Access to low vision rehabilitation services in Australia: practitioner perspective.

ABSTRACT

CLINICAL RELEVANCE The burden of vision loss is both personal and economic. Having reduced vision can restrict access to education, job opportunities, and other activities, and patients can require substantial government funds for treatment and rehabilitation. An in-depth investigation of barriers and enablers is required to improve access to low vision rehabilitation services. BACKGROUND: Several clinical trials have demonstrated the effectiveness of low vision rehabilitation services, leading to improved clinical and functional abilities. However not all patients make use of these resources. METHODS: A purposive sample of primary eyecare practitioners (optometrists and orthoptists who held a variety of roles in clinical practice, academia and low vision specific organisations) were invited to participate in focus groups that were audio-recorded and transcribed verbatim. The resulting data were de-identified, cleaned, independently coded by two researchers and compared. Data were analysed using an interpretative phenomenological approach that included inductive thematic analysis. RESULTS: Of the 21 practitioners attending the five focus groups, 67% were female and 33% were male. The participants were optometrists and orthoptists with a wide range (4 to 20+ years) of clinical experience in eyecare service delivery. Four major themes emerged from the analysis: three themes focus on identifying barriers, while one theme highlighted potential enablers. These themes encompassed barriers impacting referral frequency, practitioner knowledge, patient experience, and enablers that suggest improvement options for enhancing low vision services. CONCLUSION: Miscommunication between service providers, miscommunication between patients and clinicians, late referral, cost of services and social stigma were major barriers preventing patients from receiving low vision services. Most practitioners admitted limited knowledge of the scope of services provided by low vision organisations, suggesting there is a need for enablers such as professional development, improved communication between service providers, enhanced referral guidelines and increased public awareness.