Patient Evaluation of the 7X30 Beecher Mirage Low Vision System

The authors mailed a questionnaire to 133 patients who received 7X30 Beecher Mirage Binoculars. The patients responded to questions about frequency of use, cosmetic appearance, comfort, activities for which the device was used, need for repairs, and the case of independently adjusting the device. Results indicated that 75 percent of respondents used the device weekly or more frequently. Television viewing; distant reading activities; and watching people, wildlife, and neighborhood activities were the most frequently reported uses for this device. Visual acuity, comfort of the nosepiece, and the patient's ability to independently adjust the device were significant factors affecting the respondents’ use of the binoculars.

Quality of life of low-vision patients and outcomes of low-vision rehabilitation

PURPOSE

The impact of low vision on self-reported quality of life and changes after low-vision intervention are investigated.

METHODS

Literature reports from 1990 to 2000 are reviewed.

RESULTS

Low vision is associated with increased risk for depression and decreased functional status and quality of life. Decreased visual acuity, visual field loss, and occasional blurred vision are also associated with decreased quality of life. Improvements in both functional status and quality of life occur after low-vision service delivery.

CONCLUSIONS

Self-reported quality of life is a significant outcome measure for low-vision rehabilitation. Questionnaires that are more sensitive to rehabilitation services provided as well as patient needs and goals are required to facilitate development of rehabilitation plans and to compare techniques, devices, and programs. Attention should be given to measurement properties, validity, and reliability of instruments used currently and in development of new instruments.

Veterans Affairs Multicenter Low Vision Enhancement System (LVES) study: clinical results. Report 1: effects of manual-focus LVES on visual acuity and contrast sensitivity

PURPOSE

The Department of Veterans Affairs LVES Study is a multicenter study to determine the effectiveness of the Low Vision Enhancement System (LVES) as a visual rehabilitation device. The purpose of this study was to explore the efficacy of the Beta 1 manual-focus LVES for improving visual acuity and contrast sensitivity.

METHODS

Patients whose visual acuity was 20/80 or worse in the better eye from any disease, who did not have significant visual field loss, who had previous low vision experience and were capable of working with the LVES were enrolled in a comprehensive prospective multicenter clinical evaluation. Initially, corrected spectacle visual acuities were measured using a standardized ETDRS chart. Contrast sensitivities were also measured with spectacle correction using a standardized Peli-Robson chart. These results were then compared to the acuities and contrast sensitivity obtained with the LVES at optimal magnification. Also, visual acuities were measured using an Eschenbach 3x spectacle-mounted binocular telescope, then compared to the acuities obtained using the LVES set at the lowest magnification (3x).

RESULTS

All patients who completed the study demonstrated an improvement in visual acuity, with a median improvement of six lines of Snellen equivalent acuity using the LVES. Improvement in visual acuity was the same in both ARMD and non-ARMD causes of vision loss. Mean contrast sensitivity improved in 52 of 58 patients tested, with a mean improvement of 0.49 log units.

CONCLUSION

The LVES significantly improves both visual acuity and contrast sensitivity in visually impaired patients who fall within the study criteria. Up to 10-fold improvement in visual acuity and up to 1.80 log units improvement in contrast sensitivity were noted in the study group when the LVES was used.

Measuring the effectiveness of bioptic telescopes for persons with central vision loss

PURPOSE

1) To evaluate a vision rehabilitation program aimed at training persons with central vision loss to use a bioptic telescope for improving life skills, including driving and 2) to compare the outcomes of subjects who are given bioptic telescopes and training, with subjects who are prescribed telescopic lenses without training.

METHODS

Twenty-five subjects ranging in age from 16 to 78 years were included in the study. Each subject was randomized to one of three groups: Group 1 received bioptic telescopes and training during the first approximately 3-month-long period of the approximately 6-month-long study; Group 2 received lenses and training during the second approximately 3-month-long period of the study; and Group 3 received the lenses for approximately 3 months without any training. An assessment battery consisting of clinical vision tests, functional tasks evaluated by an orientation and mobility specialist, driving skills evaluated by a kinesiotherapist specializing in driver's education, and psychophysical measures was administered to Groups 1 and 2 at baseline, and at approximately 3 and 6 months, and to Group 3 at baseline and at approximately 3 months. The tasks were categorized into 6 major functional categories: Recognition, Mobility, Peripheral Identification, Scanning, Tracking, and Visual Memory. Training consisted of 5 weeks of laboratory-based training focusing on skills within these 6 categories, and 8 weeks of on-road driving training.

RESULTS

There was significant improvement in all task categories with use of the telescopes. There was improvement in all task groups with training, though a significant difference between the trained and untrained groups existed only in the Recognition, Peripheral Identification, and Scanning Categories, but not in Mobility, Tracking, or Visual Memory. When the tasks involving driving-related skills were analyzed separately, training also had a significant effect.

CONCLUSION

There was significant improvement in visual skills with the use of a bioptic telescope. This improvement was greater with training in the use of the lenses in a number of visual skills categories including driving-related skills.

Veterans' use of low vision devices for reading

BACKGROUND

This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through the Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs.

METHODS

Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Because most devices were used for reading, an exploratory data analysis was completed to further investigate successful use of LVDs for this task. Relationships of 21 variables with a definition of highly successful use, use and nonuse of LVDs for reading were evaluated.

RESULTS

Only visual acuity provided a statistically significant predictor of use of LVDs for reading. LVDs in the lowest visual acuity grouping tend to be used either highly successfully, or fall into the nonuse category. The highly successful LVDs are primarily video magnifiers; the nonused LVDs tended to be spectacle magnifiers.

CONCLUSIONS

This population is using devices extensively for reading, reporting frequencies of use of several times per day.

National survey of the impact of low vision device use among veterans

BACKGROUND

This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through he Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs.

METHODS

Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Factor analyses were used to describe prescription and use patterns.

RESULTS

Most (85.4%) of the devices were still in use. Having a helper in the home was a demographic variable related to continued use. Neither age, acuity, nor etiology were related to continued use. Strong prescription and use patterns emerged. Most veterans reported receiving > 20 h of training and > 20 h of practice in the use of their LVDs.

CONCLUSIONS

Most veterans who receive LVDs through the service delivery system of the Department of Veterans Affairs appear to use them for a wide variety of daily tasks and reported that they obtain a great deal of benefit from their use.

Saccadic eye movements as a measure of the effect of low vision rehabilitation on reading rate

We assessed saccadic eye movements and reading capabilities in individuals with macular disease by a masked clinical study to determine whether changes in saccadic frequency were correlated to changes in reading rates or number of errors for a reading task. We used a measure of eye movement characteristics in the form of a saccadic frequency score (SFS). Twelve subjects with macular disease were tested before and after an intense 6-week inpatient vision rehabilitation program. The mean age was 70.9 years (63 to 77 years). Mean visual acuity was 10/100 (10/40 to 10/200). Mean reading rates at entry and discharge were 8.5 words/min and 20.9 words/min, respectively (p = 0.02). SFS improved from 2.709 to 2.022 (p = 0.07). Reading errors improved from 5.60 to 4.00 (p = 0.03). Reading rates and SFS's were highly inversely correlated both pre- and post-treatment (Pearson r = -0.892 and -0.896, respectively). SFS and the number of reading errors were highly correlated with both pre- and post-treatment as well (Pearson r = 0.782 and 0.601, respectively). Interestingly the data appeared to cluster into two groups, one showing improvement and the other showing none. Cluster analysis revealed a strong association among reading rate, saccade scores, and reading errors. Membership in the two clusters is consistent pre- and post-rehabilitation in all but one case. Clustering is most evident for reading rate and reading errors and less so for saccade scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Reading performance of geriatric patients post exudative maculopathy

This study was performed to evaluate any differences in reading speed and duration of comfortable reading speed in geriatric patients with post disciform stage exudative age-related macular degeneration (ARMD) or ocular histoplasmosis. Reading speed and duration with CCTV, illuminated stand magnifier, and spectacle lenses were compared for 37 patients in the Low Vision Program at the Central Blind Rehabilitation Center. Results indicate significantly faster reading speed with CCTV and spectacle lenses as compared to illuminated stand magnifiers. The difference between reading speeds measured with spectacle reading glasses and CCTVs was borderline significant. Patients read significantly longer with CCTVs than with spectacle lenses or illuminated stand magnifiers. No significant difference was found comparing spectacle lenses or illuminated stand magnifiers with regard to reading duration.

Clinical use of the Pepper Visual Skills for Reading Test in low vision rehabilitation

The Pepper Visual Skills for Reading Test (VSRT) is an assessment instrument designed by Whittaker et al. to evaluate the reading skills of patients with macular degeneration who were able to read to their satisfaction before their vision loss. The VSRT was administered to 10 patients with macular degeneration and central scotomas from the Low Vision Optometry Program at the Hines Veterans Administration Hospital Central Blind Rehabilitation Center and the Visual Impairment Center to Optimize Remaining Sight (VICTORS) at Westside Veterans Administration Medical Center, Chicago. Reading skills were measured before and after a low vision treatment program. Results indicate that this test may be useful in designing low vision training programs, evaluating the progress of individual patients receiving low vision services, and evaluating low vision programs designed to rehabilitate those with reading difficulty.