January 27, 2020
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U.S. optometrists report barriers in low vision care

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Optometrists in the U.S. report barriers for referring patients with mild visual loss to low vision rehabilitation, according to survey results published in Optometry and Vision Science.

“This study provided an initial assessment of optometrists’ practice patterns as they relate to patients with mild vision impairment,” author Alexis G. Malkin, OD, FAAO, of the New England College of Optometry Center for Eye Care Commonwealth and Lynn Community Health Center in Boston, told Primary Care Optometry News.

“Those patients may require high adds, task lighting and/or magnification devices; there are available resources to help optometrists provide those strategies,” she said.

An anonymous survey was administered to practicing optometrists in the U.S. In total, 229 optometrists provided information on whether they completed residency, if the residency included training in low vision rehabilitation (LVR), how long they have been in practice, if they consider their practice to provide LVR, their practice volume, sex and any recent low vision continuing education within 2 years.

Responses from survey respondents were analyzed into four groups: currently in LVR practice but did not complete residency (19.3%), completed residency and work in an LVR practice (11.8%), completed residency but does not provide LVR (25.9%) and neither completed residency nor provide LVR (43%).

Twice as many optometrists who do not practice LVR responded that they never prescribe near-reading add power of 4 D or greater compared to optometrists practicing some LVR (P < .001). Among those who do not practice LVR, never prescribing add powers of 4 D or greater for patients with visual acuity of 20/25 to 20/70 was associated with having seen fewer patients with mild visual loss, the researchers found. Among those who do not practice LVR, 52% responded that they never refer patients with visual acuity of 20/25 to 20/40 for LVR (60.4% of women never refer, 34.6% of men never refer). Of those who do not practice LVR, 18.7% responded that they never refer for visual acuity of 20/50 to 20/70.

Optometrists who have graduated in the past 5 to 10 years who are not LVR practitioners have a significantly higher tendency to never prescribe high adds of 4 D or greater and fail to make LVR referrals for mild visual loss, according to the study.

“The study demonstrated that there is a sizable proportion of optometric providers who are not managing the needs of patients with mild visual loss since they never recommend high add powers for near reading and never refer for vision rehabilitation,” Malkin told PCON. “It is important for optometrists to gain a greater awareness of the functional complaints associated with mild vision loss and provide interventions to improve quality of life and reading ability.” by Erin T. Welsh

Disclosure: The authors report no relevant financial disclosures.