Low Vision Care – Out of Site. Out of Mind

ABSTRACT

Purpose

To estimate the number of patients accessing eye care with low vision (LV) at a large multi-site ophthalmology institute who utilize low vision rehabilitation (LVR) services and compare their characteristics to individuals who do not utilize LVR services.

Methods

This is an electronic health record-based retrospective chart analysis. Patients with LV were identified as having at least one encounter in 2014 where the best visual acuity (VA) in the better-seeing eye was worse than 20/40. Utilization of LVR services across 9 clinic locations was evaluated. Logistic regression analyses were used to examine patient characteristics associated with service utilization.

Results

Of the 7,752 LV patients, 1,585 (20%) utilized LVR services over the 17-month period. Those utilizing LVR were more likely to have VA between 20/60 and 20/200 or between 20/200 and 20/500 than non-users (P < .001). The highest LVR utilization rates were in patients evaluated in retina (23%), glaucoma (22%), and neuro-ophthalmology (18%) subspecialties. Patients seen at clinic locations with onsite LVR services available were more likely to utilize services (odds ratio [OR] ranged from 2.69 [95% confidence interval, 95% CI: 1.63–4.44] to 4.94 [95% CI: 2.12–11.48] across location categories), as were patients who had evidence of fluctuations in VA measurements (OR = 3.33, 95% CI: 2.89–3.84).

Conclusions

Patients are more likely to utilize services when VA is moderately to severely impaired, VA fluctuations are present, or when LVR services are provided at the same location where other ophthalmic services are obtained. These estimates are important for developing interventions aimed at improving LVR utilization.

KEYWORDS:

• Low vision rehabilitation
• utilization

Acknowledgments

We would like to acknowledge Kerry E. Smith, Center for Clinical Data Analysis, the Johns Hopkins Institute for Clinical and Translational Research for their support for the study.

Conflict of interest

None of the authors have any proprietary interests or conflicts of interest related to this submission.

Additional information

Funding

The work was supported by Reader’s Digest Partners for Sight Foundation.