Severe visual impairment on a rehabilitation unit: incidence and implications

Eleven of the first 191 admissions (5.8%) to a rehabilitation inpatient unit met the criteria for legal blindness; two additional patients (1%) had severe visual impairment (visual acuity above 20/200 but less than 20/70 with corrective lenses). All but three of these patients were ambulatory with a walkerette or cane when discharged to their homes. The commonest causes of blindness were macular degeneration, cataract, glaucoma, and diabetic retinopathy. Despite being older (mean age 79.7 years compared to 70.4 years for all 191 admissions) and having visual impairment superimposed on their primary rehabilitation diagnosis, these patients' lengths of stay (LOS) were not prolonged (mean LOS = 33.1 days compared to 35.9 days for all 191 admissions). It is concluded that severe visual impairment is not uncommon among rehabilitation inpatients, particularly those aged 70 or older. Health care professionals working in rehabilitation should become more familiar with, and proficient in, the basic principles and treatment techniques used in the rehabilitation of visually impaired persons.