[At home utilization of low-vision aids by the visually impaired]

The increase of life expectancy causes a rising number of partially sighted. Therefore our Department of Ophthalmology has founded a laboratory for partially sighted 7 years ago. To optimize patient care, the results were now reinvestigated.

For the present study, 125 patients were selected by geographical aspects (home nearby clinic) from the lab's pool. After a 3 month minimum period of using the low-vision aid (LVA) patients were visited at their homes. Near visual acuity, distance visual acuity, magnification, and contrast sensitivity were studied under domestic and optimized conditions of illumination. Patients were interviewed in detail to investigate their habits of LVA use.

An overall number of 94 patients (66 females and 28 males) could be evaluated. The most patients were between 80 and 84 years old. Vision impairment was attributable mostly to macular degeneration (55%) and diabetic retinopathy (21%). Visual acuity and contrast sensitivity decreased during the period of investigation. 79% of the patients had a unsatisfactory domestic illumination (< 1000 lx). Only 23% of the patients used their LVA at a fixed location. Main field of using LVA was reading (68%). The LVA were rarely used for writing and other fields of practice. 76% of LVA were used daily, more than 50% for a maximal duration of 1 h/d. Magnifiers were preferably used for short-time activities. Closed circuit television systems (CCTV) had a very good acceptance. Telescopes were characterized by a very high rate of rejection. The number of non-used LVA was approximately a fifth. Reasons were decreased visual acuity, impractical handling, missing introduction by delivering optician (54%) as well as unsatisfactory illumination.

Improved patient care can be obtained by regular check-up visits (6 months), enhanced illumination, low-vision training, home visits, multi-disciplinary care and modified prescription of LVA.