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Akuffo KO, Osei Duah Junior I, Acquah EA, Abadua Mensah E, Andoh AKA, Kumah DB, Boateng BS, Boateng JA, Osei-Poku K, Eisenbarth W. Low Vision Practice and Service Provision Among Optometrists in Ghana: A Nationwide Survey. Ophthalmic Epidemiol 2024:1-8. [PMID: 38451021 DOI: 10.1080/09286586.2024.2317816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE To characterize practice patterns of low vision services among Optometrists in Ghana. METHODS The nationwide cross-sectional survey identified entities through the Ghana Optometrists Association (GOA) registry and utilized a semi-structured questionnaire to consolidate survey information that comprises practitioners' demographics, available services, diagnostic equipment, barriers to service provision and utilization, and interventions. RESULTS 300 Optometrists were identified, with 213 surveyed (71% response rate). About fifty percent (52.6%) were in private practice, and more than two-thirds (77%) did not provide low vision services. Most (≥70%) reported lack of assistive devices, and basic eye care examination kits as the main barriers to low vision service provision. Similarly, practitioners reported unawareness of the presence of low vision centres (76.1%), and high cost of low vision aids (75.1%) as the prime perceived barriers for patients to utilize low vision services. Continuous professional development and public education (89-90%) were suggested as interventions to improve the uptake of low vision services. After statistical adjustment, private facility type (Adjusted odds ratio [AOR] = 0.35, p = 0.010) and lack of basic eye examination kits (AOR = 0.32, p = 0.002) were significantly associated with reduced odds of low vision service provision. Conversely, ≥15 years of work experience (AOR = 6.37, p = 0.011) was significantly associated with increased odds of low vision service provision. CONCLUSIONS Overall, the results indicate inadequate low vision coverage and service delivery. Government policies must be directed towards equipping practitioners with equipment and subsidize patient cost of treatment to optimize low vision care.
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Affiliation(s)
- Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaiah Osei Duah Junior
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Biological Sciences, Purdue University, West-Lafayette, Indiana, USA
| | - Eldrick Adu Acquah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Elna Abadua Mensah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Kwadjo Amoah Andoh
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Josephine Ampomah Boateng
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Osei-Poku
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Werner Eisenbarth
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Applied Science and Mechatronics, HM Hochschule München University of Applied Sciences, Munich, Germany
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Ramin S, Rostami F, Ahmadieh H, Daftarian N, Nourinia R, Abbasi A, Kheiri B, Sabbaghi H, Sheibani K. Vision-related quality of life in patients with retinal vein occlusion. Int Ophthalmol 2024; 44:114. [PMID: 38409518 DOI: 10.1007/s10792-024-02916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 12/24/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE This study aims to assess the vision-related quality of life in patients with retinal vein occlusion (RVO) among those referred to Labbafinejad Medical Center and Imam Hossein Hospital between 2019 and 2021. METHODS This comparative study included 37 eligible patients diagnosed with various types of RVO, with an average age of 61 ± 9. To ensure data validity, we included 74 age- and sex-matched healthy individuals. Only cases with a definitive diagnosis of RVO, confirmed by two retina specialists (ND and RN), were included. We assessed the vision-related quality of life of our participants using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). All participants underwent interviews. RESULTS In our study, we examined the vision-related quality of life in different subgroups of RVO patients. Overall, RVO patients had a significantly lower total VRQoL score compared to healthy individuals (P < 0.001), except in the subscale analysis of specific factors such as ocular pain, color vision, and driving, where no statistically significant difference was observed. A statistically significant difference was found in the comparison of subgroups, indicating lower VRQoL in central retinal vein occlusion (CRVO) patients (P = 0.010). Furthermore, a significant correlation was observed between lower VRQoL and decreased vision (P = 0.009) as well as longer disease duration (P = 0.011). CONCLUSION Retinal vein occlusion can significantly reduce vision-related quality of life, particularly in more severe cases.
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Affiliation(s)
- Shahrokh Ramin
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- NanoBaran Lab, Incubation Center for Pharmaceutical Technology (ICPT), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rostami
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narsis Daftarian
- Experimental Medicine, Department of Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Ramin Nourinia
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Abbasi
- NanoBaran Lab, Incubation Center for Pharmaceutical Technology (ICPT), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Department of Epidemiology and Biostatistics, School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Hamideh Sabbaghi
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, 23 Paidar Fard, Bostan 9, Pasdaran Ave., Tehran, 16666, Iran.
| | - Kourosh Sheibani
- Basir Eye Health Research Center, Iran University of Medical Sciences, Tehran, Iran
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Nisanova A, Barrios L, Chokshi T, Mannis M, Bloch O, Liu YA. A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours. Neuroophthalmology 2024; 48:3-12. [PMID: 38357627 PMCID: PMC10863346 DOI: 10.1080/01658107.2023.2273471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.
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Affiliation(s)
- Arina Nisanova
- School of Medicine, University of California, Davis, California, USA
| | - Laurel Barrios
- School of Medicine, University of California, Davis, California, USA
| | - Tanvi Chokshi
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Mark Mannis
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, California, USA
| | - Yin Allison Liu
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
- Department of Neurological Surgery, University of California, Davis, California, USA
- Department of Neurology, University of California, Davis, California, USA
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Vinnett A, Tariq Z, Alvarez JA, Andrews L, Okezie N, Levin MR, Kaleem MA. Eye Disease Prevalence and VF-14 Validation Among Patients Experiencing Homelessness and Presenting for Ophthalmic Examination in Baltimore, Maryland. Transl Vis Sci Technol 2023; 12:7. [PMID: 37922150 PMCID: PMC10629521 DOI: 10.1167/tvst.12.11.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/27/2023] [Indexed: 11/05/2023] Open
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic is projected to drive 1.5 million Americans toward homelessness, adding to the 3.5 million currently affected. Homelessness poses both socioeconomic and public health challenges because housing status is a social determinant of health. Given ophthalmic health's importance in daily functioning, we characterized ophthalmic disease and vision-related quality of life (VRQOL) among a population experiencing homelessness in Baltimore, Maryland. Methods Questionnaires, including a Visual Function Index-14 (VF-14) for measuring VRQOL, were administered among patients seeking eye examinations at Health Care for the Homeless (HCH) from October 2018 to March 2020. Results One hundred sixty-two participants were enrolled in this study. The average age was 53 years. Participants' most common vision concerns were blurry vision (70%) and desire for glasses (52%). Best corrected visual acuity (BCVA) measurements revealed significant vision loss (18%, P < 0.001). Physicians mostly diagnosed refractive error (77%), cataracts (36%), glaucoma/glaucoma suspect (25%), and dry eye (24%). Nearly half were referred to additional ophthalmic care (46%). VRQOL trends reflected functional vision categories (P = 0.042 and P = 0.021). The 1:1 VRQOL and BCVA comparison showed correlation (rho = -0.3, P < 0.001). Cronbach's alpha demonstrated VF-14 reliability (alpha = 0.92). Conclusions We find high ophthalmic disease prevalence within a population experiencing homelessness. Comparison to studies worldwide reveals healthcare disparities despite healthcare system differences, suggesting a need for more targeted solutions. VF-14 is valid and reliable in assessing those experiencing homelessness. Intragroup VRQOL comparisons may reveal subgroup needs. It is imperative that future studies continue monitoring those experiencing homelessness. Translational Relevance Validation of VF-14 will allow future studies to utilize this patient-oriented metric within populations experiencing homelessness.
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Affiliation(s)
- Alfred Vinnett
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zeshan Tariq
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - Nneoma Okezie
- Notre Dame of Maryland University, Baltimore, MD, USA
| | - Moran R. Levin
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mona A. Kaleem
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Xue R, Wan G. Association Between Vision-Related Functional Burden and Sleep Disorders in Adults Aged 20 and Over in the United States. Transl Vis Sci Technol 2023; 12:3. [PMID: 37917088 PMCID: PMC10627301 DOI: 10.1167/tvst.12.11.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose The impact of functional vision, rather than visual acuity, on sleep disorders is not well understood. This study estimated the relationship between vision-related functional burden and sleep disorders among a nationally representative sample in the United States. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2008 were analyzed, which included a total of 10,914 US adults 20 years and older. Sleep disorders and vision-related functional burden were measured by the NHANES questionnaire sleep disorders section and vision section, respectively. Logistic regression was used to explore the association between vision-related functional burden and sleep disorders. Results A total of 9384 NHANES participants had complete functional vision and sleep disorders data. The mean age at baseline was 47.8 years, and the weighted prevalence of sleep disorders among adults with vision-related functional burden was 20.3%. After controlling for age, gender, race, smoking status, drinking frequency, general health condition, hypertension, diabetes, coronary heart disease, and depression, vision-related functional burden remained significantly associated with sleep disorders (adjusted odds ratio, 1.502; 95% confidence interval, 1.210-1.864; P < 0.001), whereas the association between presenting visual acuity and sleep disorders was not statistically significant. Conclusions Vision-related functional burden rather than impairment of visual acuity was related to the increased prevalence of sleep disorders in adults 20 years and older in the United States. Translational Relevance Our study provides insight into the relationship between functional vision and sleep disorders. It should be noted that individuals who report vision-related functional burden might be at risk of sleep disorders.
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Affiliation(s)
- Rong Xue
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, Henan, P.R. China
| | - Guangming Wan
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, Henan, P.R. China
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Bhaskaran S, Ravikumar P, Flora J, Vijayalakshmi P. Impact of special software training on quality of life among people with visual impairment. Indian J Ophthalmol 2023; 71:3313-3317. [PMID: 37787227 PMCID: PMC10683703 DOI: 10.4103/ijo.ijo_73_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose To evaluate the impact of special software training in computer and smartphone apps as a form of rehabilitation to improve the quality of life of individuals with visual impairment (VI). Methods The study utilized a one-group pretest-posttest design. A total of 50 individuals aged 15 years and older with VI participated in the training, which included special software (NVDA) and mobile app training for 60 hours at the Visual Rehabilitation Center. The Low Vision Quality of Life Questionnaire was administered before the start of training and six months after completion. The questionnaire covered the following domains: (1) mobility, distance vision, and lighting; (2) reading and fine work; (3) social well-being; (4) economic impact; (5) attitude toward life; and (6) activities of daily living. Statistical software STATA 14.0 (Texas, USA) was used for data analysis. Paired t-tests and Wilcoxon signed-rank tests were conducted to compare the mean differences before and after training. Results Significant improvements were observed in five dimensions, namely mobility, distance vision and lighting, reading and fine work, and attitude toward life, at a highly significant level of 1% probability. The dimensions of social well-being and economic impact showed significant improvement at a 5% level of probability. Conclusion Visual impairment, whether congenital or acquired later in life, affects independence in all aspects of life. To the best of our knowledge, this is the first study to investigate the impact of special software training on the quality of life of visually impaired individuals. The authors suggest that this form of rehabilitation enhances accessibility to mainstream living, promotes independence, and ultimately improves quality of life. Participants experienced an improved quality of life through increased access to mainstream resources, enhanced ability to navigate and manage daily activities independently, and reduced reliance on multiple low vision aids or assistance from sighted individuals.
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Affiliation(s)
- Sahithya Bhaskaran
- Department of Paediatric Ophthalmology, Strabismus and Vision Rehabilitation Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Pavitra Ravikumar
- Department of Paediatric Ophthalmology, Strabismus and Vision Rehabilitation Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Jeyaseeli Flora
- Department of Paediatric Ophthalmology, Strabismus and Vision Rehabilitation Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - P Vijayalakshmi
- Department of Paediatric Ophthalmology, Strabismus and Vision Rehabilitation Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Matchinski TL, Crumbliss KE, Corgiat E, Pang Y. Near prescribing trends in two low vision rehabilitation clinics over a ten-year period. Clin Exp Optom 2023:1-8. [PMID: 37726145 DOI: 10.1080/08164622.2023.2246490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/06/2023] [Indexed: 09/21/2023] Open
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.
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Affiliation(s)
- Tracy L Matchinski
- Rosenbloom Center on Vision and Aging, Illinois College of Optometry, Chicago, IL, USA
| | - Kara E Crumbliss
- Forsythe Center for Comprehensive Vision Care, Chicago Lighthouse for People that are Blind or Visually Impaired, Chicago, IL, USA
| | - Elise Corgiat
- Forsythe Center for Comprehensive Vision Care, Chicago Lighthouse for People that are Blind or Visually Impaired, Chicago, IL, USA
| | - Yi Pang
- Rosenbloom Center on Vision and Aging, Illinois College of Optometry, Chicago, IL, USA
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Zhang Z, Griva K, Rojas-Carabali W, Patnaik G, Liu R, Sobrin L, Kempen JH, Finger RP, Gupta V, Ang B, Agrawal R. Psychosocial Well-Being and Quality of Life in Uveitis: A Review. Ocul Immunol Inflamm 2023:1-15. [PMID: 37713271 DOI: 10.1080/09273948.2023.2247077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE As a potentially sight-threatening disease with ocular, systemic, and treatment-related complications, uveitis diminishes quality of life (QOL) and affects psychosocial well-being. This review summarizes the existing tools for evaluating psychosocial well-being and/or QOL in patients with uveitis, explores the biological and non-biological factors affecting psychosocial well-being and/or QOL, and proposes future directions for incorporating these tools into clinical practice. METHODS A systematic search of the MEDLINE, Embase, and Cochrane databases from inception to June 8, 2022 was conducted, screening for articles focused on psychosocial well-being and/or QOL in patients with uveitis. Both quantitative and qualitative analyses were performed. RESULTS In uveitis research, the most frequently studied patient-reported outcome measures were vision-related QOL (e.g. Visual Function Questionnaire [VFQ-25]) and health-related QOL (e.g. Short Form Survey [SF-36]), followed by mental health indicators including depression and anxiety. Instruments have also been developed specific to the pediatric population (e.g. Effects of Youngsters' Eyesight on Quality of Life [EYE-Q]). Generally, studies report worse psychosocial outcomes and QOL in patients with uveitis compared to the general population. Contributory factors include both clinical (e.g. visual impairment, ocular comorbidities) and patient-related (e.g. older age, female sex) factors. CONCLUSION Given the heterogeneity of instruments used, it is worth considering standardization across large uveitis studies and trials. Beyond research, given the biopsychosocial effects on patients with uveitis, there are benefits to incorporating QOL and psychosocial assessments into clinical practice. Simplification of questionnaires into abridged forms, focusing on the most clinically relevant aspects of patient care, may be considered.
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Affiliation(s)
- Zheting Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - William Rojas-Carabali
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gazal Patnaik
- Sankara Netralaya, Medical Research Foundation, Chennai, India
| | - Renee Liu
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - John H Kempen
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
- MyungSung Christian Medical Center (MCM) Eye Unit, MCM Comprehensive Specialized Hospital and MyungSung Medical School, Addis Ababa, Ethiopia
| | - Robert P Finger
- Department of Ophthalmology, St. Franziskus Hospital Münster, Münster, Germany
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bryan Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Oikonomidis K, Almpanidou S, Talimtzi P, Kakavouti-Doudou A, Metaxas SM, Karampatakis V. Compliance With the Use of Low-Vision Aids in a Greek Population: An Explorative Study. Cureus 2023; 15:e42730. [PMID: 37529808 PMCID: PMC10388667 DOI: 10.7759/cureus.42730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 08/03/2023] Open
Abstract
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.
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Affiliation(s)
- Konstantinos Oikonomidis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Persefoni Talimtzi
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Angeliki Kakavouti-Doudou
- 1st Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Spyridon M Metaxas
- 2nd Department of Otorhinolaryngology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, GRC
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10
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Cavanagh N, Shrubsole K, Alsop T, Williams K. Exploring impairments and allied health professional utilisation in people with myasthenia gravis: A cross-sectional study. J Clin Neurosci 2023; 114:9-16. [PMID: 37276742 DOI: 10.1016/j.jocn.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/12/2023] [Accepted: 05/20/2023] [Indexed: 06/07/2023]
Abstract
This study aimed to explore how people with myasthenia gravis experience impairments in vision, dizziness, hearing, and fatigue, and how these relate to balance confidence, community participation, and health-related quality of life. Additionally, this study investigated the utilisation and perception of the allied health role in managing these impairments in the Australian context. Visual and hearing impairments, along with fatigue, were found to be correlated with health-related quality of life and community participation to varying degrees, while visual impairment and dizziness were correlated with balance confidence. Perception and utilisation of allied health professionals was variable; common barriers to better utilisation included participant perception of clinicians having poor knowledge around myasthenia gravis, previous poor experiences with clinicians, uncertainty about the clinicians' role, and lack of awareness that symptoms were associated with myasthenia gravis. Further research exploring clinicians' knowledge of myasthenia gravis is recommended, along with education for people with the disease about symptoms associated and how to appropriately access care.
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Affiliation(s)
- Neve Cavanagh
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Kirstine Shrubsole
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia.
| | - Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Katrina Williams
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
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11
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Almutleb ES, Almutairi SK, Almutairi RN, Almustanyir AH, Alhassan MM, Alsaqr AM, Alabdulqader BA. Provision of low-vision rehabilitation services in Saudi Arabia. British Journal of Visual Impairment 2023. [DOI: 10.1177/02646196231154468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The prevalence of low vision is expected to increase at the national and international levels, given the aging population and the association between the prevalence of ocular disease(s) and increasing age. Thus, it is important to establish knowledge of the distribution, adequacy, and quality of available low vision rehabilitation services nationally and internationally. This will in turn help prioritize eyecare plans and initiatives, and thus deliver effective services. This cross-sectional study enumerated and surveyed all local government and information regarding the geographic location of each participating entity, entity affiliation, availability and types of low vision rehabilitation services, types of providers, and referral patterns were determined. The results of the current study showed that only 4% of the entities provided low vision rehabilitation services and most (75%) were located in the central region. Additionally, the majority of the services (95%) were basic optometric rehabilitation services whereas other services were either rarely offered or not offered at all. Overall, the current low vision rehabilitation services in Saudi Arabia are inadequate to meet the increasing prevalence of the low vision population. Thus, careful planning of eyecare services is required to meet this demand.
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Affiliation(s)
- Essam S Almutleb
- Optometry Department, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | | | | | | | | | | | - Balsam A Alabdulqader
- Optometry Department, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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12
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Pur DR, Lee-Wing N, Bona MD. The use of augmented reality and virtual reality for visual field expansion and visual acuity improvement in low vision rehabilitation: a systematic review. Graefes Arch Clin Exp Ophthalmol 2023; 261:1743-1755. [PMID: 36633669 DOI: 10.1007/s00417-022-05972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 10/31/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Developments in image processing techniques and display technology have led to the emergence of augmented reality (AR) and virtual reality (VR)-based low vision devices (LVDs). However, their promise and limitations in low vision rehabilitation are poorly understood. The objective of this systematic review is to appraise the application of AR/VR LVDs aimed at visual field expansion and visual acuity improvement in low vision rehabilitation. METHODS A systematic search of the literature was performed using MEDLINE, Embase, PsychInfo, HealthStar, and National Library of Medicine (PubMed) from inception to March 6, 2022. Articles were eligible if they included an AR or VR LVD tested on a sample of individuals with low vision and provided visual outcomes such as visual acuity, visual fields, and object recognition. RESULTS Of the 652 articles identified, 16 studies comprising 382 individuals with a mean age of 52.17 (SD = 18.30) years, and with heterogeneous low vision etiologies (i.e., glaucoma, age-related macular degeneration, retinitis pigmentosa) were included in this systematic review. Most articles used AR (53%), VR (40%), and one article used both AR and VR. The main visual outcomes evaluated were visual fields (67%), visual acuity (65%), and contrast sensitivity (27%). Various visual enhancement techniques were employed including variable magnification using digital zoom (67%), contrast enhancements (53%), and minification (27%). AR LVDs were reported to expand the visual field from threefold to ninefold. On average, individuals using AR/VR LVDs experienced an improved in visual acuity from 0.9 to 0.2 logMAR. Ten articles were classified as high or moderate risk of bias. CONCLUSION AR/VR LVDs were found to afford visual field expansion and visual acuity improvement in low vision populations. Even though the results of this review are promising, the lack of controlled studies with well-defined populations, use of small, convenience samples, and incomplete reporting of inclusion and exclusion criteria among included studies makes it challenging to judge the true impact of these devices. Future studies should address these limitations and compare various AR/LVDs to determine what is the ideal LVD type and vision enhancement combination based on the user's level of visual ability and lifestyle.
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Affiliation(s)
- Daiana R Pur
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Nathan Lee-Wing
- Max Randy College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Mark D Bona
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, ON, Canada
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13
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Okonkwo UP, Okechukwu Daniel D, Onwuakagba IU, Okoye EC, Igwe ES, Maduagwu SM, Ani KU, Ekechukwu END, Amaechi IA, Nwosu IB. Knowledge and perception of clinical physiotherapy students about physiotherapy management of stroke survivors with visual impairment. British Journal of Visual Impairment 2022. [DOI: 10.1177/02646196221131737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
It is evident from clinical practice that visual disorders are prevalent in stroke medicine and are involved in all stages. The visual disorder may form all or part of the initial presentation, and subsequently, visual problems may be a rehabilitation issue or affect the quality of life and activities of daily living (ADLs) after stroke. This study aimed to determine the level of knowledge and perception of the clinical students of the Department of Medical Rehabilitation, Nnamdi Azikiwe University, about stroke survivors with visual impairment (SSVI) and the physiotherapy management of stroke survivors who are visually impaired. This study was a cross-sectional survey involving 136 respondents who were selected from the 270 clinical students of the Department of Medical Rehabilitation at Nnamdi Azikiwe University. A 25-item questionnaire was administered to assess their level of knowledge and perception of SSVI as well as the physiotherapy management methods involved. Descriptive statistics of tables, mean, and standard deviation were used to summarize participants’ responses. The Spearman rank-order correlation was used to test for correlations. Mann–Whitney U test was used to assess sex differences. Alpha was set at .05. There was a high level of knowledge and high perception (94.1% and 91.9%) of physiotherapy management of SSVI among the clinical physiotherapy students. The level of the study did not significantly influence the knowledge ( p = .386) and perception ( p = .686) of the visually impaired stroke survivor. There was a significant ( p = .008) relationship between age and knowledge of stroke survivors. No significant gender difference was observed in all results. The student’s age and gender did not influence their knowledge or perception of physiotherapy management for SSVI, the student’s level of study did influence the two variables.
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Nguyen JD, Tan SM, Azenkot S, Chu MA, Cooper EA. Longitudinal Trends in Case Histories and Rehabilitative Device Assessments at Low Vision Examinations. Optom Vis Sci 2022; 99:817-829. [PMID: 36301592 PMCID: PMC9704812 DOI: 10.1097/opx.0000000000001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/26/2022] [Indexed: 01/06/2023] Open
Abstract
SIGNIFICANCE Understanding longitudinal changes in why individuals frequent low-vision clinics is crucial for ensuring that patient care keeps current with changing technology and changing lifestyles. Among other findings, our results suggest that reading remains a prevailing patient complaint, with shifting priorities toward technology-related topics. PURPOSE This study aimed to understand changes in patient priorities and patient care in low vision over the past decade. METHODS We conducted a retrospective study of examination records (2009 to 2019, 3470 examinations) from two U.S. low-vision clinics. Automated word searches summarized two properties of the records: topics discussed during the case history and types of rehabilitative devices assessed. Logistic regression was used to model the effects of examination year, patient age, patient sex, and level of visual impairment. RESULTS Collapsing across all years, the most common topic discussed was reading (78%), followed by light-related topics (71%) and technology (59%). Whereas the odds of discussing reading trended downward over the decade (odds ratio, 0.57; P = .03), technology, social interaction, mobility, and driving trended upward (odds ratios, 4.53, 3.31, 2.71, and 1.95; all P 's < 0.001). The most frequently assessed devices were tinted lenses (95%). Over time, video magnifier and spectacle assessments trended downward (odds ratios, 0.64 and 0.72; P = .004, 0.04), whereas assessments of other optical aids increased. The data indicate several consistent differences among patient demographics. CONCLUSIONS Reading is likely to remain a prevailing patient complaint, but an increase in technology-related topics suggests shifting priorities, particularly in younger demographics. "Low-tech" optical aids have remained prominent in low-vision care even as "high-tech" assistive devices in the marketplace continue to advance.
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Affiliation(s)
- Jacqueline D. Nguyen
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Steven M. Tan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Shiri Azenkot
- Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, Cornell University, New York, New York
| | - Marlena A. Chu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Emily A. Cooper
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California
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Riazi A, Aspden T, Rubin G, Ambler G, Jichi F, Mynors-Wallice L, O’Driscoll M, Walters K. Problem-Solving Treatment for People Recently Diagnosed with Visual Impairment: Pilot Randomised Controlled Trial. J Pers Med 2022; 12:jpm12091431. [PMID: 36143215 PMCID: PMC9504279 DOI: 10.3390/jpm12091431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Problem-Solving Treatment (PST) has been used to treat and prevent depression in a variety of settings. However, the impact of PST on improving psychological well-being in those with recent vision loss remains unknown. The aim of this study was to evaluate whether PST may lead to better psychological well-being in people with recent vision loss through a pilot parallel-group randomised controlled trial. Methods: Participants who were diagnosed with visual impairment during the previous 3 months were randomly allocated to either an 8-week PST or treatment as usual (N = 61). Outcome measures were administered at baseline, 3, 6, and 9-months. Results: A linear mixed model demonstrated that PST significantly improved psychological well-being (measured by the Warwick Edinburgh Mental Well-being Scale) (treatment effect = 2.44; 95% CI = 0.40–4.47; p = 0.019). Significant improvements in the PST group for symptoms of distress, quality of life and self-efficacy were also observed. There was no significant difference in mobility. The treatment effect was consistent at all follow-ups. Attrition rate was low (13%). Conclusions: PST was associated with a significant and sustained improvement in a range of outcomes in people with recent vision loss. Further large scale RCT is now required.
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Affiliation(s)
- Afsane Riazi
- Department of Psychology, Richmond American University London, London W4 5AN, UK
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, UK
- Correspondence:
| | - Trefor Aspden
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, UK
| | - Gary Rubin
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Gareth Ambler
- Department of Statistical Science, University of London, London WC1E 6BT, UK
| | - Fatima Jichi
- Biostatistics Group, University College London Hospitals/University of London Research Support Centre, University College London, London WC1E 6BT, UK
| | | | - Miriam O’Driscoll
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
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Menaldi SL, Harini M, Nelfidayani N, Irawati Y, Setiono S, Wahyuni LK, Rahayu T, Andayani G, Friska D, Nugraha B. Functional activity limitation of leprosy cases in an endemic area in Indonesia and recommendations for integrated participation program in society. PLoS Negl Trop Dis 2022; 16:e0010646. [PMID: 35984857 PMCID: PMC9447908 DOI: 10.1371/journal.pntd.0010646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/06/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Leprosy continues to be a health problem in Indonesia, with incidence reaching over 10,000 new cases by 2021. Leprosy-related disabilities cause limitation of patients’ activity and participation in social activities. To date, no studies have been conducted in Indonesia which investigates disability in terms of bodily function, structure impairment, limitations in performing daily activities, and restrictions in participation in social activities in leprosy patients. This study is aimed to determine the demographic and clinical characteristics that might affect functional activity limitations of leprosy patients in endemic areas in Indonesia.
Methods and findings
A cross-sectional study was conducted on 267 retrospectively-diagnosed cases of leprosy. The Screening of Activity Limitation and Safety Awareness (SALSA) scale was used to measure functional activity limitation, which comprises five domains: vision, mobility, self-care, work with hands, and dexterity. Differences among variables were evaluated using Kruskal-Wallis and Mann-Whitney test. The mean age of participants was 51.89±13.66 years, the majority of which were men (62.5%), uneducated (48.3%), and classified as type 2 in the World Health Organization (WHO) disability grading for hands and feet (66.3% and 68.2%, respectively). Assessment using the SALSA Scale showed 28.5% of subjects were without limitation, 43.8% with mild limitation, 13.5% with moderate limitation, 9.4% with severe limitation, and 4.9% with extreme limitation. Significant differences in the total SALSA Scale were found between age groups (p = 0.014), educational level (p = 0.005), occupation (p<0.001), and WHO disability grades (p<0.001). Multivariate analysis showed that the most significant factor influencing the total score of SALSA was disability grading for feet (score = 0.31, p <0.001) followed by occupational status, disability grading for eyes, and age. Limitation of functional activity was significantly correlated to becoming unemployed with the odds 2.59.
Conclusion
People affected by leprosy are prone to have functional activity limitation, especially the elderly, uneducated, unemployed and those with multiple disabilities. If they can overcome their barriers in functional activities, they will have better occupational opportunities.
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Affiliation(s)
- Sri Linuwih Menaldi
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- * E-mail:
| | - Melinda Harini
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nelfidayani Nelfidayani
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Yunia Irawati
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Steven Setiono
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Luh Karunia Wahyuni
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tri Rahayu
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Gitalisa Andayani
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dewi Friska
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
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Gui H, Tseng B, Hu W, Wang SY. Looking for low vision: Predicting visual prognosis by fusing structured and free-text data from electronic health records. Int J Med Inform 2022; 159:104678. [PMID: 34999410 PMCID: PMC8792365 DOI: 10.1016/j.ijmedinf.2021.104678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Low vision rehabilitation improves quality-of-life for visually impaired patients, but referral rates fall short of national guidelines. Automatically identifying, from electronic health records (EHR), patients with poor visual prognosis could allow targeted referrals to low vision services. The purpose of this study was to build and evaluate deep learning models that integrate EHR data that is both structured and free-text to predict visual prognosis. METHODS We identified 5547 patients with low vision (defined as best documented visual acuity (VA) less than 20/40) on ≥ 1 encounter from EHR from 2009 to 2018, with ≥ 1 year of follow-up from the earliest date of low vision, who did not improve to greater than 20/40 over 1 year. Ophthalmology notes on or prior to the index date were extracted. Structured data available from the EHR included demographics, billing and procedure codes, medications, and exam findings including VA, intraocular pressure, corneal thickness, and refraction. To predict whether low vision patients would still have low vision a year later, we developed and compared deep learning models that used structured inputs and free-text progress notes. We compared three different representations of progress notes, including 1) using previously developed ophthalmology domain-specific word embeddings, and representing medical concepts from notes as 2) named entities represented by one-hot vectors and 3) named entities represented as embeddings. Standard performance metrics including area under the receiver operating curve (AUROC) and F1 score were evaluated on a held-out test set. RESULTS Among the 5547 low vision patients in our cohort, 40.7% (N = 2258) never improved to better than 20/40 over one year of follow-up. Our single-modality deep learning model based on structured inputs was able to predict low vision prognosis with AUROC of 80% and F1 score of 70%. Deep learning models utilizing named entity recognition achieved an AUROC of 79% and F1 score of 63%. Deep learning models further augmented with free-text inputs using domain-specific word embeddings, were able to achieve AUROC of 82% and F1 score of 69%, outperforming all single- and multiple-modality models representing text with biomedical concepts extracted through named entity recognition pipelines. DISCUSSION Free text progress notes within the EHR provide valuable information relevant to predicting patients' visual prognosis. We observed that representing free-text using domain-specific word embeddings led to better performance than representing free-text using extracted named entities. The incorporation of domain-specific embeddings improved the performance over structured models, suggesting that domain-specific text representations may be especially important to the performance of predictive models in highly subspecialized fields such as ophthalmology.
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Affiliation(s)
- Haiwen Gui
- Stanford University School of Medicine, Stanford, United States
| | - Benjamin Tseng
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States
| | - Wendeng Hu
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States
| | - Sophia Y Wang
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States.
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Liu J, Evans R, Wang Y, Hu B, Tong Y, Li S, Tian Z, Li J, Zhang C, He L, Zheng J. Development and Evaluation of the Quality of Life Scale for Children With Visual Impairments in China. Front Pediatr 2022; 10:739296. [PMID: 35386258 PMCID: PMC8979288 DOI: 10.3389/fped.2022.739296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Visual impairments related to non-correctable vision loss, including blindness and low vision, have been consistently shown to lower a person's health-related quality of life. This study assessed the reliability, validity, and discrimination of the Quality of Life Scale for Children with Visual Impairments (QOLS-CVI) in China. METHODS The Pediatric Quality of Life Inventory™ 4.0 and World Health Organization Quality of Life-Disability Scale for physical disability were selected to define conceptual frameworks and item libraries based on relevant existing studies. According to two rounds of expert consultations and group discussions, some items were modified, and the draft scale was developed. Two item selection processes based on classical test theory and item response theory were used to conduct a preliminary survey and a formal survey in special schools in Shanxi and Hebei Provinces. Finally, the reliability and validity of the quality of life scale for visually impaired children in China were verified. RESULTS The final QOLS-CVI consisted of 38 items, 10 subdomains, and 6 domains. Reliability was verified by Cronbach's alpha coefficient, split-half reliability, and test-retest reliability (Cronbach's alpha for the full scale, 0.841; split-half reliability, 0.629; and test-retest reliability, 0.888). The validity results showed that the multidimensional scale met expectations: exploratory factor analysis and confirmatory factor analysis indicated good fitting models for children with visual impairments. CONCLUSIONS The QOLS-CVI was determined to be reliable and valid and to have strong feasibility and effectiveness. This scale can be used as an evaluation tool to study the QOL and social-participation ability of children with visual impairments.
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Affiliation(s)
- Jie Liu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Richard Evans
- College of Engineering, Design and Physical Sciences, Brunel University London, London, United Kingdom
| | - Yanjun Wang
- Service Center of Shanxi Medical and Health Institutions, Taiyuan, China
| | - Beibei Hu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yan Tong
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Shaoqiong Li
- Center for Information, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiqiang Tian
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jing Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Cuihua Zhang
- Physiatry Department, Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Lu He
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jianzhong Zheng
- School of Public Health, Shanxi Medical University, Taiyuan, China
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Robinson JL, Liu Y, Chen Q. Licensure and Driving Status among Visually Impaired Persons. Optom Vis Sci 2021; 98:1334-1339. [PMID: 34905521 DOI: 10.1097/opx.0000000000001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to determine what proportion of visually impaired patients continue driving despite falling short of the legal cutoffs described in state licensure laws. METHODS We created a driving habits survey and administered it to 335 consecutive adult low vision patients presenting for their initial evaluation at the Vanderbilt Eye Institute. We measured visual acuity and contrast sensitivity as part of the clinical evaluation and accounted for historic visual field results where indicated. We compared self-reported licensure and driving status against the vision criteria for licensure in each subject's home state. RESULTS Two hundred fifty-seven subjects (76.7%) possessed an unexpired license. One hundred forty-one (54.9%) of these demonstrated vision, which would meet their home state's licensure criteria. Ninety-five of 134 current drivers (70.9%) met their home state's licensure criteria. Thirty-nine current drivers (29.1%) were driving outside the bounds of licensure criteria in their state. Among licensed subjects, being a current driver was associated with younger age (P < .001), better visual acuity (P < .001), and better contrast sensitivity (P < .001). CONCLUSIONS Many drivers do not possess adequate vision for licensure based on their home state's current standards. Changes to licensure qualification and renewal procedures may be advisable.
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Affiliation(s)
| | - Yuhan Liu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee
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Almhdawi KA, Alsalem MF, Obeidat D, Al-Khateeb LT, Al Aqarbah MN, Alshiyab WM, Arabiat AA, Bazel MA, Al-Share Z. Evaluating Well-being of Individuals With Chronic Visual Conditions Requiring Regular Eyecare During COVID-19 Lockdown: A Cross-Sectional Study. Eye Contact Lens 2021; 47:559-64. [PMID: 34542424 DOI: 10.1097/ICL.0000000000000834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess health-related quality of life (HRQoL) and its predictors among individuals with chronic vision conditions during COVID-19 lockdown. METHODS A cross-sectional, survey-based study targeted Jordanian adults with a variety of chronic vision conditions requiring regular ophthalmic follow-up. Outcome measures included HRQoL measured by the 12-item Short-Form Health Survey (SF-12), mental health symptoms measured by the Depression Anxiety Stress Scale, and vision ability measured by the National Eye Institute Visual Functioning Questionnaire (VFQ-25) General Vision and Role Limitation subscales. Data were analyzed descriptively and using a multiple variable linear regression model to identify HRQoL predictors. RESULTS A total of 203 participants with a mean age of 52.09 (±15.41) years participated, and SF-12 mean scores were 58.15 for the physical component and 57.48 for the mental component. The level of HRQoL was significantly associated with VFQ-25 Role Limitation subscale, diabetes, the need of ophthalmic follow-up, and stress. The regression model explained 47.1% of the variance in HRQoL (r2=0.471, F=35.57, P<0.001). CONCLUSIONS Jordanian individuals with chronic vision conditions demonstrated low levels of HRQoL during COVID-19 lockdown. Participants also showed high levels of mental health symptoms and reported low accessibility to ophthalmic care. Access to nonurgent ophthalmic care in individuals with chronic vision diseases should be carefully planned in future pandemics.
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Thevi T, Abas AL, Stephanie Yen Li C. Comparison between the English and Bahasa Malaysia language versions of the Visual Functioning Questionnaire (VFQ-25) for use in patients with cataracts. BMC Ophthalmol 2021; 21:348. [PMID: 34579663 PMCID: PMC8477526 DOI: 10.1186/s12886-021-02100-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2021] [Indexed: 01/01/2023] Open
Abstract
Background We conducted the study to compare the psychometric properties of the English version of the Questionnaire and the Bahasa Malaysia (Malay Language) version regarding the vision-related Quality of Life of patients with cataracts. Methods The Malay version was translated by two independent translators who were well versed in both languages. We carried out a cross-sectional study collecting data between June 2017 and March 2018 in the pre-operative Eye Clinic of Hospital Melaka with 224 respondents (mean age 66.8 years) and another 204 respondents (mean age 64.3 years) participating in the English version and Malay version of the Questionnaire respectively. Methods used to validate the standard questionnaire included the use of construct validity via factor analysis and the deployment of reliability test through assessment of internal consistency via Cronbach’s alpha. Results We observed both English and Bahasa Malaysia versions to have high reliability with Cronbach’s alpha values of 0.90 and above in factors on difficulty with activities and responses to vision problems. Exploratory factor analysis performed revealed that the three-factor model fits the data well for the English version of the questionnaire - difficulty with activities (23.81 % of variance), responses to vision problem (22.22 % of variance) and general health and vision (14.68 % of variance). The Bahasa Malaysia version of the questionnaire produced three factors with two of the factors resembling the factors from the original version of the questionnaire - difficulty with activities (24.3 % of variance) and responses to vision problem (23.7 % of variance). Item response theory analysis revealed that these factors for both English and Bahasa Malaysia versions comprised of adequately fitted items. Conclusion The present study observed that both the English and Bahasa Malaysia versions of the NEI VFQ-25 have comparable construct validity to the original American version. With high validity and reliability, the tool shall be able to provide health care providers the assessment of impact due to cataract and other ophthalmic conditions on the vision-related quality of life of ophthalmic patients.
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Affiliation(s)
- Thanigasalam Thevi
- Hospital Melaka, Jalan Mufti Haji Khalil, 75400, Melaka, Malaysia. .,MAHSA University, Jalan SP2, Bandar Saujana Putra, 42610, Selangor, Malaysia.
| | - Adinegara Lutfi Abas
- Manipal University College Malaysia, Jalan Padang Jambu, 75400, Melaka, Malaysia
| | - Chang Stephanie Yen Li
- Hospital Melaka, Jalan Mufti Haji Khalil, 75400, Melaka, Malaysia.,Manipal University College Malaysia, Jalan Padang Jambu, 75400, Melaka, Malaysia
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Lešin Gaćina D, Škegro B, Jandroković S, Škegro I, Bešlić I, Bukvić M. Psychometric properties of the Croatian version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Int Ophthalmol 2021. [PMID: 34312780 DOI: 10.1007/s10792-021-01975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study was to translate, adapt and validate the Croatian version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in participants with visual impairment. This study also aims at evaluating the relationship between visual impairment and health-related quality of life (HRQoL). METHODS The prospective observational study was conducted at the University Hospital Centre Zagreb, Department of Ophthalmology. The sample consisted of 175 patients with four chronic ocular diseases: cataract, glaucoma, diabetic retinopathy and age-related macular degeneration. The translation of the NEI VFQ-25 to Croatian was conducted following the standardised procedure. All participants underwent an ophthalmological examination and completed the NEI VFQ-25 and the Medical Outcomes Study Short Form-36 Questionnaire (SF-36). In order to assess the psychometric properties of the NEI VFQ-25, we calculated Cronbach's α coefficient, intraclass correlation coefficient (ICC), convergent and discriminant validity, as well as criterion and concurrent validity. RESULTS Results show high internal consistency (Cronbach α range 0.739-0.932) and high test-retest reliability (ICC 0.876-0.975) for all subscales. None of the items had failed either convergent or discriminant validity. Moderate to high Spearman's rho coefficients of correlations were found between best corrected visual acuity and eight subscales in the NEI VFQ-25 (0.430 < ρ < 0.631). Moderate correlations were found between comparable domains in the NEI VFQ-25 and in the SF-36 questionnaire (p < 0.01). CONCLUSION The Croatian version of the NEI VFQ-25 has very good psychometric properties and can be a useful instrument for assessing vision-related quality of life in Croatian population with chronic ophthalmic diseases.
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Liu J, Dong J, Chen Y, Zhang W, Tong S, Guo J. Low vision rehabilitation in improving the quality of life for patients with impaired vision: A systematic review and meta-analysis of 52 randomized clinical trials. Medicine (Baltimore) 2021; 100:e25736. [PMID: 34106601 PMCID: PMC8133190 DOI: 10.1097/md.0000000000025736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AIM Low vision rehabilitation optimizes the use of residual vision after severe vision loss, but also teaches skills to improve visual functioning in daily life. These skills promote independence and active participation in society. This meta-analysis was designed to evaluate the efficacy of low vision rehabilitation in improving the quality of life (QoL) in visually impaired adults. METHODS We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to January 1, 2020. Randomized controlled trials (RCTs) that compared rehabilitation interventions with active or inactive controls were included. The standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated to compare outcomes. Two reviewers extracted data and assessed trial quality independently. All statistical analyses were performed using the standard statistical procedures of RevMan 5.2. RESULTS A total of 52 RCTs with 6,239 participants were included in this meta-analysis. Compared to inactive comparators including waiting list or no care, low vision rehabilitation improved vision-related QoL, visual functioning (QoL: psychological aspect), and self-efficacy or self-esteem (QoL: psychological aspect), with pooled SMDs of -0.61 (95% CI -0.95 to -0.26; P = .0006), -1.14 (95% CI -1.69 to -0.59; P < .0001), and -0.84 (95% CI -1.47 to -0.22; P < .0001), respectively. Compared to active comparators, low vision rehabilitation improved vision-related QoL (SMD -0.26; 95% CI -0.46 to -0.06; P = .01) and activities of daily living (QoL: physical aspect) (SMD -0.39; 95% CI -0.67 to -0.12 P < .0001). However, no significant difference in health-related QoL and adaptation to vision loss (QoL: psychological aspect) was found between low vision rehabilitation and inactive comparators. CONCLUSIONS This meta-analysis indicated that low vision rehabilitation interventions, particularly psychological therapies and methods of enhancing vision, may improve vision-related QoL and visual functioning in people with sight loss compared to usual care. Further studies should explore longer maintenance effects and the costs of several types of low vision rehabilitation. Studies characterizing the mechanisms of rehabilitation interventions in different settings, including low-income countries, are also required.
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Affiliation(s)
- Jianhua Liu
- Department of Physical Therapy, Beijing Bo'ai Hospital, Chinese Rehabilitation Research Centre
| | - Jige Dong
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
| | - Yaping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University
| | - Weidong Zhang
- Department of Rehabilitation Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University
| | - Shuai Tong
- Department of Rehabilitation Medicine, Beijing Haidian Hospital, Beijing
| | - Jiangzhou Guo
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
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Afshari NA, Lian RR. Cultivating the Physician-Patient Relationship in Ophthalmology. Am J Ophthalmol 2021; 223:A1-A3. [PMID: 33249053 DOI: 10.1016/j.ajo.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/19/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
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Heren-Le Bastard C, Bernard A, Fliss R, Legouvello S, Allain P. [Psychometric validation of an Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA). French translation of the article]. J Fr Ophtalmol 2020; 44:S0181-5512(20)30447-2. [PMID: 34756385 DOI: 10.1016/j.jfo.2020.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE Handicap evaluation in adults with acquired or progressive congenital visual loss allows for identification of the individual's specific needs and targeted therapy (medical, technical, rehabilitative and psychological). Currently, the subjective dimension of the handicap remains poorly explored in the field of visual loss. Our questionnaire aims to understand the whole of these subjective impacts. It differs from existing quality of life scales in ophthalmology in its approach centered on the process of adaptation, individual resources (technical, cognitive, psychic and environmental), and investigation of the perception of the handicap. The goal of the present study is to validate this questionnaire, which could be used in any adult with a visual handicap, regardless of the extent of the visual loss, its etiology, or the type of treatment or compensatory mechanisms. MATERIALS AND METHODS The Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA) is composed of 28 items relating to perception of the visual impairment, its impact, and adaptive resources. They are divided into 3 sub-categories: perception of daily life and relationships (10 items), Perception of visual status and compensatory mechanisms (8 items), and Psychological impact of the visual handicap (10 items). The responses are graded on a Likert scale. Factor analysis and verification of psychometric qualities were performed based on the responses of 446 subjects. The discriminatory validity of the NEI-VFQ 25 was proven with 99 subjects. Reliability over time (mean interval between T1 and T2=49.43 days) was measured in 31 subjects. Sensitivity to change between pre- and post-management (mean interval between T1 and T2=410 days) was tested in 123 subjects. RESULTS Internal consistency was very good for the global scale (α=.90) as well as for the 3 sub-dimensions (α=.86; α=.79; α=.80). The discriminatory validity was satisfactory (r=.70). This result had to be interpreted as a function of the qualitative specificity of the questionnaire. The questionnaire enjoyed good reproducibility over time with regard to its total score and relatively satisfactory reproducibility with regard to its sub-dimensions. Sensitivity to change was very high and accounted for adaptations to the disability over time. CONCLUSION The QUEPAHVA displays good psychometric qualities. It constitutes a new means of evaluation. Its potential applications are many. It permits evaluation of the needs of the individual and adaptation of the protocol of care. Its use in institutions may support a step forward in the science of evaluation and continued improvement in quality of care.
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Affiliation(s)
- C Heren-Le Bastard
- Centre régional basse vision et troubles de l'audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France; Laboratoire de psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, Maison de la recherche Germaine Tillion, université Angers, université Nantes, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France.
| | - A Bernard
- Équipe BePsyLab, université d'Angers, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France
| | - R Fliss
- Département de neurologie, CHU Angers, 49033 Angers, France; Centre de réadaptation Les Capucins, 49100 Angers, France
| | - S Legouvello
- Centre régional basse vision et troubles de l'audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France
| | - P Allain
- Laboratoire de psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, Maison de la recherche Germaine Tillion, université Angers, université Nantes, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France; Département de neurologie, CHU Angers, 49033 Angers, France
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Heren-Le Bastard C, Bernard A, Fliss R, Legouvello S, Allain P. Psychometric validation of an Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA). J Fr Ophtalmol 2020; 43:e341-e350. [PMID: 33020020 DOI: 10.1016/j.jfo.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Handicap evaluation in adults with acquired or progressive congenital visual loss allows for identification of the individual's specific needs and targeted therapy (medical, technical, rehabilitative and psychological). Currently, the subjective dimension of the handicap remains poorly explored in the field of visual loss. Our questionnaire aims to understand the whole of these subjective impacts. It differs from existing quality of life scales in ophthalmology in its approach centered on the process of adaptation, individual resources (technical, cognitive, psychic and environmental), and investigation of the perception of the handicap. The goal of the present study is to validate this questionnaire, which could be used in any adult with a visual handicap, regardless of the extent of the visual loss, its etiology, or the type of treatment or compensatory mechanisms. MATERIALS AND METHODS The Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA) is composed of 28 items relating to perception of the visual impairment, its impact, and adaptive resources. They are divided into 3 sub-categories: Perception of daily life and relationships (10 items), Perception of visual status and compensatory mechanisms (8 items), and Psychological impact of the visual handicap (10 items). The responses are graded on a Likert scale. Factor analysis and verification of psychometric qualities were performed based on the responses of 446 subjects. The discriminatory validity of the NEI-VFQ 25 was proven with 99 subjects. Reliability over time (mean interval between T1 and T2=49.43 days) was measured in 31 subjects. Sensitivity to change between pre- and post-management (mean interval between T1 and T2=410 days) was tested in 123 subjects. RESULTS Internal consistency was very good for the global scale (α=.90) as well as for the 3 sub-dimensions (α=.86; α=.79; α=.80). The discriminatory validity was satisfactory (r=.70). This result had to be interpreted as a function of the qualitative specificity of the questionnaire. The questionnaire enjoyed good reproducibility over time with regard to its total score and relatively satisfactory reproducibility with regard to its sub-dimensions. Sensitivity to change was very high and accounted for adaptations to the disability over time. CONCLUSION The QUEPAHVA displays good psychometric qualities. It constitutes a new means of evaluation. Its potential applications are many. It permits evaluation of the needs of the individual and adaptation of the protocol of care. Its use in institutions may support a step forward in the science of evaluation and continued improvement in quality of care.
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Affiliation(s)
- C Heren-Le Bastard
- Centre Régional Basse Vision et Troubles de l'Audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France; Laboratoire de Psychologie des Pays-de-la-Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, UNIV Nantes, Maison de la recherche Germaine Tillion, 5 bis Boulevard Lavoisier, 49045 Angers cedex 01, France.
| | - A Bernard
- Équipe BePsyLab, Université d'Angers, 5 bis, Boulevard Lavoisier, 49045 Angers cedex 01, France
| | - R Fliss
- Département de Neurologie, CHU Angers, 49033 Angers, France; Centre de réadaptation Les Capucins, 49100 Angers, France
| | - S Legouvello
- Centre Régional Basse Vision et Troubles de l'Audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France
| | - P Allain
- Laboratoire de Psychologie des Pays-de-la-Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, UNIV Nantes, Maison de la recherche Germaine Tillion, 5 bis Boulevard Lavoisier, 49045 Angers cedex 01, France; Département de Neurologie, CHU Angers, 49033 Angers, France
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Nowak-Gospodarowicz I, Różycki R, Rękas M. Quality of Life in Patients with Unresolved Facial Nerve Palsy and Exposure Keratopathy Treated by Upper Eyelid Gold Weight Loading. Clin Ophthalmol 2020; 14:2211-2222. [PMID: 32801632 PMCID: PMC7415438 DOI: 10.2147/opth.s254533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background Loading of the upper eyelid with gold weights is a well-established procedure for the correction of paralytic lagophthalmos. There is no reliable research evaluating the results of this treatment from the patients’ viewpoint. Aim The aim of this research was to evaluate quality of life (QOL) domains through two standardized questionnaires (SF-36 and NEI-VFQ39) in patients treated by upper eyelid gold weight loading compared to healthy individuals (the “healthy” group) as well as patients with other ophthalmologic conditions (the “sick” group). Patients and Methods This prospective comparative clinical study of 416 surveys was conducted in 2012–2018. The study group includes 59 people: 40 women, 19 men aged 55.5 ± 17.4 treated with gold weights for corneal complications due to unresolved facial nerve palsy. General QOL was assessed using the SF-36 questionnaire. Eye-related QOL was assessed through the NEI-VFQ39 questionnaire. The results were compared with those obtained in 2 control groups: the “healthy” and the “sick,” 53 individuals each. Results A statistically significant increase in QOL domains was noted in patients with facial nerve palsy after treatment (p<0.001). No statistically significant differences were found in categories defining the Physical Component Score in these patients as compared to those from the “sick” control group (p = 0.95). After surgery, the results of the Mental Component Score were comparable to those in the “healthy” control group (p = 0.51). The eye-related health scores changed significantly after surgery and differed significantly compared to the “sick” control group (p <0.05); however, they did not reach the level of the “healthy” control group (p <0.001). Conclusion Patients with untreated facial nerve palsy had the lowest QOL levels among all individuals involved in this study. Treatment of lagophthalmos by gold weights significantly improved their QOL, with the greatest impact on mental aspects of health.
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Affiliation(s)
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Medicine, Warsaw 04-141, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, Warsaw 04-141, Poland
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Guo J, Dong J, Chen Y, Zhang W, Tong S, Liu J. WITHDRAWN:The efficacy of low vision rehabilitation in improving the quality of life for patients with impaired vision: a systematic review and meta-analysis of 46 randomized clinical trials. Int J Surg 2020:S1743-9191(20)30519-7. [PMID: 32650120 DOI: 10.1016/j.ijsu.2020.06.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/06/2020] [Accepted: 06/21/2020] [Indexed: 01/08/2023]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Jiangzhou Guo
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, 100102
| | - Jige Dong
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, 100102
| | - Yaping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, Beijing, 100073
| | - Weidong Zhang
- Department of Rehabilitation Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, 101149
| | - Shuai Tong
- Department of Rehabilitation Medicine, Beijing Haidian Hospital, Beijing, 100080
| | - Jianhua Liu
- Department of Physical Therapy, Beijing Bo'ai Hospital, Chinese Rehabilitation Research Centre, Beijing, 100068
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Somma AT, Montiani-Ferreira F, Schafaschek AI, Gatti L, Featherstone H. Surveying veterinary ophthalmologists to assess the advice given to owners of pets with irreversible blindness. Vet Rec 2020; 187:e30. [PMID: 32532841 DOI: 10.1136/vr.105784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/03/2020] [Accepted: 05/12/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The primary purpose of this survey was to determine how veterinary ophthalmologists manage cases of irreversible blindness and to report the most common causes of blindness. METHODS Respondents completed a questionnaire sent by email with the cooperation of the American College of Veterinary Ophthalmologists, the European College of Veterinary Ophthalmologists and the Latin American College of Veterinary Ophthalmologists. The questionnaire was developed containing 12 questions with both open and closed multiple-choice response options. RESULTS One hundred and eight veterinary ophthalmologists answered the questionnaire. Of the respondents, 83 per cent had graduated for more than 10 years. Glaucoma (63.56 per cent) was the main cited cause of blindness, followed by progressive retinal atrophy (PRA) (17.80 per cent) and retinal detachment (6.78 per cent). The major concerns of owners refer to the impact of blindness on quality-of-life, (39.31 per cent), followed by depression and anxiety (20 per cent), and environment adaptation (11.72 per cent). General recommendations include avoidance of changes in the domestic environment (18.45 per cent), use of auditory stimulation (14.09 per cent) and avoidance of dangerous areas (12.75 per cent). Almost 31 per cent of professionals do not recommend the use of literature on how to deal with blind pets. CONCLUSIONS The survey determined glaucoma and PRA as the most common causes of irreversible blindness in pets. Several recommendations that are frequently given to owners of blind pets are presented.
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Affiliation(s)
- Andre Tavares Somma
- Department of Veterinary Medicine, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | - Luisa Gatti
- Department of Veterinary Medicine, Universidade Federal do Paraná, Curitiba, Brazil
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Cherny C, Zimmerman A, Sherman S. A novel collaboration: Multifocal RGPs and low vision aids increase quality of life in visually impaired. Cont Lens Anterior Eye 2020; 43:274-276. [DOI: 10.1016/j.clae.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/28/2019] [Indexed: 11/24/2022]
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Uhr JH, Governatori NJ, Zhang QE, Hamershock R, Radell JE, Lee JY, Tatum J, Wu AY. Training in and comfort with diagnosis and management of ophthalmic emergencies among emergency medicine physicians in the United States. Eye (Lond) 2020; 34:1504-11. [PMID: 32350451 DOI: 10.1038/s41433-020-0889-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/07/2020] [Accepted: 03/04/2020] [Indexed: 12/26/2022] Open
Abstract
Background/objectives Patients with ophthalmic emergencies often present to emergency rooms. Emergency medicine (EM) physicians should feel comfortable encountering these conditions. We assessed EM physicians’ comfort working up, diagnosing, and managing ophthalmic emergencies. Subjects/methods 329 EM physicians participated in this cross-sectional multicentre survey. Questions inquired about the amount, type, and self-perceived adequacy of ophthalmic training. Likert scales were used to assess confidence and comfort working up, diagnosing, and managing ophthalmic emergencies. Results Participants recall receiving a median of 5 and 10 h of ophthalmic training in medical school and residency, respectively. Few feel this prepared them for residency (16.5%) or practice (52.0%). Only 50.6% feel confident with their ophthalmic exam. Most (75.0%) feel confident in their ability to identify an ophthalmic emergency, but 58.8% feel well prepared to work them up. Responders feel more comfortable diagnosing acute retrobulbar hematoma (72.5%), retinal detachment (69.8%), and acute angle closure glaucoma (78.0%) than central retinal artery occlusion (28.9%) or giant cell arteritis (53.2%). Only 60.2% feel comfortable determining if canthotomy and cantholysis is necessary in the setting of acute retrobulbar hematoma, and 40.3% feel comfortable performing the procedure. There was a trend towards attending physicians and providers in urban and academic settings feeling more comfortable diagnosing and managing ophthalmic emergencies compared to trainees, non-urban, and non-academic physicians. Conclusions Many participants do not feel comfortable using ophthalmic equipment, performing an eye exam, making vision or potentially life-saving diagnoses, or performing vision-saving procedures, suggesting the need to increase ophthalmic training in EM curricula.
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van Nispen RMA, Virgili G, Hoeben M, Langelaan M, Klevering J, Keunen JEE, van Rens GHMB. Low vision rehabilitation for better quality of life in visually impaired adults. Cochrane Database Syst Rev 2020; 1:CD006543. [PMID: 31985055 PMCID: PMC6984642 DOI: 10.1002/14651858.cd006543.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Low vision rehabilitation aims to optimise the use of residual vision after severe vision loss, but also aims to teach skills in order to improve visual functioning in daily life. Other aims include helping people to adapt to permanent vision loss and improving psychosocial functioning. These skills promote independence and active participation in society. Low vision rehabilitation should ultimately improve quality of life (QOL) for people who have visual impairment. OBJECTIVES To assess the effectiveness of low vision rehabilitation interventions on health-related QOL (HRQOL), vision-related QOL (VRQOL) or visual functioning and other closely related patient-reported outcomes in visually impaired adults. SEARCH METHODS We searched relevant electronic databases and trials registers up to 18 September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs) investigating HRQOL, VRQOL and related outcomes of adults, with an irreversible visual impairment (World Health Organization criteria). We included studies that compared rehabilitation interventions with active or inactive control. DATA COLLECTION AND ANALYSIS We used standard methods expected by Cochrane. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 44 studies (73 reports) conducted in North America, Australia, Europe and Asia. Considering the clinical diversity of low vision rehabilitation interventions, the studies were categorised into four groups of related intervention types (and by comparator): (1) psychological therapies and/or group programmes, (2) methods of enhancing vision, (3) multidisciplinary rehabilitation programmes, (4) other programmes. Comparators were no care or waiting list as an inactive control group, usual care or other active control group. Participants included in the reported studies were mainly older adults with visual impairment or blindness, often as a result of age-related macular degeneration (AMD). Study settings were often hospitals or low vision rehabilitation services. Effects were measured at the short-term (six months or less) in most studies. Not all studies reported on funding, but those who did were supported by public or non-profit funders (N = 31), except for two studies. Compared to inactive comparators, we found very low-certainty evidence of no beneficial effects on HRQOL that was imprecisely estimated for psychological therapies and/or group programmes (SMD 0.26, 95% CI -0.28 to 0.80; participants = 183; studies = 1) and an imprecise estimate suggesting little or no effect of multidisciplinary rehabilitation programmes (SMD -0.08, 95% CI -0.37 to 0.21; participants = 183; studies = 2; I2 = 0%); no data were available for methods of enhancing vision or other programmes. Regarding VRQOL, we found low- or very low-certainty evidence of imprecisely estimated benefit with psychological therapies and/or group programmes (SMD -0.23, 95% CI -0.53 to 0.08; studies = 2; I2 = 24%) and methods of enhancing vision (SMD -0.19, 95% CI -0.54 to 0.15; participants = 262; studies = 5; I2 = 34%). Two studies using multidisciplinary rehabilitation programmes showed beneficial but inconsistent results, of which one study, which was at low risk of bias and used intensive rehabilitation, recorded a very large and significant effect (SMD: -1.64, 95% CI -2.05 to -1.24), and the other a small and uncertain effect (SMD -0.42, 95%: -0.90 to 0.07). Compared to active comparators, we found very low-certainty evidence of small or no beneficial effects on HRQOL that were imprecisely estimated with psychological therapies and/or group programmes including no difference (SMD -0.09, 95% CI -0.39 to 0.20; participants = 600; studies = 4; I2 = 67%). We also found very low-certainty evidence of small or no beneficial effects with methods of enhancing vision, that were imprecisely estimated (SMD -0.09, 95% CI -0.28 to 0.09; participants = 443; studies = 2; I2 = 0%) and multidisciplinary rehabilitation programmes (SMD -0.10, 95% CI -0.31 to 0.12; participants = 375; studies = 2; I2 = 0%). Concerning VRQOL, low-certainty evidence of small or no beneficial effects that were imprecisely estimated, was found with psychological therapies and/or group programmes (SMD -0.11, 95% CI -0.24 to 0.01; participants = 1245; studies = 7; I2 = 19%) and moderate-certainty evidence of small effects with methods of enhancing vision (SMD -0.24, 95% CI -0.40 to -0.08; participants = 660; studies = 7; I2 = 16%). No additional benefit was found with multidisciplinary rehabilitation programmes (SMD 0.01, 95% CI -0.18 to 0.20; participants = 464; studies = 3; I2 = 0%; low-certainty evidence). Among secondary outcomes, very low-certainty evidence of a significant and large, but imprecisely estimated benefit on self-efficacy or self-esteem was found for psychological therapies and/or group programmes versus waiting list or no care (SMD -0.85, 95% CI -1.48 to -0.22; participants = 456; studies = 5; I2 = 91%). In addition, very low-certainty evidence of a significant and large estimated benefit on depression was found for psychological therapies and/or group programmes versus waiting list or no care (SMD -1.23, 95% CI -2.18 to -0.28; participants = 456; studies = 5; I2 = 94%), and moderate-certainty evidence of a small benefit versus usual care (SMD -0.14, 95% CI -0.25 to -0.04; participants = 1334; studies = 9; I2 = 0%). ln the few studies in which (serious) adverse events were reported, these seemed unrelated to low vision rehabilitation. AUTHORS' CONCLUSIONS In this Cochrane Review, no evidence of benefit was found of diverse types of low vision rehabilitation interventions on HRQOL. We found low- and moderate-certainty evidence, respectively, of a small benefit on VRQOL in studies comparing psychological therapies or methods for enhancing vision with active comparators. The type of rehabilitation varied among studies, even within intervention groups, but benefits were detected even if compared to active control groups. Studies were conducted on adults with visual impairment mainly of older age, living in high-income countries and often having AMD. Most of the included studies on low vision rehabilitation had a short follow-up, Despite these limitations, the consistent direction of the effects in this review towards benefit justifies further research activities of better methodological quality including longer maintenance effects and costs of several types of low vision rehabilitation. Research on the working mechanisms of components of rehabilitation interventions in different settings, including low-income countries, is also needed.
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Affiliation(s)
- Ruth MA van Nispen
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
| | - Gianni Virgili
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Palagi, 1FlorenceItaly50134
| | - Mirke Hoeben
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
| | - Maaike Langelaan
- Netherlands institute for health services, NIVEL researchP.O. Box 1568UtrechtNetherlands3500 BN
| | - Jeroen Klevering
- Radboud University Medical CenterDepartment of OphthalmologyNijmegenNetherlands
| | - Jan EE Keunen
- Radboud University Medical CenterDepartment of OphthalmologyNijmegenNetherlands
| | - Ger HMB van Rens
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
- Elkerliek HospitalDepartment of OphthalmologyHelmondNetherlands
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Schakel W, Bode C, Elsman EBM, van der Aa HPA, de Vries R, van Rens GHMB, van Nispen RMA. The association between visual impairment and fatigue: a systematic review and meta-analysis of observational studies. Ophthalmic Physiol Opt 2020; 39:399-413. [PMID: 31696537 PMCID: PMC6899802 DOI: 10.1111/opo.12647] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/21/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE The aim was to compare fatigue levels between patients with visual impairment and controls with normal sight and to examine the association between fatigue and vision loss severity. METHODS A systematic literature search was performed using databases of PubMed, Embase, PsycINFO and Cochrane to identify observational studies with outcomes related to fatigue (e.g. vitality subscale of the Short-Form 36, Fatigue Assessment Scale). A meta-analysis was performed using standardised mean differences (SMDs) and odds ratios (OR) to quantitatively summarise the association between visual impairment and fatigue. Sources of heterogeneity were explored by subgroup and sensitivity analyses. Study quality was assessed with the Newcastle-Ottawa scale. RESULTS After reviewing 4477 studies, 22 studies with a total of 40 004 participants were included, of which 18 contributed to meta-analysis. Among these, eight were assessed as moderate quality studies and 10 as high quality studies. Pooled analysis involving 2500 patients and 8395 controls showed higher fatigue severity levels (S.M.D. = -0.36, 95% CI -0.50 to -0.22, 14 studies) among visually impaired patients compared to normally sighted controls. This effect size was small and persisted in sensitivity analyses that involved study quality, fatigue assessment tools and visual acuity data. Furthermore, pooled analysis of four studies including 2615 patients and 5438 controls showed a significant association between visual impairment and fatigue (OR = 2.61, 95% CI 1.69 to 4.04). Secondary meta-analysis of four studies showed no significant difference in fatigue severity (S.M.D. = 0.01, 95% CI -0.37 to 0.39) between patients with moderate visual impairment and patients with severe visual impairment or blindness. CONCLUSIONS Current moderate to high quality evidence suggest that patients with visual impairment experience more severe fatigue symptoms than persons with normal sight. However, a limited number of available studies indicates that fatigue is not associated with severity of vision loss. Future studies are required to determine which factors and underlying mechanisms may explain the association between visual impairment and fatigue. Discussing fatigue at an early stage and developing intervention options for vision-related fatigue should be considered within the field of low vision rehabilitation.
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Affiliation(s)
- Wouter Schakel
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Christina Bode
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Ellen B M Elsman
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hilde P A van der Aa
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Gerardus H M B van Rens
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Ophthalmology, Elkerliek Hospital, Helmond, The Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Papastefanou VP, Kang S, Simkiss P, Zambarakji H. Eye clinic liaison officers service in the United Kingdom. Int J Health Plann Manage 2019; 35:506-519. [PMID: 31729071 DOI: 10.1002/hpm.2938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the role of eye clinic liaison officers (ECLOs) in the United Kingdom and analyse patients' demographics and services provided. METHODS This is a retrospective observational study. Data were collected from the Royal National Institute of Blind People for ECLOs in Wales, Scotland, Northern Ireland and England for the first quarter of 2015. Statistical analysis was performed using chi-square and t test as appropriate. RESULTS Trusts with ECLOs support vary greatly in the UK regions. Only one-third of NHS trusts in England have an ECLO service. Over 4000 patients were assessed. The majority of patients were of White ethnic background (94%), lived alone (37%), had no carers (58%) and were in their 80s (29.5%). The principal ocular conditions causing sight loss and certification were age-related macular degeneration (41.6%) and glaucoma (18.1%). Approximately 70% of patients are first seen at 13 to 18 months from diagnosis. CONCLUSIONS ECLO services vary in the UK regions. England has the lowest ECLO availability per trust and the majority of those assessed were of White British origin with AMD. There are significant delays from diagnosis to the first visit indicating the need for improved services. Further studies are necessary to develop the evidence base for the expansion and funding of ECLO services.
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Affiliation(s)
| | - Swan Kang
- Eye Treatment Centre, Barts Health, Whipps Cross University Hospital, London, UK
| | | | - Hadi Zambarakji
- Eye Treatment Centre, Barts Health, Whipps Cross University Hospital, London, UK
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Green-Gomez M, Bernstein PS, Curcio CA, Moran R, Roche W, Nolan JM. Standardizing the Assessment of Macular Pigment Using a Dual-Wavelength Autofluorescence Technique. Transl Vis Sci Technol 2019; 8:41. [PMID: 31867142 PMCID: PMC6922273 DOI: 10.1167/tvst.8.6.41] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE It is essential to have an appropriate measure to assess macular pigment (MP) that can provide an accurate, valid, and reliable representation of the MP within the macula. The aim of this study was to describe and introduce MP optical volume (MPOV) as an optimal value for reporting MP. METHODS Three hundred ninety-three subjects were analyzed using the Heidelberg Spectralis with the investigational MP optical density (MPOD) module to measure MPOV and MPOD at four foveal eccentricities (0.23°, 0.51°, 0.98°, 1.76° [7° as reference point]). Lutein (L) and zeaxanthin (Z) dietary intake and serum concentrations were evaluated. RESULTS MPOV mean was 5094 (95%CI, 4877-5310); range: 527 to 10,652. MPOV was inversely correlated with body mass index and positively correlated with education (r = -0.156, P = 0.002 and r = 0.124, P = 0.014, respectively). Serum concentrations of L and Z were positively correlated with MPOV (r = 0.422, P < 0.001 and r = 0.285, P < 0.001, respectively). MPOV was positively correlated to MPOD at all measured eccentricities, with the strongest agreement at 1.76° (r = 0.906, P < 0.001). Serum concentrations of L and Z, BMI, education, and age (P < 0.001) were found to be significant predictors of MPOV. CONCLUSIONS The Spectralis MPOV measurement provided a comprehensive and detailed evaluation of the MP profile. The Spectralis MPOV should be considered a preferred metric for the assessment of MP. TRANSLATIONAL RELEVANCE Applying a standardized method for the assessment and report of MP will allow to fully derive meaning from observational studies and to successfully implement this MP measurement technique in research and clinical settings.
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Affiliation(s)
- Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | | | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
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Chen XD, Gardner TW. Patient-Reported Outcomes Reveal Impairments Not Explained by Psychophysical Testing in Patients With Regressed PDR. Transl Vis Sci Technol 2019; 8:11. [PMID: 31380143 PMCID: PMC6664865 DOI: 10.1167/tvst.8.4.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/28/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose We evaluated the correlations between visual deficits and patient-reported symptoms in patients with regressed proliferative diabetic retinopathy (PDR) to determine whether there is a psychophysical basis for vision-related impairments. Methods Visual acuity, reading acuity, contrast sensitivity, frequency doubling perimetry (FDP), Humphrey field analyzer (HFA), and dark adaptation assessed visual function. The National Eye Institute Vision Function Questionnaire-25 (NEI VFQ-25) and Low Luminance Questionnaire (LLQ) assessed quality of life. Results We recruited 30 adults who received panretinal photocoagulation (PRP) for PDR and 15 control subjects; 22 diabetic and 11 control participants completed a second evaluation 5 years later. Visual acuity of the worse-seeing eyes tended to correlate better with NEI VFQ-25 and LLQ than did the acuity of the better-seeing eyes. Other vision measures were generally not associated with either questionnaire, especially responses related to driving ability and mental health. Visual acuity only detected subnormal performance in 43% to 45% of patients, while FDP 24-2, HFA 60-4, and LLQ detected abnormal performance in >80% of patients. Conclusions Poor visual acuity may explain some vision-related impairments in daily function. However, many patients with regressed PDR have normal acuity but reduced visual field and poor quality of life. In these patients, their reported symptoms were not fully explained by visual acuity or any psychophysical tests alone. Translational Relevance Visual acuity is a poor indicator of overall visual function in people with regressed PDR. In clinical settings, visual field tests and patient-reported outcomes may provide more comprehensive assessments of their functional deficits than visual acuity.
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Affiliation(s)
- Xing D Chen
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Thomas W Gardner
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
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Teresi J, Morse AR, Holmes D, Yatzkan ES, Ramirez M, Rosenthal B, Kong J. Impact of a Vision Intervention on the Functional Status of Nursing Home Residents. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0509900204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the outcomes associated with an intervention for residents of two nursing homes who had low vision and cognitive impairments that included diagnosis, optical correction, ensuring that the participants wore their eyeglasses, and staff training in recognizing vision problems. It found that a significantly decreased decline in function was associated with the provision of both eyeglasses and Croakies to the residents and staff training to recognize vision problems and provide reinforcement techniques, rather than only the provision of eyeglasses and Croakies.
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Affiliation(s)
- Jeanne Teresi
- Research Division, Hebrew Home for the Aged at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471 and senior research scientist, Columbia University Stroud Center and Geriatrics Department, New York State Psychiatric Institute
| | - Alan R. Morse
- The Jewish Guild for the Blind, 15 West 65th Street, New York, NY 10023
| | - Douglas Holmes
- Hebrew Home for the Aged at Riverdale;Faculty of Medicine, Columbia University
| | | | | | - Bruce Rosenthal
- Low Vision Services, Lighthouse International, 111 East 59th Street, New York, NY 10021
| | - Jian Kong
- Research Division, Hebrew Home for the Aged at Riverdale
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Abstract
This pilot study of the perceptions of 149 men and women, aged 50 and older, of their need for low vision devices found that the most frequently reported uses of low vision devices were for close, intermediate, and distance reading tasks; television viewing; recognizing people; and finding items.
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Affiliation(s)
- Joan A. Stelmack
- Blind Rehabilitation Service, Edward Hines Veterans Hospital, Building 13, Hines, IL 60141
| | - Alfred A. Rosenbloom
- Chicago Lighthouse for People Who Are Blind or Visually Impaired, 1850 West Roosevelt Road, Chicago, IL 60608
| | - Carl S. Brenneman
- Blind Rehabilitation Service, Edward Hines Veterans Hospital, Hines, IL 60141
| | - Thomas R. Stelmack
- Optometry section, director, VICTORS, Chicago Health Care System, West Side Division, 820 South Damen Avenue, Chicago, IL 60612
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Abstract
This qualitative article describes the impact of age-related macular degeneration (ARMD) among 15 participants: how a person makes sense of ARMD, the effect of ARMD on the person's quality of life, the psychological disturbances associated with the limitations of ARMD, and the influence of ARMD on social interactions. Such in-depth appreciation of the impact of ARMD will assist in the design of specific and appropriate rehabilitation programs to minimize limitations and enhance participation in people with ARMD.
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Affiliation(s)
- Elaine Y. H. Wong
- Center for Eye Research Australia, University of Melbourne, Locked Bag 8, East Melbourne, Victoria 8002, Australia
| | - Robyn H. Guymer
- Center for Eye Research Australia, University of Melbourne, Locked Bag 8, East Melbourne, Victoria 8002, Australia
| | - Jennifer B. Hassell
- Center for Eye Research Australia, University of Melbourne, Locked Bag 8, East Melbourne, Victoria 8002, Australia
| | - Jill E. Keeffe
- Center for Eye Research Australia, University of Melbourne, Locked Bag 8, East Melbourne, Victoria 8002, Australia
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Tey CS, Man REK, Fenwick EK, Aw AT, Drury V, Chiang PPC, Lamoureux EL. Effectiveness of the "living successfully with low vision" self-management program: Results from a randomized controlled trial in Singaporeans with low vision. Patient Educ Couns 2019; 102:1150-1156. [PMID: 30712946 DOI: 10.1016/j.pec.2019.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To determine the effectiveness of the "Living Successfully with Low Vision" (LSLV) self-management program to improve patient-reported outcomes in Singaporeans. METHODS In this randomized controlled trial, 165 participants with low vision (LV) were recruited and assigned to usual care (LV aid training only; N = 82) or LSLV program (N = 83). The LSLV program focuses on problem solving, coping mechanism and anticipation/preparation for future needs. The primary outcome was vision-related quality of life (VRQoL; measured using the Impact of Vision Impairment [IVI] questionnaire), while secondary outcomes included health-related quality of life; mental health; and self-efficacy, assessed at baseline, 2-weeks and 6-months post-intervention. Within- and between-group comparisons were conducted using paired t-tests and repeated measures analysis of covariance, respectively. RESULTS A total of 128 individuals (77.6%) completed all assessments. At 2 weeks, LSLV participants alone experienced a significant within-group improvement in the mean IVI Emotional score (P = 0.05) but not at 6 months. No other within- or between-group effects were observed. CONCLUSION While SM programs have shown promising results in the management of many chronic diseases, our findings suggest that the LVSM program was not an effective approach for LV rehabilitation in Singapore. PRACTICE IMPLICATION Other evidence-based strategies to improve QoL in patients with LV may be warranted.
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Affiliation(s)
- Ching Siong Tey
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ryan Eyn Kidd Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore
| | - Ai Tee Aw
- Singapore National Eye Centre, Singapore
| | - Vicki Drury
- Singapore National Eye Centre, Singapore; Curtin University, Perth, Australia
| | | | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore.
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Napo A, Guirou N, Boro A, Dougnon A, Keita F, Simaga A, Sylla F, Théra J, Traore L, Bamani S. [Evaluation of the quality of life of adult patients treated in low vision at the CHU-IOTA]. J Fr Ophtalmol 2019; 42:492-498. [PMID: 30987760 DOI: 10.1016/j.jfo.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/28/2018] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Visual impairment is a handicap defined as any alteration of visual function responsible for a partial or total limitation of the activities of daily living (OMS, 2004). The objective of this study is to assess quality of life in patients before and after management of low vision. PATIENTS AND METHODS This was a mono-centric, transverse, analytical study over a period of 6 months. Our study population included all adult patients seen in ophthalmologic consultation and followed in the low vision unit with visual acuity less than 3/10 and greater than or equal to 1/20 in the best eye with best optical correction. The National Eye Institute's quality of life questionnaire, the NEF VFQ 25, was administered to patients on site prior to management and then a month later. RESULTS Low-vision management improved overall the dimensions of the quality of life questionnaire. Following the end-of-care assessment, the score for ocular pain was lowest (38.20), followed by the overall vision score (44.95) and near vision difficulty score (45.33). DISCUSSION Our sample population was distinguished by a cultural mix, with diversity of beliefs and lifestyles, and also by the relatively advanced age of the subjects constituting it. This can influence the individual's perception of him- or herself within his or her environment, modifying the patient's estimation of his or her condition and therefore his or her behavior. CONCLUSION Low-vision rehabilitation can improve the quality of life of visually impaired patients, particularly for near vision, activities of daily living and psychological health.
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Affiliation(s)
- A Napo
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali.
| | - N Guirou
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Boro
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Dougnon
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - F Keita
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Simaga
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - F Sylla
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - J Théra
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - L Traore
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - S Bamani
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
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Elsman EBM, Rens GHMB, Nispen RMA. Quality of life and participation of young adults with a visual impairment aged 18-25 years: comparison with population norms. Acta Ophthalmol 2019; 97:165-172. [PMID: 30207073 PMCID: PMC6585861 DOI: 10.1111/aos.13903] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 07/29/2018] [Indexed: 11/26/2022]
Abstract
Purpose To compare health‐related quality of life and participation of visually impaired young adults with normative groups, and to explore severity of vision loss and its association with participation and quality of life. Methods Young adults aged 18–25 years (n = 172) registered at two Dutch low vision rehabilitation organizations completed the Short Form Health Survey (SF‐36), EuroQol‐5 Dimensions (EQ‐5D), Impact on Participation and Autonomy (IPA) and Low Vision Quality of Life questionnaire (LVQOL). EQ‐5D and SF‐36 scores were compared to age‐specific norms. IPA scores were compared to norms of a population having three chronic diseases simultaneously. Linear regression was used to assess the association between severity of vision loss (mild VI, moderate VI and severe VI/blindness), and quality of life and participation. Results Participants scored significantly worse on almost all (sub)scales compared with relevant norms. Effect sizes for the EQ‐5D and SF‐36 (sub)scales were mostly small; moderate and large effect sizes were found for the IPA. Compared to young adults with mild VI, corrected models showed a significant association between having moderate VI and the physical component score of the SF‐36, and between severe VI/blindness and the LVQOL. Conclusion VI has a moderate impact on some aspects of quality of life and a large impact on participation of young adults when compared with relevant normative populations. Severity of vision loss is associated with worse physical functioning and vision‐related quality of life. The results contribute to a better understanding of the impact of VI and might lead to improved low vision services.
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Affiliation(s)
- Ellen Bernadette Maria Elsman
- Department of Ophthalmology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Gerardus Hermanus Maria Bartholomeu Rens
- Department of Ophthalmology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands
- Department of Ophthalmology Elkerliek Hospital HA Helmond The Netherlands
| | - Ruth Marie Antoinette Nispen
- Department of Ophthalmology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands
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Sutradhar I, Gayen P, Hasan M, Gupta RD, Roy T, Sarker M. Eye diseases: the neglected health condition among urban slum population of Dhaka, Bangladesh. BMC Ophthalmol 2019; 19:38. [PMID: 30704423 PMCID: PMC6357461 DOI: 10.1186/s12886-019-1043-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 01/18/2019] [Indexed: 11/08/2022] Open
Abstract
Introduction Globally, eye diseases are considered as one of the major contributors of nonfatal disabling conditions. In Bangladesh, 1.5% of adults are blind and 21.6% have low vision. Therefore, this paper aimed to identify the community-based prevalence and associated risk factors of eye diseases among slum dwellers of Dhaka city. Methods The study was carried out in two phases. In the first phase, a survey was conducted using multistage cluster sampling among 1320 households of three purposively selected slums in Dhaka city. From each household, one family member (≥ 18 years old) was randomly interviewed by trained data collectors using a structured questionnaire. After that, each of the participants was requested to take part in the second phase of the study. Following the request, 432 participants out of 1320 participants came into the tertiary care hospitals where they were clinically assessed by ophthalmologist for presence of eye diseases. A number of descriptive and inferential statistics were performed using Stata 13. Result The majority of total 432 study participants were female (68.6%), married (82.6%) and Muslim (98.8%). Among them almost all (92.8%) were clinically diagnosed with eye disease. The most prevalent eye diseases were refractive error (63.2%), conjunctivitis (17.1%), visual impairment (16.4%) and cataract (7.2%). Refractive error was found significantly associated with older age, female gender and income generating work. Cataract was found negatively associated with the level of education, however, opposite relationship was found between cataract and visual impairment. Conclusion Our study provides epidemiologic data on the prevalence of eye diseases among adult population in low-income urban community of Dhaka city. The high prevalence of refractive error, allergic conjunctivitis, visual impairment, and cataract among this group of people suggests the importance of increasing access to eye care services. Electronic supplementary material The online version of this article (10.1186/s12886-019-1043-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ipsita Sutradhar
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
| | - Priyanka Gayen
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Mehedi Hasan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Rajat Das Gupta
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Stelmack JA, Rinne S, Mancil RM, Dean D, Moran D, Tang XC, Cummings R, Massof RW. Successful Outcomes from a Structured Curriculum Used in the Veterans Affairs Low Vision Intervention Trial. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0810201008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A low vision rehabilitation program with a structured curriculum was evaluated in a randomized controlled trial. The treatment group demonstrated large improvements in self-reported visual function (reading, mobility, visual information processing, visual motor skills, and overall). The team approach and the protocols of the treatment program are described.
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Affiliation(s)
- Joan A. Stelmack
- Blind Rehabilitation Service, Blind Rehabilitation Center (124), Edward E. Hines VA Hospital, 500 South 5th Avenue, Hines, IL 60141
| | - Stephen Rinne
- Blind Rehabilitation Center (124), Edward E. Hines VA Hospital
| | - Rickilyn M. Mancil
- Vision Rehabilitation Research Laboratory, W. G. Hefner VA Medical Center, 1601 Brenner, Salisbury, NC 28144
| | - Deborah Dean
- Blind Rehabilitation Center (124), Edward E. Hines VA Hospital
| | - D'Anna Moran
- Blind Rehabilitation Center (124), Edward E. Hines VA Hospital
| | - X. Charlene Tang
- Cooperative Studies Program Coordinating Center, Edward E. Hines VA Hospital
| | - Roger Cummings
- Vision Rehabilitation Research Laboratory, W. G. Hefner VA Medical Center
| | - Robert W. Massof
- Lions Vision Research and Rehabilitation Center, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, 550 North Broadway, 6th floor, Baltimore, MD 21205
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Smith TM, Thomas K, Dow K. The Effect of an Educational Program for Persons with Macular Degeneration: A Pilot Study. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0910300407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Theresa Marie Smith
- Department of Occupational Therapy, Texas Woman's University, 6700 Fannin Street, Houston, TX 77030
| | - Kimberly Thomas
- Rehabilitation Department, Memorial Hermann Hospital, 6411 Fannin, Houston, TX 77030
| | - Katherine Dow
- Occupational Therapy Department, St. Luke's Episcopal Health System, 6720 Bertner Avenue, Houston, TX 77345
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Inoue S, Kawashima M, Hiratsuka Y, Nakano T, Tamura H, Ono K, Murakami A, Tsubota K, Yamada M. Assessment of physical inactivity and locomotor dysfunction in adults with visual impairment. Sci Rep 2018; 8:12032. [PMID: 30104680 DOI: 10.1038/s41598-018-30599-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/20/2018] [Indexed: 12/29/2022] Open
Abstract
To evaluate the association between vision-related quality of life (QoL), physical inactivity, and locomotor dysfunction in subjects with visual impairment.This cross-sectional study included 215 visually impaired subjects recruited from six ophthalmology departments in Japan. The physical inactivity and locomotor dysfunction associated with their visual impairment was investigated. The physical activity level was assessed using the short form of the International Physical Activity Questionnaire and classified as high, moderate, or low. Locomotor function was evaluated with the Geriatric Locomotive Function Scale. Vision-related QoL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire. Background data, including for age, sex, best-corrected visual acuity for each eye, causative eye diseases, systemic comorbidities, and body mass index, were also collected.The average patient age was 69.6 (range, 20-93 years; standard deviation, 14.5 years) and 118 patients (54.9%) were men. Multivariate analysis showed that vision-related QoL and best-corrected visual acuity in the worse eye were significantly associated with physical inactivity and that vision-related QoL, female sex, age, and presence of systemic comorbidity were significantly associated with locomotor dysfunction. Vision-related quality of life is associated with physical inactivity and locomotor dysfunction.
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Elsman EBM, van Rens GHMB, van Nispen RMA. Psychometric properties of a new intake questionnaire for visually impaired young adults: The Participation and Activity Inventory for Young Adults (PAI-YA). PLoS One 2018; 13:e0201701. [PMID: 30086161 PMCID: PMC6080798 DOI: 10.1371/journal.pone.0201701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/20/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To be able to identify and monitor personal needs and goals of visually impaired young adults before and during rehabilitation trajectories, the Participation and Activity for Young Adults (PAI-YA) was developed involving young adults (18-25 years) and professionals as stakeholders. The psychometric properties of this new patient-reported outcome measure were investigated in order to develop an improved version. METHODS Young adults registered at two low vision rehabilitation centers in the Netherlands were invited to complete the 141-item PAI-YA (n = 186) in a test-retest design. To select the best items for the PAI-YA, response frequencies were assessed and a graded response model (GRM) was fitted. Item reduction was informed by response frequencies, insufficient item information, and participants' comments. Fit indices, item and person (theta) parameters were computed, after which known-group validity, concurrent validity, test-retest reliability and feasibility were studied. RESULTS Response frequencies, violation of assumptions and item information informed the elimination of 81 items, resulting in a unidimensional PAI-YA showing satisfactory fit to the GRM. Known-group validity showed significant differences for visual impairment, financial situation, sex, educational situation and employment situation. Concurrent validity with (scales of) other questionnaires showed moderate to strong expected correlations. Test-retest reliability was satisfactory for all items (kappa 0.47-0.87), as was agreement (63.1-92.0%). Four items and one response option were added to increase feasibility. CONCLUSIONS This study contributes to the development and assessment of psychometric properties of the PAI-YA, which resulted in an improved 64-item version. Evidence was provided for construct validity, known-group validity, concurrent validity and test-retest reliability. These results are an important step in the development of a feasible instrument to investigate and monitor rehabilitation needs of visually impaired young adults, to structure the intake procedure at low vision rehabilitation services and to evaluate the effectiveness of rehabilitation.
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Affiliation(s)
- Ellen Bernadette Maria Elsman
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, the Amsterdam Public Health research institute, De Boelelaan, Amsterdam, the Netherlands
| | - Gerardus Hermanus Maria Bartholomeus van Rens
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, the Amsterdam Public Health research institute, De Boelelaan, Amsterdam, the Netherlands
- Department of Ophthalmology, Elkerliek Hospital, Helmond, the Netherlands
| | - Ruth Marie Antoinette van Nispen
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, the Amsterdam Public Health research institute, De Boelelaan, Amsterdam, the Netherlands
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Shah P, Schwartz SG, Gartner S, Scott IU, Flynn HW. Low vision services: a practical guide for the clinician. Ther Adv Ophthalmol 2018; 10:2515841418776264. [PMID: 29998224 PMCID: PMC6024512 DOI: 10.1177/2515841418776264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/20/2018] [Indexed: 12/03/2022] Open
Abstract
Low vision has been defined by best-corrected visual acuity worse than 20/40 in the better eye, substantial visual field loss, or substantial loss of contrast sensitivity that cannot be corrected by refraction, medical treatment, or surgery. In the United States, low vision is most commonly caused by age-related macular degeneration, glaucoma, and diabetic retinopathy. Most patients with low vision are elderly, although patients of all ages – including pediatric patients – may be affected. Low vision may decrease a patient’s quality of life substantially, leading to emotional distress and possibly depression. Low vision specialists aim to maximize the remaining vision of a patient by providing optical aids, orientation and mobility training, psychosocial support, and other methods of rehabilitation. Innovations in technology and devices offer additional options in low vision rehabilitation. Clinicians should consider referral to low vision specialists when a patient has difficulty with reading, mobility, driving, recognizing faces, or suffers from emotional distress due to low vision. Early referral may lead to improved outcomes.
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Affiliation(s)
- Parth Shah
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL, USA
| | - Stephen G Schwartz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL, USA
| | - Scott Gartner
- Miami Lighthouse for the Blind and Visually Impaired, Miami, FL, USA Lighthouse for the Blind of the Palm Beaches, West Palm Beach, FL, USA
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Sabel BA, Wang J, Cárdenas-Morales L, Faiq M, Heim C. Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine. EPMA J 2018; 9:133-160. [PMID: 29896314 PMCID: PMC5972137 DOI: 10.1007/s13167-018-0136-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/18/2018] [Indexed: 12/14/2022]
Abstract
The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.
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Affiliation(s)
- Bernhard A. Sabel
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Jiaqi Wang
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Lizbeth Cárdenas-Morales
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Muneeb Faiq
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029 India
- Department of Ophthalmology, NYU Langone Health, New York University School of Medicine, New York, NY USA
| | - Christine Heim
- Berlin Institute of Health (BIH), Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA USA
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Abstract
BACKGROUND The purpose of low-vision rehabilitation is to allow people to resume or to continue to perform daily living tasks, with reading being one of the most important. This is achieved by providing appropriate optical devices and special training in the use of residual-vision and low-vision aids, which range from simple optical magnifiers to high-magnification video magnifiers. OBJECTIVES To assess the effects of different visual reading aids for adults with low vision. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 12); MEDLINE Ovid; Embase Ovid; BIREME LILACS, OpenGrey, the ISRCTN registry; ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The date of the search was 17 January 2018. SELECTION CRITERIA This review includes randomised and quasi-randomised trials that compared any device or aid used for reading to another device or aid in people aged 16 or over with low vision as defined by the study investigators. We did not compare low-vision aids with no low-vision aid since it is obviously not possible to measure reading speed, our primary outcome, in people that cannot read ordinary print. We considered reading aids that maximise the person's visual reading capacity, for example by increasing image magnification (optical and electronic magnifiers), augmenting text contrast (coloured filters) or trying to optimise the viewing angle or gaze position (such as prisms). We have not included studies investigating reading aids that allow reading through hearing, such as talking books or screen readers, or through touch, such as Braille-based devices and we did not consider rehabilitation strategies or complex low-vision interventions. DATA COLLECTION AND ANALYSIS We used standard methods expected by Cochrane. At least two authors independently assessed trial quality and extracted data. The primary outcome of the review was reading speed in words per minute. Secondary outcomes included reading duration and acuity, ease and frequency of use, quality of life and adverse outcomes. We graded the certainty of the evidence using GRADE. MAIN RESULTS We included 11 small studies with a cross-over design (435 people overall), one study with two parallel arms (37 participants) and one study with three parallel arms (243 participants). These studies took place in the USA (7 studies), the UK (5 studies) and Canada (1 study). Age-related macular degeneration (AMD) was the most frequent cause of low vision, with 10 studies reporting 50% or more participants with the condition. Participants were aged 9 to 97 years in these studies, but most were older (the median average age across studies was 71 years). None of the studies were masked; otherwise we largely judged the studies to be at low risk of bias. All studies reported the primary outcome: results for reading speed. None of the studies measured or reported adverse outcomes.Reading speed may be higher with stand-mounted closed circuit television (CCTV) than with optical devices (stand or hand magnifiers) (low-certainty evidence, 2 studies, 92 participants). There was moderate-certainty evidence that reading duration was longer with the electronic devices and that they were easier to use. Similar results were seen for electronic devices with the camera mounted in a 'mouse'. Mixed results were seen for head-mounted devices with one study of 70 participants finding a mouse-based head-mounted device to be better than an optical device and another study of 20 participants finding optical devices better (low-certainty evidence). Low-certainty evidence from three studies (93 participants) suggested no important differences in reading speed, acuity or ease of use between stand-mounted and head-mounted electronic devices. Similarly, low-certainty evidence from one study of 100 participants suggested no important differences between a 9.7'' tablet computer and stand-mounted CCTV in reading speed, with imprecise estimates (other outcomes not reported).Low-certainty evidence showed little difference in reading speed in one study with 100 participants that added electronic portable devices to preferred optical devices. One parallel-arm study in 37 participants found low-certainty evidence of higher reading speed at one month if participants received a CCTV at the initial rehabilitation consultation instead of a standard low-vision aids prescription alone.A parallel-arm study including 243 participants with AMD found no important differences in reading speed, reading acuity and quality of life between prism spectacles and conventional spectacles. One study in 10 people with AMD found that reading speed with several overlay coloured filters was no better and possibly worse than with a clear filter (low-certainty evidence, other outcomes not reported). AUTHORS' CONCLUSIONS There is insufficient evidence supporting the use of a specific type of electronic or optical device for the most common profiles of low-vision aid users. However, there is some evidence that stand-mounted electronic devices may improve reading speeds compared with optical devices. There is less evidence to support the use of head-mounted or portable electronic devices; however, the technology of electronic devices may have improved since the studies included in this review took place, and modern portable electronic devices have desirable properties such as flexible use of magnification. There is no good evidence to support the use of filters or prism spectacles. Future research should focus on assessing sustained long-term use of each device and the effect of different training programmes on its use, combined with investigation of which patient characteristics predict performance with different devices, including some of the more costly electronic devices.
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Affiliation(s)
- Gianni Virgili
- University of FlorenceDepartment of Translational Surgery and Medicine, Eye ClinicLargo Brambilla, 3FlorenceItaly50134
| | | | - Sharon A Bentley
- Queensland University of TechnologySchool of Optometry and Vision ScienceBrisbaneAustralia
| | - Giovanni Giacomelli
- University of FlorenceDepartment of Translational Surgery and Medicine, Eye ClinicLargo Brambilla, 3FlorenceItaly50134
| | | | - Jennifer R Evans
- London School of Hygiene & Tropical MedicineCochrane Eyes and Vision, ICEHKeppel StreetLondonUKWC1E 7HT
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