Targeted Vision Function Goals and Use of Vision Resources in Ophthalmology Patients with Age-Related Macular Degeneration and Comorbid Depressive Symptoms

Abstract

Introduction This study characterizes self-reported functional vision goals and the use of low vision resources (for example, services and devices) in ophthalmology clinic patients with age-related macular degeneration (AMD) and comorbid depressive symptoms. Methods From July 2009 to February 2013, we assessed 188 consecutive patients (age 65 +; mean 84.0 years; 70.2% female) with AMD (best corrected distance acuity 20/70 or worse) enrolled in a 12-month randomized clinical trial to test the efficacy of a multi-component intervention that combined low vision optometry and home-based occupational therapy to prevent depression (Low Vision Depression Prevention Trial [VITAL]). A geriatric nurse conducted in-home assessments to measure visual acuity and contrast sensitivity, self-reported functional vision, functional vision goals that were personally important yet difficult to achieve (targeted vision function goals), and the use of low vision resources (defined as services, devices and strategies utilized by low vision patients to compensate for visual deficits). This study reports on baseline data collected prior to randomization. Results Only 9.6% of the sample had received formal low vision services. The five most common goals were newspaper reading, leisure and entertainment, computer use, personal communication, and correspondence. Participants engaged in targeted vision function goals less frequently since being diagnosed with AMD, despite using low vision resources and reporting low to moderate difficulty in using them. Discussion Few patients with AMD seen in ophthalmology clinics received low vision rehabilitation. Patients who utilized resources engaged in goals less frequently since being diagnosed with AMD. Implications for practitioners Patients with AMD are underutilizing low vision rehabilitation resources. Strategies for increasing low vision referrals are suggested.