New Research: Which Factors Influence Persons with Low Vision to Pursue Rehabilitation Services?

  • When is the best time for a person to pursue low vision rehabilitation services?
  • What are the factors that influence a person to make a “positive personal choice” to seek out low vision rehabilitation?
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A multi-disciplinary group of Canadian researchers has attempted to answer these questions, via a study that (a) categorizes the “predictors of awareness” of low vision rehabilitation services and (b) examines the critical factors that influence an individual’s decision to access vision rehabilitation services.

They conclude that, even among persons who make a positive personal choice, it may be best to offer rehabilitation services early in the eye disease process. In addition, males and persons who experience moderate or greater difficulty with functional daily living tasks may need additional education about the benefits of low vision services in order to make a positive personal choice to access these services.

From Ophthalmic and Physiological Optics

The research, entitled Critical success factors in awareness of and choice towards low vision rehabilitation, was published in the January 2015 edition of Ophthalmic and Physiological Optics (OPO). It is published by the College of Optometrists, the professional, scientific, and examining body for optometry in the United Kingdom.

The authors are Sarah A. Fraser, Aaron P. Johnson, Walter Wittich, and Olga Overbury, who represent the following Montréal, Canada-based institutions: McGill University; Institut Raymond-Dewar; MAB-Mackay Rehabilitation Center; Centre de recherche interdisciplinaire en réadaptation de Montréal métropolitaine; Concordia University; and Université de Montréal.

What Is Low Vision?

If your eye doctor tells you that your vision cannot be fully corrected with ordinary prescription lenses, medical treatment, or surgery, and you still have some usable vision, you have what is called low vision.

signature and writing guides

Having low vision is not the same as being blind; instead, low vision is better defined as “not enough vision to do whatever it is you need to do,” which can vary from person to person.

Low vision means that even with regular glasses, contact lenses, medicine, or surgery, you might find it challenging, or even difficult, to perform everyday tasks, such as reading, preparing meals, shopping, signing your name (signature and writing guides are pictured at left), watching television, playing card and board games, and threading a needle.

You can learn more amount low vision, including the differences between low vision and legal blindness, at Low Vision and Legal Blindness Terms and Descriptions.

About the Research

Excerpted from For Visually Impaired, Early Offer of Low Vision Rehab May Be Best, via Doctors Lounge:

Several factors, including the duration of symptoms, influence the decision to seek low vision rehabilitation services, according to a study published in the January issue of Ophthalmic and Physiological Optics. Sarah A. Fraser, Ph.D., from McGill University in Montreal, and colleagues examined critical factors indicative of an individual’s choice to access low vision rehabilitation services.

A structured interview and questionnaires were administered to 749 visually impaired individuals. Seventy-five factors were assessed to determine the [relevant low vision rehabilitation] “awareness” group: (a) positive personal choice (I knew and I went), (b) negative personal choice (I knew and did not go), or (c) lack of information (Nobody told me, and I did not know).

The researchers found that making a positive personal choice to seek rehabilitation was indicated by having a response of moderate to no difficulty on item 6 (reading signs) of the Visual Function Index 14 (VF-14); having a great deal of difficulty on this item correlated with lack of information on low vision rehabilitation.

[Editor’s note: The Visual Function Index 14 is explained below and includes an example of each question.]

Those who were more likely to have made a positive personal choice had (a) symptom duration of under nine years, (b) moderate difficulty or less on item 5 (seeing steps or curbs) of the VF-14, and (c) little difficulty or less on item 3 (reading large print) of the VF-14.

Males and those with greater difficulty on items 3 (reading large print) and 5 (seeing steps or curbs) of the VF-14 were more likely to be in the lack of information group.

What Is Low Vision Rehabilitation?

The term “vision rehabilitation” includes a wide range of professional services that can restore functioning after vision loss, just as physical therapy restores function after a stroke or other injury. Vision rehabilitation services allow people who are blind or have low vision to continue to live independently and maintain quality of life.

Vision rehabilitation services for adults who are blind or have low vision are provided by a team of specially trained professionals, including low vision therapists, vision rehabilitation therapists, and orientation and mobility specialists.

Low Vision Therapists

Certified Low Vision Therapists (CLVTs) instruct individuals in the use of remaining vision with optical devices, non-optical devices, and assistive technology.

Vision Rehabilitation Therapists

Certified Vision Rehabilitation Therapists (CVRTs) teach adaptive independent living skills, enabling adults who are blind or have low vision to confidently carry out a range of daily activities.

Orientation and Mobility Specialists

Certified Orientation and Mobility Specialists (COMS or O&Ms) teach safe and independent indoor and outdoor travel skills, including the use of a long cane, electronic travel devices, public transportation, and sighted guide, human guide, and pre-cane skills.

Explaining the Visual Function Index 14 (VF-14)

The Visual Function Index 14 (VF-14) is a brief questionnaire that is designed to measure functional visual impairment and low vision. It consists of 18 questions in 14 subject areas (items 13-18 involve driving) that address the respondent’s difficulty with a range of typical daily tasks and activities.

If the person responding answers “yes” to having difficulty with any of the listed items, he or she then indicates their level of difficulty on the following scale: (a) a little; (b) a moderate amount; (c) a great deal; or (d) unable to do the activity.

  1. Do you have any difficulty, even with glasses, reading small print, such as labels on medicine bottles, a telephone book, food labels?

  2. Do you have any difficulty, even with glasses, reading a newspaper or a book?

  3. Do you have any difficulty, even with glasses, reading a large-print book or large-print newspaper or numbers on a telephone?

  4. Do you have any difficulty, even with glasses, recognizing people when they are close to you?

  5. Do you have any difficulty, even with glasses, seeing steps, stairs or curbs?

  6. Do you have any difficulty, even with glasses, reading traffic signs, street signs, or store signs?

  7. Do you have any difficulty, even with glasses, doing fine handwork like sewing, knitting, crocheting, carpentry?

  8. Do you have any difficulty, even with glasses, writing checks or filling out forms?

  9. Do you have any difficulty, even with glasses, playing games such as bingo, dominos, card games, mahjong?

  10. Do you have any difficulty, even with glasses, taking part in sports like bowling, handball, tennis, golf?

  11. Do you have any difficulty, even with glasses, cooking?

  12. Do you have any difficulty, even with glasses, watching television?

  13. Do you currently drive a car? If Yes, go to 14. If No, go to 16.

  14. How much difficulty do you have driving during the day because of your vision?

  15. How much difficulty do you have driving at night because of your vision?

  16. Have you ever driven a car? If Yes, go to 17. If No, stop.

  17. When did you stop driving? (a) less than 6 months ago, (b) 6-12 months ago, (c) more than 12 months ago

  18. Why did you stop driving? (a) vision, (b) other illness, (c) other reason

More about the Study from Ophthalmic and Physiological Optics

From the article abstract:

Purpose: The goal of the current study was to examine the critical factors indicative of an individual’s choice to access low vision rehabilitation services.

Methods: 749 visually impaired individuals, from the Montreal Barriers Study, completed a structured interview and questionnaires (on visual function, coping, depression, satisfaction with life). Seventy-five factors from the interview and questionnaires were entered into a data-driven [analysis] in order to determine the best “predictors of awareness” group: positive personal choice (I knew and I went), negative personal choice (I knew and did not go), and lack of information (Nobody told me, and I did not know).

Results: Having a response of moderate to no difficulty on item 6 (reading signs) of the Visual Function Index 14 (VF-14) indicated that the person had made a positive personal choice to seek rehabilitation, whereas reporting a great deal of difficulty on this item was associated with a lack of information on low vision rehabilitation.

In addition to this factor, symptom duration of under nine years, moderate difficulty or less on item 5 (seeing steps or curbs) of the VF-14, and an indication of little difficulty or less on item 3 (reading large print) of the VF-14 further identified those who were more likely to have made a positive personal choice. Individuals in the lack of information group also reported greater difficulty on items 3 and 5 of the VF-14 and were more likely to be male.

Conclusion: The “duration-of-symptoms” factor suggests that, even in the positive choice group, it may be best to offer rehabilitation services early. Being male and responding “moderate difficulty or greater” to the VF-14 questions about far, medium-distance, and near situations involving vision was associated with individuals that lack information. Consequently, these individuals may need additional education about the benefits of low vision services in order to make a positive personal choice.

Additional Low Vision Information

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