Purpose To investigate abandonment rate of prescribed low vision devices for near tasks and factors associated with abandonment in a U.S. outpatient population. Methods A telephone survey was administered to 88 patients with low vision from four clinical sites approximately one year after examination and prescription of devices. Patients were surveyed on timing and frequency of use and reasons for abandonment of devices. The main outcome measure (abandonment) was defined as patient report of no use of prescribed device in the previous three months. Multivariate logistic regression was used to investigate significant vision and demographic factors related to abandonment. Results Of 119 prescribed devices, 19% (95% CI, 12–26) had not been used within the previous three months. Mean (±SD) better eye visual acuity at examination was 0.61±0.29 logMAR and mean age was 77±17 years. Mean time between device prescription and survey was 11±3 months. Device abandonment was not associated with age (p = 0.863), time since prescription (p = 0.125), visual acuity (p = 0.804), or category of magnification device (spectacle, handheld, stand, or video) (p = 0.412). There was a significant association between documented non-central visual field loss and abandonment of magnification device (p=0.046). Repeat administration of the survey resulted in the same abandonment classification in 15 of 15 patients (100%). Conclusions Abandonment rate was similar for this outpatient population to those previously reported in the U.S. veteran inpatient population and in other countries. Patients with visual field loss may be more likely to abandon prescribed devices.

Although more device recommendations are given per patient on the mobile clinic, there is no significant difference in device abandonment for patients seen on the mobile clinic versus other outpatient LVR delivery models.

Sparing or partial recovery of visual fields in hemianopic patients is frequently difficult to document. This is because when testing large field losses, the standard automated or manual visual field testing systems have limited fixation controls. Measured visual field recovery in these cases may not be real but instead may be due to an artifact such as scanning eye movement. This article illustrates a way to separate the actual visual field sparing from scanning eye movement artifact by using perimetry testing with the scanning laser ophthalmoscope (SLO). During the SLO perimetry, the examiner has a direct and magnified view of the retinal fixation locus. This direct view allows for the added ability to monitor the fixation stability during target presentation. When eye movements larger than 1 degrees are noted, the examiner can repeat the trial. During static perimetry, our SLO records the retinal position of the fixation target at the end of the stimulus presentation and corrects scanning eye movements that occur during stimulus presentation. These special features enable us to identify when the apparent sparing of the visual field is due to the artifact of scanning. To demonstrate this, we selected the records of four hemianopic patients whose fields were examined by both standard perimetry and the SLO. We then compared the clinical visual fields with the SLO perimetry fields. One of the patients had a complete homonymous hemianopia on both the clinical perimetry and the SLO perimetry. A second patient was found by the SLO to have unstable fixation during testing. The SLO perimetry revealed that the apparent spared fields seen in standard perimetry were the result of eye scanning and not an actual enlargement of the visual field. Two other patients were confirmed by the SLO findings to have valid partial recovery of the visual field, one with and one without scanning eye movements. The advantages and limitations of SLO perimetry in analyzing hemianopic field sparing are discussed.

Mobile clinic LVR is effective at expanding access to care and produces clinically meaningful outcomes comparable to those seen in other outpatient LVR delivery models.