Predictors of successful optical rehabilitation in ARM

Nova Southeastern University, Ft Lauderdale FL

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): Age-related maculopathy (ARM) is the most common cause of lost reading vision in the elderly. Difficulties with daily activities such as cooking, driving and watching television have also been documented. This condition is not curable and no treatments effective at reversing vision loss due to ARM are on the horizon. Thus, low vision rehabilitation is currently the primary mode of enhancing visual function. To date, however, there have been no large-scale, well-designed studies to examine the effects of low vision rehabilitation (primary optical rehabilitation or comprehensive low vision rehabilitation) on visual function or quality of life (QoL). Although there is much anecdotal evidence that suggests that low vision rehabilitation is useful for restoring function among persons with vision impairment, many third party payers do not cover low vision intervention services. Only recently has Medicare created a nation-wide policy for coverage for rehabilitation services. These services, however, are exclusive of optical aid prescription. The lack of published, well designed studies showing the benefits of optical rehabilitation surely contributes to policies that fail to classify low vision aids as prosthetic devices. Appropriate scientific investigations looking at low vision interventions may contribute to changing these policies. A long-term goal of this research is to develop a model of low vision rehabilitation for ARM that significantly increases the QoL for patients. The short-term goal of this proposed project is to first develop a test, or battery of tests, to determine which patients are most likely to be successful with optical low vision rehabilitation. Patients likely to be successful would then proceed directly to optical rehabilitation, whereas patients not likely to be successful would be referred for other interventions that would enhance their ability to succeed with optical magnification, such as counseling or eccentric viewing training. Development of a successful testing protocol will allow a more patient-based approach to rehabilitation, allow more accurate treatment recommendations, improve treatment efficiency, and create a greater overall success rate by initially placing patients at their correct treatment level. The outcome of this proposed research project will also provide a tool for more appropriate standardization of participants in future large scale well-designed studies examining the effects of low vision rehabilitation.