Evaluating the effectiveness of a vision rehabilitation intervention using an objective and subjective measure of functional performance.
OBJECTIVE
To test the hypothesis that vision rehabilitation using optometry, occupational therapy and social work services increases patients' functional ability and to assess whether involving families in the intervention results in more successful outcomes.


METHODS
We conducted an outcome study of 97 patients new to the Vision Rehabilitation Service. Subjects were between the ages of 19 and 91 years, with a median age of 76. Their visual acuities were 20/100 or worse in the better eye, with 50% of the subjects having acuities worse than 20/200. Macular degeneration was the most prevalent diagnosis. Subjects were assigned to either an individually focused (n=48) or a family focused (n=49) intervention. The outcome measure was change in function, as assessed by speed and accuracy of performance (objective measure) and by the patients' self-reports of difficulty and dependency in performing daily activities (subjective measures). Data were collected before and after the intervention.


RESULTS
Most patients had documented improvement after rehabilitation on both objective (p=.0001) and subjective (decreased dependency, p=.01) measures of function. The sample size did not provide adequate statistical power to show differences between family focused and individually focused interventions.


CONCLUSIONS
This study documents significant improvement after vision rehabilitation for a predominantly elderly population. Patients in both family and individually focused interventions improved comparably.
Department of Ophthalmology, Vision Rehabilitation Center, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. cpmccabe@meei.harvard.edu
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P
McCabe
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F
Nason
P
P
Demers Turco
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D
Friedman
J M
JM
Seddon
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods; D009907:Optometry / Q000379:methods; D012046:Rehabilitation / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D015354:Vision, Low / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity