A holistic model of low vision care for improving vision‐related quality of life

Abstract

Vision impairment can have a significant impact on the wellbeing and quality of life of an individual. Vision rehabilitation has the potential to improve these areas; however, four in five patients with vision impairment are not being referred to the appropriate services. Barriers to on-referral include, but are not limited to: (1) misunderstandings by both practitioners and patients alike regarding which individuals with vision impairment might benefit or qualify for low vision services; (2) lack of awareness of available services; (3) unfamiliarity with practice guidelines; (4) miscommunication between practitioners and patients; (5) required patient travel or limitations in access; and (6) the perceived costs of goods and services. Further, current referral patterns do not represent a holistic patient-centric approach. Vision-related quality of life questionnaires are tools which can assist health professionals in providing optimal individualised care. This review explores current evidence regarding low vision service delivery within Australia and globally, the impact of vision impairment on activities of daily living, the instruments used for the assessment of visionrelated quality of life (VRQOL), competing priorities of individual needs in low vision services and rehabilitation, and provides recommendations for a more patient-centred model of care.

Barriers to Low-Vision Rehabilitation Services for Visually Impaired Patients in a Multidisciplinary Ophthalmology Outpatient Practice

“…Although multiple practice guidelines have emphasized the importance of referral to LVR [ 13 ], only 5–10% of patients who qualify for LVR services end up obtaining them [ 17 ]. In a review study, Luu et al [ 18 ] identified potential barriers to accessing LVR services and proposed a holistic model of low-vision care for improving vision-related quality of life. Barriers identified in this study included lack of appropriate referrals by optometrists and ophthalmologists due to unawareness of available services and lack of patient understanding about the referrals.…”

Developing consensus‐based referral criteria for low vision services in Australia

“…The benefits of shared decision making, and patients' involvement are widely reported in the literature, 43,44 suggesting that patient participation often results in improved rehabilitation of patients. 45 Patient-centred care leads to increased uptake of service, greater health literacy, improved self-care, increased satisfaction with services and improved patient-clinician relationships. 43 In addition, the importance of involving patients in decisions about their care is highlighted in professional guidelines.…”

Designing an internet‐based intervention for improving wellbeing in people with acquired vision loss: A Delphi consensus study

“…The theoretical framework of the intervention design was based on Luu et al .’s Quality of Life (QoL) model 45 . This model has four dimensions: (i) physical factors, (ii) functional factors, (iii) social factors and (iv) psychological factors.…”