Rehab Program Improves Visual Function for
Low-Vision Elderly with Macular Disease
Low-vision rehabilitation aims to restore functional
ability, such as reading
May
13, 2008 - A low-vision rehabilitation program that includes a home
visit, counseling, assistive devices such as magnifiers and assignments
to practice using them appears to significantly improve vision in
elderly veterans with diseases of the macula (the area of the retina
with the sharpest vision), according to a report in the May issue of
Archives of Ophthalmology, one of the JAMA/Archives journals.
Low vision, chronic visual impairment that limits
everyday function, is one of the 10 most prevalent causes of disability
in America, the authors write as background information in the article.
In addition to affecting daily function, low vision increases the risk
of depression, injury and an overall decline in health.
Most diseases that cause low vision are not
curable.
In most cases, impaired vision cannot be corrected
and rehabilitation is the only option for regaining lost function for
the patient with low vision. Low-vision rehabilitation aims to restore
functional ability, the ability to perform tasks modulated by visual
impairment.
Joan A. Stelmack, O.D., M.P.H., of the Edward E.
Hines Jr. VA Hospital, Hines, Ill., and the University of Illinois at
Chicago College of Medicine, and colleagues studied 126 patients
(average age 78.9, 98 percent male) with low vision and diseases
affecting the macula who were eligible for Veterans Affairs (VA)
services.
Between November 2004 and November 2006,
participants were randomly assigned to one of two groups. In one,
patients received a low-vision rehabilitation program incorporating a
low-vision examination, counseling, assistive devices such as magnifiers
and five weekly sessions provided by a low-vision therapist to teach use
of the assistive devices and other adaptive strategies.
They were also assigned homework to ensure they
used the devices outside of rehabilitation. The other group was placed
on a wait list for the rehabilitation program and received no treatment
for four months, an amount of time veterans might normally wait to
receive such services.
After four months, the 64 patients in the treatment
group received an average of 10.46 hours of face-to-face low-vision
rehabilitation and experienced a significant improvement in all aspects
of visual function, including reading ability. Among the 62 patients in
the group that did not receive rehabilitation, vision and functional
ability declined over the four-month follow-up.
Significant improvements in functional ability for
mobility, visual information processing, visual motor skills and overall
ability also were seen in the treatment group; small losses in these
functions were observed in the control group, the authors write.
At least 10 hours of low-vision therapy, including
a home visit and assigned homework to encourage practice, is justified
for patients with moderate and severe vision loss from macular
diseases, they conclude.
Because the waiting-list control patients
demonstrated a decline in functional ability, low-vision services should
be offered as early as possible.
Editor's Note: Funding for this research was
provided by a Department of Veterans Affairs Rehabilitation Research and
Development grant. Funding for the low-vision devices prescribed and
dispensed to veteran participants was provided by the Department of
Veterans Affairs Prosthetics Service.
More Links to News
Archives about Age-Related Macular Degeneration
May
13, 2008 - A low-vision rehabilitation program that includes a home
visit, counseling, assistive devices such as magnifiers and assignments
to practice using them appears to significantly improve vision in
elderly veterans with diseases of the macula (the area of the retina
with the sharpest vision), according to a report in the May issue of
Archives of Ophthalmology, one of the JAMA/Archives journals.