The different LVAs prescribed were high plus reading spectacles (up to 10 D) in 23.3%, hand-held magnifiers in 53.3%, base in prisms in 10%, stand held magnifiers in 6.7%, and bar and dome magnifiers in 3.3%. Conclusion: LVAs are effective in visual rehabilitation in patients with AMD. Self-reported reduction in visual dependency and improvement in vision-related quality of life post use of aids corroborated perceived benefit.

Morphological and Functional Aspects and Quality of Life in Patients with Achromatopsia.

(1) Background: Achromatopsia is a rare disease of which the natural course and impact on life are still unknown to this date. We aimed to assess the morphological, functional characteristics, and quality of life in a large sample size of patients with achromatopsia. (2) A total of 94 achromats were included in this retrospective cohort study. Sixty-four were patients of the Department of Ophthalmology, Saarland University Medical Centre in Homburg/Saar, Germany, between 2008 and 2021. Thirty further participants with achromatopsia from the national support group were included using an online questionnaire, which is available under 'Supplementary data'. Statistical analysis was performed using SPSS Version 25; (3) The 94 patients (37 males (39.4%) and 57 females (60.6%)) showed a mean age of 24.23 ± 18.53 years. Visual acuity was stable (SD ± 0.22 logMAR at 1.0 logMAR) over a time of observation from 2008 to 2021. Edge filter glasses were the most used optical aids, while enlarged reading glasses were the most used low vision aids. (4) Conclusions: Our findings give an insight into describing the natural process and the quality of life of achromatopsia. The results demonstrate that achromatopsia is a predominantly stationary disease. The individual prescription of edge filters and low-vision aids is essential following a personalised fitting.

Need of optical aids for schools for blind students in Pune and Nasik districts and compliance of their use.

Purpose: To assess the need for spectacles and low-vision aids (LVA) in students attending schools for the blind and study their compliance with use. Methods: Comprehensive ocular evaluation was performed using a hand-held slit lamp and ophthalmoscope. Vision acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart for distance, as well as for near. Spectacles and LVAs were dispensed after refraction and LVA trial. Follow-up was performed to assess the vision using the LV Prasad Functional Vision Questionnaire (LVP-FVQ) along with compliance with use after 6 months. Results: Of the 456 students examined from six schools, 188 (41.2%) were female; 147 (32.2%) were <10 years of age. In all, 362 (79.4%) were blind since birth. The students dispensed only LVAs were 25 (5.5%), only spectacles were 55 (12.1%), and both spectacle and LVAs were 10 (2.2%). The vision improved using LVAs in 26 (5.7%) and using spectacles in 64 (9.6%). There was a significant improvement in LVP-FVQ scores (P < 0.001). Also, 68/90 students were available for follow-up, of whom 43 (63.2%) were compliant to use. Causes of not wearing spectacles or LVA in 25 were left somewhere or lost 13 (52%), broken 3 (12%), uncomfortable to use 6 (24%), not interested to use 2 (8%), and got operated 1 (4%). Conclusion: Although the dispensing of LVA and spectacles improved the visual acuity and vision function of 90/456 (19.7%) students, nearly a third were not using them after 6 months. Efforts need to be taken to improve the compliance of use.

A Descriptive Analysis of Unique Disability Identification Card (UDID)-Certified Visually Disabled Patients at a Tertiary Eye Care Center in Central India.

Objective In this study, we aimed to examine the demographic characteristics, causes, and severity of visual disability and the reasons for seeking disability certificates among Unique Disability Identification Card (UDID)-certified visually disabled patients at a tertiary eye care center in central India. Materials and methods A retrospective observational analysis of medical records and data from the UDID portal involving 600 visually disabled individuals who were certified between February 2019 to March 2022 was performed. Demographic characteristics, diagnosis of the ocular disease, primary etiology, and percentage and grade of visual disability, as well as the main reasons for seeking a visual disability certificate, were analyzed statistically. Best-corrected visual acuity of less than 6/24 to 3/60 or a visual field less than 40 degrees to 10 degrees around the center of fixation or hemianopia involving the macula in the better eye were included in the low-vision category. Best corrected visual acuity of less than 3/60 to "no light perception" or visual field less than 10 degrees around the center of fixation in the better eye were included in the blindness category. Results Out of the total 600 patients, 214 (35.67%) were in the age group of 11-30 years. There were more males (63.67%) than females (36.33%) in the study. Four hundred patients (66.67%) had 100% disability. Retinal diseases (n=229, 48.50%) including retinitis pigmentosa (RP) (n=130, 21.67%) were the most common cause of visual disability. Travel concessions and Government allowances were the most common reasons for seeking a disability certificate. Conclusion The study highlights the leading causes of visual disability, and RP was found to be the most common one. Avoidance of consanguineous marriages and genetic counseling should be made mandatory to prevent blindness due to RP. We recommend the widespread institution of eye care facilities, increasing the availability of healthcare facilities to all, and community education to eliminate avoidable blindness. This study provides key data to the Government to implement new policies or change the existing ones, plan for future strategies, and prioritize the rehabilitation of visually disabled individuals. Government programs to increase awareness among unregistered visually disabled patients regarding the benefits and rehabilitative measures like UDID card and low vision aids is the need of the hour.

Characteristics of Visual Impairment and the Impact of Low Vision Assessment in a Tertiary Academic Hospital in Jordan.

Purpose: This project aims to describe the characteristics of patients with visual impairment referred from a tertiary academic hospital in Jordan for a comprehensive low vision evaluation and to study its impact on their functional needs. Methods: A retrospective analysis of the records of 108 patients from the ophthalmology clinic at Jordan University Hospital over the period from January 2014 to December 2018 was performed. Gathered information included age, gender, clinical diagnosis, family history of ocular disease, and type of low vision aid prescribed and its impact on patients' functional needs. Results: The mean age was 44.64 years (range 4-88). Most participants were in the 19-60 years age group (50.0%). Fifty percent of the participants were the offspring of consanguineous marriages. The main cause of visual impairment in this cohort was retinitis pigmentosa, followed by diabetic retinopathy. The majority of low vision aids were prescribed for near distance tasks, and reading spectacles were the most prescribed visual aid. Eighty-nine percent of patients reported functional improvement and retained their visual aids upon follow-up. Conclusion: Retinitis pigmentosa was the main cause of visual impairment in this cohort of patients referred from a tertiary academic hospital for low vision assessment. We report a consanguinity rate of 50%. The overwhelming majority of patients reported functional improvement and retained their visual aids upon follow-up. Awareness and integration of low vision services into a multidisciplinary approach and improving referral protocols is essential to better address the needs of patients with visual impairment. Familial counselling regarding consanguineous marriages and emerging research to treat inherited retinal diseases should be pursued.

Current Modalities for Low Vision Rehabilitation.

Visual rehabilitation is an effective method for increasing the quality of life among individuals with low vision or blindness due to untreatable causes. Low vision rehabilitation aims for patients to use their residual vision effectively and efficiently to enable them to live independent and productive lives. Low vision rehabilitation includes assessment of residual visual functions, prescription of rehabilitation aids, and training in the use of devices. A multidisciplinary approach and coordinated effort are necessary to take advantage of new scientific advances and achieve optimal results for the patient. This article aims to review the various aids and methods available for low vision rehabilitation and also discusses technology advances that can enhance the visual functioning of individuals who are visually impaired.

Role of improved distance and near visual acuity with low vision aids to enhance stereopsis in retinal diseases.

Purpose: The purpose of this study was to examine role of improved distance and near best-corrected visual acuity (DBCVA and NBCVA) with use of magnification devices to enhance stereopsis in low vision (LV) subjects having retinal diseases. Methods: In a cross-sectional observational study without control, 84 subjects having LV due to retinal diseases were examined for an improvement of BCVA with use of magnifying low vision aids (LVAs) (2X for DBCVA and 3X for NBCVA). The stereopsis scores on titmus fly test were recorded with near refractive correction "on" and then with 3X magnification. The improvement in stereopsis for distance was however estimated through statistical correlation values. Results: The DBCVA (P < 0.001), NBCVA (P < 0.001) and stereopsis (P < 0.001) improved statistically significantly (SS) following magnifying LVA. There was no correlation between pre-LVA stereopsis and pre-LVA DBCVA (r = 0.059; P = 0.444;NSS) and post-LVA DBCVA (r = 0.054; P = 0.487;NSS); and no correlation between post-LVA stereopsis and pre-LVA DBCVA (r = 0.042; P = 0.592;NSS) and post-LVA DBCVA (r = 0.08; P = 0.920;NSS). There was no correlation between pre-LVA stereopsis and pre-LVA NBCVA (r = 0.044; P = 0.572;NSS) and no correlation between post-LVA stereopsis and pre-LVA NBCVA (r = 0.108; P = 0.165;NSS). But positive correlation between pre-LVA stereopsis and post-LVA NBCVA (r = 0.347; P < 0.001) and between post-LVA stereopsis and post-LVA NBCVA (r = 0.445; P < 0.001) was SS. Conclusion: The use of magnification as LVA improves both the BCVA and stereopsis. The increase in DBCVA with LVA improves the stereopsis for distance though it may not be SS while improvement in NBCVA with LVA enhances stereopsis for near objects in SS manner.

Is the high contrast visual acuity chart a good predictor of improvement in visual acuity with low vision aids?

Purpose: To assess whether the objective improvement seen with HCVA chart using LVAs correlates with subjective improvement in the quality of life as measured on low vision quality of life (LVQOL) questionnaire of such patients. Methods: This was a prospective, consecutive, observational study. Objective improvement in visual function was assessed using LVAs with high contrast LogMAR visual acuity chart for near and distance. Subjective improvement for distance was assessed using LVQOL score for "distance mobility and lighting", whereas for near it was assessed using the LVQOL score for "near and fine work". A total of 46 patients completed one follow-up after low vision trial and were included in the study. Results: Improvement in objective visual acuity was highly significant for both near and distance (P < 0.001) with LVAs. LVQOL score improved from 65.85 to 76.83 after one of using low vision aids (P < 0.001). The improvement in LVQOL score for distance and mobility was also highly significant (2.55; P < 0.001); and so was for near and fine work (5.89; P < 0.001). However, Spearman rank correlation coefficient showed no correlation between improvement in visual acuity for distance and LVQOL score improvement for distance (rs = -.086; P = 0.57). For near also, improvement in acuity did not correlate with the LVQOL score improvement for near and fine work (rs = 0.036; P = 0.81). Conclusion: No statistical correlation was observed between the improvements measured by objective HCVA charts and subjective improved as perceived by the patient after use of low vision devices.

Quality of life in children with low vision following use of low vision aids.

CONTEXT: Vision loss early in life has profound functional and psychological implications. Functional vision, defined as vision that can be used to perform a task(s) requiring vision, can be assessed by a number of tools. Questionnaires are a popular tool. AIMS: This study aimed at assessing the vision-related quality of life (QOL) with the help of LV Prasad-Functional Vision Questionnaire (LVP-FVQ) and also to analyze the outcome of baseline best-corrected visual acuity (BCVA) 3 months after the introduction of low vision aids (LVAs) in children with low vision (LV). SETTINGS AND DESIGN: This was a prospective, longitudinal study. SUBJECTS AND METHODS: Thirty children aged between 8 and 18 years with LV were recruited and prescribed LVAs for distance and/or near based on their needs. The QOL and BCVA for distance and near were assessed before and 3 months after the introduction of LVAs. STATISTICAL ANALYSIS USED: Descriptive and inferential statistical analyses. Student's t-test was used to calculate the P value. RESULTS: There was a significant improvement in the vision-related QOL (P < 0.001) as well as the baseline BCVA (P = 0.002), 3 months after use of LVAs. CONCLUSION: LVAs are effective in improving the vision-related QOL and can also act as vision stimulator.

The efficacy of low vision aids with contact lenses in pediatric population.

PURPOSE: To compare the efficacy of contact lens use with low vision aids (LVA) with the efficacy of spectacle use with low vision aids. METHODS: Thirty-six pediatric patients with low vision were enrolled in this study between January 2015 and March 2017. The patients were examined for best-corrected visual acuity (BCVA) with spectacles, spectacles with LVA, contact lenses and contact lenses with LVA. Toleration of the patients with contact lenses and LVA were recorded at the final follow-up exam. RESULTS: The mean BCVA with spectacles was detected as 1.11 ± 0.25 log MAR and the mean BCVA improved to 0.35 ± 0.13 log MAR with the use of spectacles and LVA, which was statistically significant. The mean BCVA with contact lens, which was 0.99 ± 0.22 log MAR, improved to 0.40 ± 0.21 log MAR with contact lens and LVA, which was also significant. There was a statistically significant improvement in BCVA of the patients with contact lenses only when compared to spectacles only. The mean BCVA significantly improved in patients using LVA with contact lenses when compared to LVA with spectacles. Tolerations of the patients with contact lenses and LVA were found to be well at 29 of 36 (80.55%) at final follow-up (26.11 ± 6.85 months). CONCLUSION: Contact lens use in pediatric patients with low vision especially with LVA offers better visual acuity, a decrease in nystagmus amplitude, wider field of view and comfort.

Visual rehabilitation of patients with corneal diseases.

BACKGROUND: Although most patients with visual impairment due to corneal diseases can be treated successfully with surgery, some require visual rehabilitation to restore reading ability. To evaluate the best LVAs especially in terms of reading speed and characterize this specific patient group we performed a prospective, randomized cross-over trial. METHODS: All 34 patients underwent a detailed examination (slit-lamp, funduscopy, SD-OCT, ETDRS) as screening. Only patients with corneal diseases without other ocular diseases were included. Reading-speed was assessed with International-Reading-Speed-Texts (IReST) consecutively with five different LVAs (low vision aids) during one day in a randomized cross-over design. Corneal haze was quantified with corneal densitometry (Pentacam). RESULTS: Patients were either visually impaired (n = 28), severely impaired (n = 4) or legally blind (n = 2). Patients read significantly faster with LVAs (p < 0.0001). Fastest reading speed could be achieved with video magnifier (CCTV). Optical magnifier and portable-electronic magnifier enabled significantly lower reading speeds (p < 0.01). In a subgroup of patients (VA < 3/60,n = 6) black background enabled patients to read significantly faster compared to white background (p = 0.03). CONCLUSION: Patients with low magnification requirement can be treated successfully with optical LVAs and portable-electronic magnifiers. More severely afflicted patients need a CCTV. Black background enables fastest reading-speeds, probably due to less blinding. Visual impairment can be estimated with corneal densitometry. Our trial confirms the capability of LVAs to successfully restore the reading ability in patients with corneal diseases, which is a crucial part of visual rehabilitation. TRIAL REGISTRATION: This trial was registered at the German Clinical Trials Register as DRKS00010887 at 09.08.2016.

Visual rehabilitation of people with oculocutaneous albinism in a tertiary clinical setting in Pakistan.

PURPOSE: All people with oculocutaneous albinism (OCA) have reduced vision. This study aimed to assess the benefits of low vision aids for people with OCA. METHODS: Seventy-seven consecutive people with OCA age 4 years and above examined in a low vision clinic were included in the study. Uncorrected and best-corrected visual acuity (VA), VA with low vision devices, types of low vision aids, and refractive errors data were analyzed. RESULTS: Of the 77 people with OCA, 57% were in the age group between 4 and 15 years and 43% in the age group of 16 years and above. At the time of presentation, the percentages of visually impaired, severe visually impaired, and blind (using WHO low vision criteria) were 52%, 22%, and 25%. Among them, 39% has near VA of 1 M or better. Difference in the means of the spherical equivalent refractive error in the right eyes and left eyes was -0.494 diopters (-01.686, 0.699; 95% confidence interval). VA improved significantly after adequate refractive correction by more than one log MAR lines in 38.6% (P < 0.01). With low vision devices, in 85.7% (n = 66) participants, VA was enhanced to normal level (6/18 or better) in the better eye while 7.8% still remained in the blind category. Telescopes were prescribed to 61% people for the enhancement of distance VA and hand hold magnifiers were prescribed to 22% people to meet their needs. CONCLUSION: Low vision aids can be successfully used in visual rehabilitation of people with OCA to meet their needs.

Functional outcome of the low vision aids for visual impairment secondary to central nervous system tumors in children.

To assess functional outcomes of optical low vision aids (LVAs) for pediatric visual impairment due to central nervous system (CNS) tumors. A prospective case study was conducted on 15 children with history of CNS tumors with mean age of 10.47±1.85y. Lighthouse distance, near visual acuity tests, cycloplegic refraction, reading speed measurement and visual field examination were done. Prescription of far and near LVAs followed by training sessions. LVPrasad-functional vision questionnaire was done to evaluate performance. Visual impairment was moderate (13.3%), severe (73.3%), profound (6.7%) and near blindness in 6.7%. Telescopes prescribed in 33.4%, video magnifier in 46.7%. Questionnaire scores were significantly improved for distant rather than near tasks (P≤0.05) after training. LVAs rehabilitation is an effective method of improving vision in pediatric visual defects secondary to CNS tumors.

Evaluación oftalmológica en niños derivados a un proyecto de rehabilitación en baja visión de un organismo de apoyo social / Ophthalmological evaluation in children referred to a low-vision rehabilitation project of a social assistance agency

INTRODUCCIÓN: Un niño con baja visión (BV) rehabilitado puede tener una educación integral. Objetivo: Estudiar el perfil de los escolares derivados para evaluación a un Proyecto de Rehabilitación en un organismo de apoyo social. PACIENTES Y MÉTODO: Estudio transversal descriptivo de beneficiarios evaluados entre septiembre 2015 y septiembre 2016 en JUNAEB. Se consideró diagnóstico de derivación, agudeza visual monocular (AV) con corrección óptica para lejos (cartillas Feinbloom) y cerca (cartillas Zeiss). Se clasificaron según AV y perimetría. Se consideró éxito de tratamiento lograr AV > 0,4 para le jos y/o cerca con ayuda óptica. RESULTADOS: Se evaluaron 278 escolares. 153 (55%) fueron hombres, 121(43,5%) entre 10 a 14 años. Catarata congénita bilateral, distrofias retinales, alta miopía, atrofia óptica y nistagmus congénito fueron las patologías más frecuentes. 224 (80,6%) se habilitaron con ayudas. 85 (37,9%) presentaron BV moderada y 63 (28,6%) BV severa. 122 (54,5%) presentaban perimetría normal, 68 (30,4%) campo visual (CV) tubular, 19 (8,5%) defecto sectorial del CV y 15 (6,7%) compromiso central del CV. 198 (88,4%) escolares lograron éxito visual de lejos y todos lograron éxito visual de cerca. 48 (17,2%) escolares no pudieron ser rehabilitados, estando asocia dos a una afección neuroftalmológica (41,7%), alto error refractivo (16,6%) o glaucoma congénito (10,4%). 6 (2,2%) casos mejoraron su AV con nueva corrección óptica. CONCLUSIÓN: El éxito obtenido demuestra la necesidad de habilitar visualmente a escolares con BV. Nuestro desafío es mantener este programa y educar al oftalmólogo prestador para una derivación oportuna.

INTRODUCTION: A low-vision (LV) rehabilitated child can receive comprehensive education. OBJECTIVE: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. PATIENTS AND METHODS and Method: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. RESULTS: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. CONCLUSION: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

A Common Approach to Low Vision: Examination and Rehabilitation of the Patient with Low Vision

Due to the increasing age of the global population, rates of visual disability are increasing. Visual rehabilitation is an effective method for increasing quality of life among individuals with low vision or blindness due to unpreventable or untreatable causes. The goal of low vision rehabilitation is to produce people who are independent, have an economically viable profession or skill, and are able to enjoy their lives. The stages of modern low vision rehabilitation include the intake interview, assessment of residual visual functions, assessment of residual functional vision, interventions and recommendations, and vision rehabilitation therapies.