Functional Low Vision and Patient Barriers to the Uptake of a Multidisciplinary Low Vision Rehabilitation Service: A Case Study.

Aims: To estimate the prevalence, describe causes and prescription needs of functional low vision (FLV) patients, and highlight the barriers these patients encounter to the uptake of multidisciplinary low vision rehabilitation (LVR) service.

Materials and methods: A mixed study design was adopted. Quantitative analysis consisted of a retrospective and cross-sectional review of 241 (FLV) patients managed at the National Eye Centre, Kaduna. Relevant data extracted from patient records were age, sex, occupation, best-corrected visual acuity, cause of low vision and low vision aids or rehabilitation prescribed. Qualitatively, 45 FLV patients were selected by systematic random sampling. Patient barriers to the uptake of LVR services were elicited through one-on-one interviews.

Results: The prevalence of FLV was 1.02% (95% confidence interval: 0.98-1.06). The mean age was 44.45 ± 20 years. One hundred and forty two (59%) were above 40 years old and 60.5% were unemployed. Major causes of FLV were glaucoma (31%), age-related macular degeneration (24%) and retinitis pigmentosa (12%). Prescription needs were magnifiers (29%), non-optical (23%) low vision aids, telescopes (17%), multiple aids (15%) and visual rehabilitation (28%). The uptake of LVRs was 67%. The most common barriers to LVR uptake were the cost of the device (97%), lack of family support (90%) and hesitancy using the device (84%).

Conclusion: FLV was caused by progressively worsening diseases like glaucoma. The major patient barrier to assessing a multidisciplinary LVR service was financial constraint.