Research published in Optometry and Vision Science found that the majority of patients who qualify for low vision services never actually receive treatment—due in large part to eye care practitioners’ (ECPs’) and patients’ perceptions.
Tell me about this.
Investigators from the University of Wisconsin gathered electronic medical records (EMRs) of 2,014 patients with visual acuity (VA) of 20/70 or worse between 2014 and 2019.
Patients were separated into two groups based on the VA in their better-seeing eye: Group 1 with a VA of 20/70 to 20/200 (91.7% of patients) and Group 2 with a VA of 20/200 to worse vision.
Note: a low vision program was established in 2017 that was significantly advertised to the participating patients.
What was the goal?
The records were reviewed to determine which patients qualifying for low vision services actually went on to receive care—and, thus, identify gaps in the referral process.
What did they find?
Investigators found that 89.8% of patients with a VA of 20/70 to 20/200 (Group 1) and 74.4% of patients with VA worse than 20/200 (Group 2) did not receive any referrals for low vision.
Prior to the establishment of the low vision program, only 2.2% of patients in Group 1 received a referral on their first visit; that percentage jumped to 8% after the program opened (odds ratio [OR], 3.88; 95% confidence interval [CI], 2.37 to 6.33; P < .001).
What else?
In Group 2, 12% of patients were referred for low vision services on their first visit prior to the program being established; post-establishment, 31.9% received referrals (OR, 3.29; 95% CI, 1.50 to 7.19; P = .002).
Overall patients in Group 2 (with VA 20/200 or worse) were more likely to be referred than in Group 1.
Anything factors to take into account?
The study authors noted that 10.3% of patients declined to receive low vision services.
Expert thoughts?
The authors stated that perception toward low vision rehabilitative services may have played a key role in referral outcomes, and that ECPs play an important role in how that perception is driven.
Take home.
Researchers concluded that, while the low vision program establishment increased the number of low vision care referrals for study patients, improvement is necessary.
“We hope to break down patients’ misconceptions of low vision services and deconstruct providers’ assumption that low vision services are a last-resort treatment for those with poor vision,” they stated. “Ultimately, we want to break societal stigmas and promote a positive perception of low vision services in the community to increase access and timely referrals.”