Guidelines in establishing telerehabilitation services for people with vision impairment.

Telerehabilitation is a viable option to provide continuum of rehabilitation intervention in situations like the ongoing pandemic. Presently, there is no policy guidelines to the minimum standard of telerehabilitation. This paper describes procedures for telerehabilitation for people with blindness and low vision from the evidence-based practices from a premier eye institute in South India. The suggested guidelines can help develop and replicate similar models of telerehabilitation to reach people in need in difficult situations like COVID 19 pandemic.

Tele-rehabilitation for persons with vision impairment during COVID-19: Experiences and lessons learned.

Purpose: The COVID-19 pandemic imposed challenges to access rehabilitation intervention to individuals with visual impairment, thereby increasing their disability effects. This study explored the viability maintaining the continuum of care through telerehabilitation. Methods: This study is a retrospective analysis of individuals with vision impairment who underwent telerehabilitation at the center of excellence in eye care at Hyderabad, Telangana, India, between April and September 2020. The International Classification of Functioning, Disability and Health framework was followed to provide services such as counseling for mental well-being, information and resources, educational interventions, Assistive Technology programs, therapeutic interventions for children with multiple disabilities, access to digital audio books and rehabilitation helpline.A team of professionals involved in the service care. Phone and what's app calls were used to facilitate the training.The duration and the number of training sessions were individual need-based with an average of 45 minutes per session and 175 training sessions. Results: Three hundred and fifty individuals and their families benefited. The service include early intervention (n = 129), and low vision care (n = 176) inclusive of computer training (n = 53), soft skills (n = 53), digital books (n = 55).Nearly two-thirds of the participants were male (n = 205). Conclusion: Evidence from this study suggests telerehabilitation as a successful model of care.A well-planned telerehabilitation approach can expand the scope of reaching the visually impaired from geographically isolated areas where scarcity of service providers and service centers.

User feedback on usefulness and accessibility features of mobile applications by people with visual impairment.

Purpose: This study aimed at compiling a catalog of mobile applications with accessibility features. The results are expected to provide useful insight into its usage in daily life. Methods: This study was conducted at the Institute for Vision Rehabilitation, Hyderabad in two steps. In step one 57 potentials mobile applications that were useful for persons with visual impairment were identified. In step two, these were explored by 15 participants and their feedback was analyzed through SPSS statistical package. Results: Fifteen mobile users who are visually impaired took part in the study whose mean age was 22 years. A total of 57 mobile applications were explored and rated as per the user's feedback on its usage and accessibility features. Overall rating of general applications ranged from 2.3 to 4.55 and the rating of exclusive applications designed for visually impaired ranged from 2.8 to 4.8. Compilation of catalog of mobile assistive software and its usage through the data generated from this study provides important information to the early mobile users with visual impairment. The built-in accessibility features of the apps that were originally developed for the general population is the constructive move by the app developers towards inclusion. The same should be reinforced that henceforth all-new applications to be accessible for people with disabilities to the standard prescribed by the Web Content Accessibility Guidelines. Conclusion: Mobile technology is a real boon to persons with visual impairment in enhancing their independence. The catalog on accessible mobile applications developed through this study is a valuable tool in providing information on a wider collection of apps to new mobile users.

Fittle: A Novel Braille Toy.

SIGNIFICANCE: Toys for children with visual impairment and blindness are very limited. We have developed a three-dimensional (3D)-printed Braille puzzle with a potential for educational use. PURPOSE: This article describes the development of a novel Braille toy using 3D printing technology that potentially could be used for teaching Braille for children with blindness and/or profound visual impairment. METHODS: Fittle is a 3D-printed puzzle with embossed Braille letters. Upon correct fitting of the puzzle, one not only can spell the Braille word but also would be able to feel the contour of the representative object that the word denotes. A smartphone application (Sound of Fittle) was developed to be used in conjunction with Fittle. A pilot testing was done on participants with vision impairment. Time taken to solve the puzzle and/or identify the Braille letters was calculated. Three Fittle puzzles were tested. Instructions to solve the puzzle were given only after the first attempt. RESULTS: Seven participants (one adult and six children) were recruited. The mean time taken for the first attempt was longer (4.5 minutes), and upon instructions, the time taken to solve the puzzle was reduced on an average by a factor of 2.5. All the subjects were able to fit and read the embossed Braille in the Fittle. CONCLUSIONS: Fittle is a novel Braille toy made using 3D printing technology. Fittle can potentially be used as an educational toy. The Sound of Fittle application gives the experiential sound for the associated word. The designs for the Fittle and the application are made available as open source on the Internet. Anyone with an access to a 3D printer can print, produce, and use the Fittle for free. With instructions, an individual can quickly learn to solve and play with the puzzle.

A randomized controlled trial assessing the effectiveness of strategies delivering low vision rehabilitation: design and baseline characteristics of study participants.

PURPOSE: To design a randomized controlled trial (RCT) to compare the effectiveness of four different strategies to deliver low vision rehabilitation services. METHODS: The four arms of the RCT comprised-center based rehabilitation, home based rehabilitation, a mix of center based and home based rehabilitation, and center based rehabilitation with home based non interventional supplementary visits by rehabilitation workers. Outcomes were assessed 9 months after baseline and included measuring changes in adaptation to age-related vision loss, quality of life, impact of vision impairment and effectiveness of low vision rehabilitation training. The socio-demographic and vision characteristics of the sample in each of the 4 arms were compared to ensure that outcomes are not associated with differences between the groups. RESULTS: Four hundred and thirty six individuals were enrolled in the study; 393 individuals completed the study. One-fifth of participants were children aged 8 to 16 years. At baseline, socio-demographic and clinical characteristics were similar between individuals in the four arms of the trial. Socio-demographic and clinical characteristics did not differ significantly, except for age, between the 393 individuals who completed the trial and the 43 individuals who dropped out of the study. Twenty six (60.46%) of the forty three drop outs were from the center based arm of the trial. CONCLUSIONS: Information from this trial has the potential to shape policy and practice pertaining to low vision rehabilitation services.