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Cynthia Owsley, PhD, MSPH; Gerald McGwin Jr, MS, PhD; Paul P. Lee, MD, JD; Nicole Wasserman, MPH; Karen Searcey, MSPH

Arch Ophthalmol. 2009;127(5):681-689.

Objectives  To describe characteristics of services, providers, and patients in low-vision rehabilitation entities serving adults in the United States.

Methods  Entities (excluding Veterans Affairs clinics) were identified through professional associations, Web searches, and a telephone survey to retina practices. A census obtained information on entity types, provider types, rehabilitation services available, and clientele. Surveys were administered by telephone, fax, e-mail, or mail, whichever was preferred by the respondent.

Results  A total of 1228 low-vision rehabilitation service entities were identified, with 608 surveyed (49.5% response rate). Almost half (42.7%) were private optometry practices. State agencies had the highest number of clients per week (45.0 clients per week) whereas private optometry practices had the lowest (4.1 clients per week). Most (88.0%) established rehabilitation goals, fit optical aids with basic training, and conducted eye examinations. Scanning, eccentric viewing, orientation and mobility, and advanced device training were less commonly offered (25%-50% of entities). Central vision impairment was the most common deficit (74.1% of clients), with age-related macular degeneration being the most common cause (67.1%). Among the clients, 85.9% had problems reading and 67.7% had problems driving; 44.9% had adjustment disorders. Almost 1 in 3 clients was aged 80 years or older.

Conclusion  This census for the first time characterizes usual-care low-vision rehabilitation services in the United States for nonveteran adults.

Author Affiliations: Departments of Ophthalmology (Drs Owsley and McGwin and Mss Wasserman and Searcey) and Surgery (Dr McGwin), School of Medicine, and Department of Epidemiology, School of Public Health (Dr McGwin), University of Alabama at Birmingham; and Duke University Eye Center, Durham, North Carolina (Dr Lee).

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