Perspectives on low vision service in Canada: a pilot study.
BACKGROUND
A review of the literature and current practice patterns for vision rehabilitation care in Canada provide a basis for this pilot study, which was undertaken to explore related issues from the perspectives of older adults and low vision service providers. The pilot study was overseen by a number of collaborators whose names are listed at the end of this paper.


METHODS
Thirty people aged 60 years or older who had vision impairments and were clients of the Canadian National Institute for the Blind were surveyed by telephone. Ophthalmologists, optometrists, and opticians completed a mail questionnaire. Vision rehabilitation practitioners and nurses, ophthalmic technicians, and service providers for low vision technical aids were surveyed by e-mail.


RESULTS
Ophthalmologists are a primary source of referrals to low vision services, but low functional vision does not always trigger such referrals, nor are referrals always timely. Optometrists are primary providers of low vision services, including dispensing of low vision aids, but such aids are expensive, and inadequate training in their use may contribute to noncompliance. Costs associated with providing low vision assessments and services are higher than compensation to vision service providers, whose capacity to meet increasing demand is limited. In addition, there are disparities between rural and urban areas and among provinces in the availability of, and funding for, services and aids.


CONCLUSIONS
On the basis of the findings, an emergent theory is proposed on the consequences resulting from lack of planning and standards for vision rehabilitation care. The implications of this study form the basis for further research.
Gold
Deborah
D
Canadian National Institute for the Blind, Toronto, ON. deborah.gold@cnib.ca
Zuvela
Biljana
B
Hodge
William G
WG
D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003695:Delivery of Health Care / Q000592:standards*; D006282:Health Personnel / Q000592:standards*; D006302:Health Services Research / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009885:Ophthalmology; D009907:Optometry; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000534:rehabilitation*