W. Wittich

Disparities in awareness and use of low-vision rehabilitation.

OBJECTIVEnTo describe the demographic, visual, health, and psychological variables associated with awareness and use of low-vision rehabilitation services in Montreal, Que.nnnSTUDY DESIGNnHospital-based cross-sectional study.nnnPARTICIPANTSnFour hundred forty-eight patients with best-corrected visual acuity worse than 20/70 in their better eye recruited from 4 ophthalmology departments.nnnMETHODSnPatients answered questions about their awareness and use of low-vision services. Visual acuity was recorded and patients answered the Brief Cope and Center for Epidemiologic Studies - Depression Scale questionnaires and provided information on demographics and health status. Multiple logistic regression was used to identify independent predictors of awareness and use of low-vision rehabilitation services.nnnRESULTSnA majority of patients in the sample (71%) were aware of low-vision rehabilitation. Of those who were aware, 81% reported participating in low-vision rehabilitation. Black patients, those whose first language was French, those with less severe visual acuity loss, and those who reported less acceptance on the Brief Cope questionnaire were less likely to know about low-vision services (p < 0.05). Of those who knew about low-vision services, those with less severe visual acuity loss were less likely to have participated in low-vision services (p < 0.05).nnnCONCLUSIONSnIt is important that all those who qualify for low-vision rehabilitation services can access them. Although the patients in this Montreal area study showed a high rate of awareness and use of low-vision rehabilitation, awareness and use could be improved in certain demographic populations and in those with less severe vision loss.

Beyond visual acuity: functional outcome and patient satisfaction following treatment for age-related macular degeneration

OBJECTIVEnThe success of current medical treatments for choroidal neovascular membranes secondary to age-related macular degeneration (AMD) has often been determined anatomically by change in lesion size and cessation of leakage. Measuring the functional success of treatments has most often revolved around visual acuity and has seldom encompassed patients satisfaction with treatment. Using additional objective and subjective measures to assess the outcome of treatments may provide greater insight into the visual functions that are lost, maintained, or improved during the course of treatment.nnnSTUDY DESIGNnCross-sectional study.nnnPARTICIPANTSnForty-six patients diagnosed with exudative AMD. Participants had received at least 1 photodynamic therapy (PDT) treatment at the time of testing (mean 3.0, SD 1.9).nnnMETHODSnObjective tests of visual function (Snellen, Early Treatment Diabetic Retinopathy Study, Minnesota Low-Vision Reading Test, Contrast Sensitivity, Face Acuity) and a subjective questionnaire, the Visual Function-14 (VF-14) were administered to all patients. Treating ophthalmologists completed a 3-item questionnaire.nnnRESULTSnNo objective measures of visual function correlated with patient satisfaction or with the ophthalmologists evaluation of treatment success. The VF-14 was not related to the ophthalmologists evaluation of treatment outcome. Similarly, patient satisfaction was unrelated to the ophthalmologists assessment of treatment success. A correlation was found between the VF-14 and patient satisfaction, r = 0.50, p < 0.05.nnnCONCLUSIONSnObjective measures of visual function do not necessarily reflect the viewpoint of patients regarding PDT treatment outcome. Patients and doctors differ in their interpretation of treatment success and patients overall satisfaction might best be reflected through a visual function questionnaire.

Vision Impairment by Choice: Why Do Patients Decline Macular Hole Surgery?

Introduction: Vision care providers generally assume that patients who are affected with treatable vision impairment are interested in appropriate medical options. It has been our clinical experience, however, that approximately 10% of macular hole (MH) patients opt to decline surgery, even though its beneficial effects have been well established. They, thereby, choose to remain visually impaired in the affected eye. The present study investigated visual acuity in the unaffected eye, living distance from the hospital, and the presence of other age-related medical conditions as possible factors in the decision-making process of seniors affected with MH. Method: Thirty patients (aged 59–81 years) who declined treatment between 1998 and 2003 were matched on age and gender with a group of patients who chose the surgical intervention during the same time period. Information from their medical files was used for statistical comparison. Results: The groups did not differ statistically with regard to acuity in th...

Aging Research Across Disciplines: A Student-Mentor Partnership Using the United Nations Principles for Older Persons

A grant from the Canadian Institutes of Health Research for training on communication and social interaction in healthy aging was used to support the collaboration of three students and one program mentor from various age-related backgrounds (e.g., vision, hearing, cognition, and social work) to develop a transdisciplinary and interinstitutional research program. The first project focused on integrating the United Nations Principles for Older Persons into a research agenda to gauge awareness of the principles in 100 seniors-related organizations in Ontario, Canada. The questionnaire elicited both quantitative and qualitative data related to the principles, and these data are discussed herein.