| Summary: | 碩士 === 國立東華大學 === 特殊教育學系 === 107 === Since optometric license had just been legislated on 18th Dec, 2015 in Taiwan, low-vision service, including refractive correction and low vision assessment, are now included in optometric profession. During the practice period, the researchers found that the refractive error of many low vision patients are often not well cared for, making it impossible for low vision patients to make good use of residual vision, which in turn affects the choice of other optical aids and optical prescriptions.This study aims to understand the prevalence of ophthalmologic eye diseases and visual symptoms, and to study the refractive correction efficiency of patients with low vision, and equivalent viewing power, and optical devices use for patients with low vision.
There were totally 220 participants aged from 7 to 99 (51.41±18.51) who were all referred from Taiwan Resource Portal of Assistive Technology, the Ministry of Health and Welfare. There were 120males (54.3%) and 101 females (45.7%); 42(19.0%) participants were identified as mild visual impairment, 76(34.4%) were moderate, and 103(46.6%) were severe. Five experienced and licensed optometrists were responsible for comprehensive eye examination. Statistical analyses were performed by using the SPSS 22 package (IBM), descriptive statistic, Pearson X², odds ratio, and paired sample t test.
The most common eye diseases in this study are retinal-related diseases, optic nerve-related diseases, and glaucoma. Some of participants even suffered more than two kinds of eye diseases. Unquestionably, except visual acuity decrease, eye diseases can cause a variety of visual symptoms, such as retinitis pigmentosa, which can lead to photophobia and glare disability, contrast sensitivity problems, color vision deficit, difficulty in adapting to light and dark, or visual field loss. In terms of refractive error, there were 186 (84.2%) refractive errors in this study, but only 80 (43.0%) participants wearing glasses and 106 (67.4%) participants did not wear glasses. After refractive errors correction, 139 (74.7%) participants had improved visual acuity, and 43 (61.4%) had better visual acuity after refractive correction than the original glasses. There was a statistically significant difference between before and after refractive errors correction of visual acuity (t =7.29, p<.001). In addition, even if the visual acuity is not improved after refractive error correction (N = 47, 25.3%), there are still more than 36.2% of the participants need special glasses for special functions. The visual acuity improvement leads to a decrease in the equivalent viewing power (+17.0D to +10.0D), which makes the second optical aid have more disposal options.
Incorrect or insufficient refractive errors correction are not only often found in patients with low vision, but are often overlooked by patients themselves or evaluator. This study found that a high proportion of patients with low vision were not well visually cared for. Visual acuity improvement through refractive correction might also apply lower equivalent viewing power needs, lager field of view, or more ergonomics working distance at the same time. Refractive correction not only plays an absolutely important role in vision improvement, but also positively affects the disposal of low vision optical aids.
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