Evidence-based guidelines on the referral of visually impaired persons to low vision services.
OBJECTIVE
One to two percent of the population in the Western world is visually impaired or blind. For most of these people there is no curative therapy. Therefore, the Dutch Ophthalmic Society has taken the initiative to develop an evidence-based guideline for the referral of visually impaired persons to low vision services.


METHODS
A systematic literature search was performed in the Embase (1991-2001) and Medline (1966-2003) databases. Literature was searched for definitions of visual impairment, for physician-patient communication, and for outcome of interventions for visually impaired persons. Results of the articles that were selected were summarized and rated according to the level of evidence. Other considerations such as the current organization of rehabilitation for visually impaired persons in the Netherlands were also taken into account.


RESULTS
The World Health Organization criteria were slightly adapted in order to include all people who experience problems with reading and other daily life activities due to visual impairment. A large number of recommendations were devised. Among these is that the complete diagnosis should be communicated to the patient and that a second appointment should be offered in which the diagnosis and potential treatment options are discussed again. Another recommendation is that in general visually impaired adults eligible for referral should be referred for the provision of low vision aids and that patients with complex problems or extensive rehabilitative demand should be referred to a rehabilitation center.


CONCLUSIONS
This article presents a summary of the first European evidence-based guideline for the referral of visually impaired persons.
De Boer
M R
MR
Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
Langelaan
M
M
Jansonius
N M
NM
Van Rens
G H M B
GH
D000328:Adult; D000368:Aged; D002648:Child; D004185:Disability Evaluation; D005060:Europe; D019317:Evidence-Based Medicine; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D010819:Physician's Role; D017410:Practice Guidelines as Topic / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D012955:Societies, Medical; D015354:Vision, Low / Q000175:diagnosis / Q000534:rehabilitation*; D019987:Persons with Visual Disabilities / Q000534:rehabilitation*