Low Vision Rehabilitation/Principles of rehabilitation & barriers to access

This topic looks at how to manage patients with low vision and why they do or do not access appropriate services. There is an overall enquiry question you will need to answer, and scenarios with supporting information to help guide your understanding and formulate your answer. You should spend around 4-6 hours with this topic.

Enquiry

Why do people with low vision not access, or have difficulty accessing services that could help them?
Use the scenario you already know (Mrs Thelma Scope) in addition to the resources below to formulate your own response to this question. You are looking for reasons as well as proposed solutions. Share your findings within a multidisciplinary team, collate what your team things are the best 3 responses and formulate a single response for the team.

This enquiry is intended to guide your understanding of the the value of low vision rehabilitation to expose you to the reasons why patients do not access low vision services, whether intentional or unintentional.

Scenario

1. Thelma Scope's low vision

Principles of low vision rehabilitation

Through your patient, Mrs Thelma Scope, you have come to understand what the difference is between low vision, vision impairment and legal blindness. You have also considered the psychosocial and financial/economic impact of vision impairment.
The next task is to consider the key elements are of a low vision assessment and the principles of low vision rehabilitation. Once again, Thelma Scope's case study will assist your understanding of these concepts.

Task

Watch the playlist related to Principles of Vision Rehabilitation.

Read the following articles:

• Markowitz SN. Principles of modern low vision rehabilitation. Can J Ophthalmol 2006;41:289–312
• Vukicevic M. Functional vision assessment. Aust Orth J 2008; 40(2).

These readings are essential to your understanding of the principles of low vision rehabilitation.

Service models and barriers to access

Task

Working with the members of your group, read the following two articles and answer the questions below.

• Matti AI et. al. Access to low-vision rehabilitation services: barriers and enablers. Clin Exp Optom. 2011; 94: 2: 181–186
• O’Connor PM et. al. Access and utilization of a new low-vision rehabilitation service. Clin Exp Ophthal. 2008; 36: 547–552

Questions - Service models and barriers to access

What is the definition of “low-vision” according to O’Connor? How does Matti define “low-vision rehabilitation”? Does this differ from what your perception of it had been? Explain. How many patients access low-vision services in Australia and what factors stop them from doing so? Describe the differences in the provision of low vision services across Australia and across different agencies, as indicated in the article by Matti. Briefly describe the referral process/patient journey as described by Matti. What criticisms/comments do you have about this process? How could it be improved? In the studies by Matti and O’Connor what are the main barriers that inhibit low-vision patients from accessing services? What do you think could be done to help improve access to low-vision rehabilitation services in Australia?

Resources and help

• Focus on Low Vision is an excellent publication by the Centre for Eye Research which will be useful to complete all the topics in this enquiry. You should refer to it often.