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.

Ophthalmologic abnormalities among students with cognitive impairment in eastern Taiwan: The special group with undetected visual impairment.

PURPOSE: Students with cognitive impairment are at increased risk of suffering from visual impairment due to refractive errors and ocular disease, which can adversely influence learning and daily activities. The purpose of this study was to evaluate the ocular and visual status among students at the special education school in Hualien. METHODS: All students at the National Hualien Special Education School were evaluated. Full eye examinations were conducted by a skilled ophthalmologist. The students' medical records and disability types were reviewed. RESULTS: A total of 241 students, aged 7-18 years, were examined. Visual acuity could be assessed in 138 students. A total of 169/477 (35.4%) eyes were found to suffer from refractive errors, including 20 eyes with high myopia (≤-6.0 D) and 16 eyes with moderate hypermetropia (+3.0 D to +5.0 D). A total of 84/241 (34.8%) students needed spectacles to correct their vision, thus improving their daily activities and learning process, but only 15/241 (6.2%) students were wearing suitable corrective spectacles. A total of 55/241 students (22.8%) had ocular disorders, which influenced their visual function. The multiple disability group had a statistically significant higher prevalence of ocular disorders (32.9%) than the simple intellectual disability group (19.6%). CONCLUSION: Students with cognitive impairment in eastern Taiwan have a high risk of visual impairment due to refractive errors and ocular disorders. Importantly, many students have unrecognized correctable refractive errors. Regular ophthalmic examination should be administered to address this issue and prevent further disability in this already handicapped group.

Risk Factor Analysis of Early-Onset Cataracts in Taiwan.

PURPOSE: According to previous studies, the prevalence rate of cataracts has increased in recent years. This study aims to investigate and analyze the risk factors of early-onset cataracts in Taiwan. METHODS: A total of 71 subjects aged between 20 and 55 were diagnosed with cataracts in a medical center. Participants were divided into three groups: control, early-onset cataract (EOC), and combined (EOC combined with dry eye) groups. Eye examinations including autorefraction, best-corrected visual acuity (BCVA), subjective refraction, axial length, fundus, slit lamp, and reactive oxygen species (ROS, including total antioxidative capacity, TAC; C-reactive protein, CRP; and glutathione peroxidase, GPx) were performed. In addition, a questionnaire on patient information, history, habits, family history, and Depression Anxiety Stress Scales (DASS) was completed before the examination. RESULTS: 27 non-EOC (control group), 20 EOC, and 24 combined patients participated in the study. Compared with the control group, Body Mass Index (BMI), gender, educational level, hypertension, diabetes, hyperlipidemia, chronic pain, and body-related diseases were significantly different between the three groups. Family history was also significantly different: family heart disease, hypertension, asthma, allergies, stroke, and immune system were also significantly different. In addition, subjects who took hypertensive drugs, antihistamines, and other medications were also significantly different. Statistical analysis indicated that best corrective visual acuity and the spherical equivalent were significantly different between the three groups. Similar results were found in CRP blood analysis. DISCUSSION AND CONCLUSION: According to the results, EOC may result from systemic diseases. The risk corresponded to an increase in ROS blood analysis. Furthermore, eye drops and medicine intake significantly influenced EOC patients. To prevent or defer early-onset cataracts, monitoring physical health, CRP, and GPx analysis may be worth considering in the future.

Relationship between refractive correction, visual symptoms, and optical device selection for low-vision patients in Taiwan.

According to Taiwan optometry act, low-vision services, such as refractive correction and low vision assessment, are now included in Optometric profession. This study was designed to investigate the efficiency of refractive correction and the relationship between refractive correction, eye diseases, visual symptoms, and optical device selection for patients with low vision. METHODS: This study involved a total of 220 participants aged from 7 to 99, with 119 males and 101 females. All of them were referred from three institutes of Taiwan Resource Portal of Assistive Technology under the supervision of the Ministry of Health and Welfare during Feb 2016 to Jan 2018. Accordingly, 42, 76, and 102 of the participants were identified as having mild, moderate, and severe visual impairments, respectively, by five experienced and licensed optometrists for this comprehensive low vision examination. RESULTS: The most common eye diseases in this study were retinal disease, cataract, glaucoma, and optic nerve hypoplasia; some of the participants had multiple eye diseases while participating in the study. Except visual acuity decrease, eye diseases were highly correlated with participants' visual symptoms. Refractive correction is the first step in low-vision examination, therefore, it might be much helpful to some types of eye diseases, visual symptoms, and to the decisions of optical devices for low-vision patients. The results herein suggest that color vision and contrast sensitivity should be taken into consideration when calculating the second optical magnifying power after refractive correction. CONCLUSIONS: Refractive correction is necessary for the treatment of patients' visual symptoms and also for the prescription of low-vision aids.