[Patients with late-life vision damage in occupational rehabilitation. Preliminary ophthalmologic treatment, concomitant manifestations and an illustration provided by the growing number of patients with juvenile diabetes].
The rehabilitation centre in Veitshöchheim (near Würzburg) offers different kinds of training programs for the adult visually handicapped. This is usually preceded by a long time of unemployment. Diabetes mellitus was the third most common disease at the centre and 25% of the patients with diabetes mellitus were already legally blind. In a retrospective study we looked at the medical and ophthalmological treatment and the education the 76 patients with diabetes mellitus had received before coming to the rehabilitation center. All charts from February, 87, to September, 90, were included in the study. According to the classification of visual acuities by the WHO we formed four groups (less than or equal to 1/50; 1/35-0.1; 0.125-0.3; greater than 0.3) and compared them with each other. In the groups with the lowest visual acuity the medical management of the diabetes mellitus had been much poorer than in the better groups. Related to the bad visual acuity was the higher incidence of proliferative diabetic retinopathy and the significantly lower percentage of panretinal lasercoagulations. 47% of the patients with diabetes mellitus had been trained in jobs that would not have been recommended to a potential visually disabled by an ophthalmologist or the office for labour exchange. Only in 10% of the cases could a job be maintained by the help of technical devices (including low vision aids). To ensure best medical treatment and counselling concerning the choice of an appropriate job a close team work between practising ophthalmologist, general practitioner, and the office for labour exchange is needed. Thereby the cost and psychological impact of a retraining program could hopefully be lowered.
Bothe
N
N
Universitäts-Augenklinik Würzburg.
Hetzer
R
R
Deinlein
E
E
D000328:Adult; D001766:Blindness / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery; D001786:Blood Glucose / Q000378:metabolism; D003363:Cost Control / Q000639:trends; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000534:rehabilitation*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D005858:Germany; D006801:Humans; D008028:Light Coagulation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000534:rehabilitation; D012050:Rehabilitation, Vocational / Q000191:economics; D012189:Retrospective Studies; D012682:Sensory Aids; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D001786:Blood Glucose
Spätsehgeschädigte in der beruflichen Rehabilitation. Augenärztliche Vorbehandlung, Begleiterscheinungen und Vorbildung am Beispiel der steigenden Zahl von Patienten mit juvenilem Diabetes mellitus.