Jamie C Brown1, Judith E Goldstein2, Tiffany L Chan3, Robert Massof3, Pradeep Ramulu1. 1. Wilmer Eye Institute, The Johns Hopkins Medical Institute, Baltimore, Maryland. 2. The Lions Vision Research and Rehabilitation Center, The Johns Hopkins Medical Institute, Baltimore, Maryland. Electronic address: jgolds28@jhmi.edu. 3. The Lions Vision Research and Rehabilitation Center, The Johns Hopkins Medical Institute, Baltimore, Maryland.
Abstract
PURPOSE: To characterize functional complaints of new low-vision rehabilitation patients. DESIGN: Prospective observational study. PARTICIPANTS: The Low Vision Rehabilitation Outcomes Study recruited 819 patients between 2008 and 2011 from 28 clinical centers in the United States. METHODS: New patients referred for low-vision rehabilitation were asked, "What are your chief complaints about your vision?" before their appointment. Full patient statements were transcribed as free text. Two methods assessed whether statements indicated difficulty in each of 13 functional categories: (1) assessment by 2 masked clinicians reading the statement, and (2) a computerized search of the text for specific words or word fragments. Logistic regression models were used to predict the influence of age, gender, and visual acuity on the likelihood of reporting a complaint in each functional category. MAIN OUTCOME MEASURES: Prevalence and risk factors for patient concerns within various functional categories. RESULTS: Reading was the most common functional complaint (66.4% of patients). Other functional difficulties expressed by at least 10% of patients included driving (27.8%), using visual assistive equipment (17.5%), mobility (16.3%), performing in-home activities (15.1%), lighting and glare (11.7%), and facial recognition and social interactions (10.3%). Good agreement was noted between the masked clinician graders and the computerized algorithm for categorization of functional complaints (median κ of 0.84 across the 13 categories). Multivariate logistic regression models demonstrated that the likelihood of reading difficulties increased mildly with age (odds ratio, 1.4 per 10-year increment in age; 95% confidence interval, 1.3-1.6), but did not differ with visual acuity (P = 0.09). Additionally, men were more likely to report driving difficulties and difficulties related to lighting, whereas women were more likely to report difficulty with either in-home activities or facial recognition or social interaction (P<0.05 for all). Mobility concerns, defined as walking difficulty and out-of-home activities, showed no relationship to gender, age, or visual acuity. CONCLUSIONS: Reading was the most commonly reported difficulty, regardless of the patient's diagnosis. Neither visual acuity nor gender were predictive of reading concerns, although, age showed a small effect. Addressing reading rehabilitation should be a cornerstone of low-vision therapy.
PURPOSE: To characterize functional complaints of new low-vision rehabilitation patients. DESIGN: Prospective observational study. PARTICIPANTS: The Low Vision Rehabilitation Outcomes Study recruited 819 patients between 2008 and 2011 from 28 clinical centers in the United States. METHODS: New patients referred for low-vision rehabilitation were asked, "What are your chief complaints about your vision?" before their appointment. Full patient statements were transcribed as free text. Two methods assessed whether statements indicated difficulty in each of 13 functional categories: (1) assessment by 2 masked clinicians reading the statement, and (2) a computerized search of the text for specific words or word fragments. Logistic regression models were used to predict the influence of age, gender, and visual acuity on the likelihood of reporting a complaint in each functional category. MAIN OUTCOME MEASURES: Prevalence and risk factors for patient concerns within various functional categories. RESULTS: Reading was the most common functional complaint (66.4% of patients). Other functional difficulties expressed by at least 10% of patients included driving (27.8%), using visual assistive equipment (17.5%), mobility (16.3%), performing in-home activities (15.1%), lighting and glare (11.7%), and facial recognition and social interactions (10.3%). Good agreement was noted between the masked clinician graders and the computerized algorithm for categorization of functional complaints (median κ of 0.84 across the 13 categories). Multivariate logistic regression models demonstrated that the likelihood of reading difficulties increased mildly with age (odds ratio, 1.4 per 10-year increment in age; 95% confidence interval, 1.3-1.6), but did not differ with visual acuity (P = 0.09). Additionally, men were more likely to report driving difficulties and difficulties related to lighting, whereas women were more likely to report difficulty with either in-home activities or facial recognition or social interaction (P<0.05 for all). Mobility concerns, defined as walking difficulty and out-of-home activities, showed no relationship to gender, age, or visual acuity. CONCLUSIONS: Reading was the most commonly reported difficulty, regardless of the patient's diagnosis. Neither visual acuity nor gender were predictive of reading concerns, although, age showed a small effect. Addressing reading rehabilitation should be a cornerstone of low-vision therapy.
Authors: Frank G Holz; Srinivas R Sadda; Brandon Busbee; Emily Y Chew; Paul Mitchell; Adnan Tufail; Christopher Brittain; Daniela Ferrara; Sarah Gray; Lee Honigberg; Jillian Martin; Barbara Tong; Jason S Ehrlich; Neil M Bressler Journal: JAMA Ophthalmol Date: 2018-06-01 Impact factor: 7.389
Authors: Priya M Mathews; Gary S Rubin; Michael McCloskey; Sherveen Salek; Pradeep Y Ramulu Journal: Invest Ophthalmol Vis Sci Date: 2015-03-03 Impact factor: 4.799
Authors: Angeline M Nguyen; Suzanne W van Landingham; Robert W Massof; Gary S Rubin; Pradeep Y Ramulu Journal: Invest Ophthalmol Vis Sci Date: 2014-07-22 Impact factor: 4.799
Authors: Ahmed M Sayed; Mostafa Abdel-Mottaleb; Rashed Kashem; Vatookarn Roongpoovapatr; Amr Elsawy; Mohamed Abdel-Mottaleb; Richard K Parrish; Mohamed Abou Shousha Journal: Am J Ophthalmol Date: 2019-10-15 Impact factor: 5.258