The Experts below are selected from a list of 204 Experts worldwide ranked by ideXlab platform
Barbara Ryan - One of the best experts on this subject based on the ideXlab platform.
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Barriers to integrating routine depression screening into community Low Vision rehabilitation Services: a mixed methods study
BMC psychiatry, 2020Co-Authors: Claire Nollett, Barbara Ryan, Rebecca Bartlett, Ryan Man, Timothy Pickles, Jennifer H. ActonAbstract:Undetected depression is common in people with Low Vision and depression screening has been recommended. However, depression screening is a complex procedure for which Low Vision practitioners need training. This study examined the integration of routine depression screening, using two questions, and referral pathways into a national Low Vision Service in Wales at 6 months folLowing practitioner training, and identified key barriers to implementation. This pre-post single group study employed a convergent mixed methods design to collect quantitative questionnaire and qualitative interview data on Low Vision practitioners’ clinical practice and perceived barriers to implementing depression screening. Forty practitioners completed questionnaires pre-, immediately post- and 6 months post-training and nine engaged in interviews 6 months post-training. Ordinal questionnaire scores were Rasch-transformed into interval-level data before linear regression analyses were performed to determine the change in scores over time and the association between perceived barriers and clinical practice. Thematic Analysis was applied to the interviews and the narrative results merged with the questionnaire findings. Before training, only one third of practitioners (n = 15) identified depression in Low Vision patients, increasing to over 90% (n = 37) at 6 months post-training, with a corresponding increase in those using validated depression screening questions from 10% (n = 4) to 80% (n = 32). Six months post-training, practitioners reported taking significantly more action in response to suspected depression (difference in means = 2.77, 95% CI 1.93 to 3.61, p
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Models of Low Vision care: past, present and future
Clinical & experimental optometry, 2014Co-Authors: Barbara RyanAbstract:Over the last 50 years, the concept of a Low Vision Service has changed considerably. It has moved away from just the optometrist or optician dispensing magnifiers, to having a large team working across the health and social/ community care sectors, with voluntary organisations often playing an important role. This paper reviews how Low Vision rehabilitation Services have evolved and what models of Low Vision care are currently available. It goes on to consider the effectiveness and accessibility of Low Vision care. Finally it explores what the future might hold for Low Vision Services, to be better prepared for the increase in the number of people with Low Vision and their evolving needs and what role(s) an optometrist might have within these anticipated developments.
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Effectiveness of the community-based Low Vision Service Wales: a long-term outcome study
The British journal of ophthalmology, 2013Co-Authors: Barbara Ryan, Catey Bunce, Jyoti Khadka, Helen CourtAbstract:Aims To evaluate the long-term effectiveness of the community-based Low Vision Service Wales (LVSW). Methods A long-term observational study of the Government-funded, community-based, Low-Vision rehabilitation Service which operates in over 180 optometry practices in Wales. Participants were recruited from the LVSW (n=342; 246 women; median age 82 years) at baseline (before the Low Vision intervention). The primary outcome measure was change in visual disability as evaluated by the seven-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). Change was measured on the same cohort at three separate time points, and comparisons were made between these: baseline–3 months; 3–18 months; baseline–18 months. Secondary outcome measures included: use of Low-Vision aids (LVAs) and satisfaction with the Service provided. Results Questionnaires were sent to 281 participants (whose visual disability had been measured at baseline and 3 months) at 18 months postintervention. Responses were received from 190 (67.6%) people; 24 were deceased. Self-reported visual disability was significantly reduced (Wilcoxon Signed Rank (WSR) test: p Conclusions This study provides evidence that the effect of the LVSW persists over a period of 18 months; disability is reduced from baseline, and use of LVAs remains high.
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The Welsh Low Vision Service - a summary
2013Co-Authors: Michael N. Charlton, David R. Jenkins, Chantel Rhodes, Tracy Martin-smith, Barbara RyanAbstract:In many areas of the UK, Low-Vision Services have not been available for all those who might benefit from them (Culham et al. 2002). Many Service models have been developed, including some based in the community. This article summarises how the Welsh Low Vision Service (WLVS) works to ensure everyone needing Low-Vision rehabilitation in Wales can access an effective Service in a local optometry practice.
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How effective is the new community-based Welsh Low Vision Service?
The British journal of ophthalmology, 2010Co-Authors: Helen Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims To determine if there was a significant difference between user-centred and clinical outcomes in people with Low Vision who attended a new community-based Low Vision Service (CLVS) or the hospital-based Low Vision Service (HBLV). Methods A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82 years) and from the HLVS (n=145; 55 male, 90 female; median age 80 years). The primary outcome measure was change (baseline to 3 months) in visual disability as evaluated by the seven-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ). Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS, respectively. Conclusion This study provides strong evidence that CLVS and HLVS are effective methods of Service proVision in Wales.
Thomas Hengist Margrain - One of the best experts on this subject based on the ideXlab platform.
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effect of rehabilitation worker input on visual function outcomes in individuals with Low Vision study protocol for a randomised controlled trial
Trials, 2016Co-Authors: Jennifer H. Acton, Helen Court, Alison Binns, Bablin Molik, Thomas Hengist MargrainAbstract:Visual Rehabilitation Officers help people with a visual impairment maintain their independence. This intervention adopts a flexible, goal-centred approach, which may include training in mobility, use of optical and non-optical aids, and performance of activities of daily living. Although Visual Rehabilitation Officers are an integral part of the Low Vision Service in the United Kingdom, evidence that they are effective is lacking. The purpose of this exploratory trial is to estimate the impact of a Visual Rehabilitation Officer on self-reported visual function, psychosocial and quality-of-life outcomes in individuals with Low Vision. In this exploratory, assessor-masked, parallel group, randomised controlled trial, participants will be allocated either to receive home visits from a Visual Rehabilitation Officer (n = 30) or to a waiting list control group (n = 30) in a 1:1 ratio. Adult volunteers with a visual impairment, who have been identified as needing rehabilitation officer input by a social worker, will take part. Those with an urgent need for a Visual Rehabilitation Officer or who have a cognitive impairment will be excluded. The primary outcome measure will be self-reported visual function (48-item Veterans Affairs Low Vision Visual Functioning Questionnaire). Secondary outcome measures will include psychological and quality-of-life metrics: the Patient Health Questionnaire (PHQ-9), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), the Adjustment to Age-related Visual Loss Scale (AVL-12), the Standardised Health-related Quality of Life Questionnaire (EQ-5D) and the UCLA Loneliness Scale. The interviewer collecting the outcomes will be masked to the group allocations. The analysis will be undertaken on a complete case and intention-to-treat basis. Analysis of covariance (ANCOVA) will be applied to folLow-up questionnaire scores, with the baseline score as a covariate. This trial is expected to provide robust effect size estimates of the intervention effect. The data will be used to design a large-scale randomised controlled trial to evaluate fully the Visual Rehabilitation Officer intervention. A rigorous evaluation of Rehabilitation Officer input is vital to direct a future Low Vision rehabilitation strategy and to help direct government resources. The trial was registered with ( ISRCTN44807874 ) on 9 March 2015.
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How effective is the new community-based Welsh Low Vision Service?
The British journal of ophthalmology, 2010Co-Authors: Helen Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims To determine if there was a significant difference between user-centred and clinical outcomes in people with Low Vision who attended a new community-based Low Vision Service (CLVS) or the hospital-based Low Vision Service (HBLV). Methods A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82 years) and from the HLVS (n=145; 55 male, 90 female; median age 80 years). The primary outcome measure was change (baseline to 3 months) in visual disability as evaluated by the seven-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ). Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS, respectively. Conclusion This study provides strong evidence that CLVS and HLVS are effective methods of Service proVision in Wales.
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HOW EFFECTIVE IS THE NEW COMMUNITY BASED WELSH Low Vision Service?
British Journal of Ophthalmology, 2010Co-Authors: Helen J Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims: To determine if there is a significant difference between user-centred and clinical outcomes in people with Low Vision who attend the new Community based Low Vision Service (CLVS) and the Hospital based Low Vision Service (HLVS). Methods: A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82) and from the HLVS (n=145; 55 male, 90 female; median age 80). The primary outcome measure was change (baseline-3 months) in visual disability as evaluated by the seven-item NEI-VFQ. Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results: There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS respectively. Conclusion: This study provides strong evidence that the community and hospital based Low Vision Services are effective methods of Service proVision in Wales.
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The newly established primary care based Welsh Low Vision Service is effective and has improved access to Low Vision Services in Wales
Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2010Co-Authors: Barbara Ryan, Helen Court, John Millington Wild, Sean White, Thomas Hengist MargrainAbstract:Aim: The aim of this study was to determine whether the new, primary care based, Welsh Low Vision Service (WLVS) improved access to Low Vision Services in Wales and was effective. Method: The impact of the WLVS was determined by measuring the number of Low Vision appointments; travel time to the nearest Service provider; and waiting times for Low Vision Services for 1 year before, and for 1 year after, its establishment. Change in self-report visual function (using the 7 item NEI-VFQ), near visual acuity, patient satisfaction and use of Low Vision aids were used to determine the effectiveness of the Service. Results: FolLowing instigation of the WLVS, the number of Low Vision assessments increased by 51.7%, the waiting time decreased from more than 6 months to less than 2 months for the majority of people, and journey time to the nearest Service provider reduced for 80% of people. Visual disability scores improved significantly (p < 0.001) by 0.79 logits and 97.42% patients found the Service helpful. Conclusions: The extension of Low Vision rehabilitation Services into primary care identified a considerable unmet burden of need as evidenced by the substantial increase in the number of Low Vision assessments provided in Wales. The new Service is effective and exhibits improved access.
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Measuring Low Vision Service outcomes: Rasch analysis of the seven-item National Eye Institute Visual Function Questionnaire.
Optometry and vision science : official publication of the American Academy of Optometry, 2008Co-Authors: Barbara Ryan, Helen Court, Thomas Hengist MargrainAbstract:Purpose. To describe a short, functional visual disability instrument capable of measuring the outcomes of a government funded country-wide multicenter LowVision Service in Wales and to determine if postal implementation might lead to response bias. Methods. Seven items from the National Eye Institute Visual Function Questionnaire (NEI VFQ), which have previously been shown to be responsive to Low Vision Service intervention, were incorporated into a postal questionnaire which was given to patients before they attended the all Wales Low Vision Service. Rasch analysis was used to describe the instrument’s psychometric properties. Results. Rasch analysis of 490 completed questionnaires showed that all seven questions worked together to form a unidimensional scale. By combining the first two response categories, category utilization and targeting was improved. There were no significant differences in the age (p 0.29), gender (p 0.75), distance binocular Visual Acuity (VA; p 0.86), living situation (p 0.34) or prevalence of macular degeneration (p 0.31) between those who returned a completed questionnaire and those who did not. Conclusions. The seven-item National Eye Institute Visual Function Questionnaire is an appropriate and precise outcome measure that is acceptable to patients and easy to administer. It measures aspects of near, reading, and distance visual disability that have been shown to be amenable to Low Vision Service proVision and, therefore, it should be highly responsive to this intervention and facilitate inter-Service assessment. We found no evidence to suggest that postal implementation results in response bias. The instrument is an appropriate measure of patient based outcomes for a large-scale, multicenter Low Vision Service. (Optom Vis Sci 2008;85:112–121)
Helen Court - One of the best experts on this subject based on the ideXlab platform.
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effect of rehabilitation worker input on visual function outcomes in individuals with Low Vision study protocol for a randomised controlled trial
Trials, 2016Co-Authors: Jennifer H. Acton, Helen Court, Alison Binns, Bablin Molik, Thomas Hengist MargrainAbstract:Visual Rehabilitation Officers help people with a visual impairment maintain their independence. This intervention adopts a flexible, goal-centred approach, which may include training in mobility, use of optical and non-optical aids, and performance of activities of daily living. Although Visual Rehabilitation Officers are an integral part of the Low Vision Service in the United Kingdom, evidence that they are effective is lacking. The purpose of this exploratory trial is to estimate the impact of a Visual Rehabilitation Officer on self-reported visual function, psychosocial and quality-of-life outcomes in individuals with Low Vision. In this exploratory, assessor-masked, parallel group, randomised controlled trial, participants will be allocated either to receive home visits from a Visual Rehabilitation Officer (n = 30) or to a waiting list control group (n = 30) in a 1:1 ratio. Adult volunteers with a visual impairment, who have been identified as needing rehabilitation officer input by a social worker, will take part. Those with an urgent need for a Visual Rehabilitation Officer or who have a cognitive impairment will be excluded. The primary outcome measure will be self-reported visual function (48-item Veterans Affairs Low Vision Visual Functioning Questionnaire). Secondary outcome measures will include psychological and quality-of-life metrics: the Patient Health Questionnaire (PHQ-9), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), the Adjustment to Age-related Visual Loss Scale (AVL-12), the Standardised Health-related Quality of Life Questionnaire (EQ-5D) and the UCLA Loneliness Scale. The interviewer collecting the outcomes will be masked to the group allocations. The analysis will be undertaken on a complete case and intention-to-treat basis. Analysis of covariance (ANCOVA) will be applied to folLow-up questionnaire scores, with the baseline score as a covariate. This trial is expected to provide robust effect size estimates of the intervention effect. The data will be used to design a large-scale randomised controlled trial to evaluate fully the Visual Rehabilitation Officer intervention. A rigorous evaluation of Rehabilitation Officer input is vital to direct a future Low Vision rehabilitation strategy and to help direct government resources. The trial was registered with ( ISRCTN44807874 ) on 9 March 2015.
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Effectiveness of the community-based Low Vision Service Wales: a long-term outcome study
The British journal of ophthalmology, 2013Co-Authors: Barbara Ryan, Catey Bunce, Jyoti Khadka, Helen CourtAbstract:Aims To evaluate the long-term effectiveness of the community-based Low Vision Service Wales (LVSW). Methods A long-term observational study of the Government-funded, community-based, Low-Vision rehabilitation Service which operates in over 180 optometry practices in Wales. Participants were recruited from the LVSW (n=342; 246 women; median age 82 years) at baseline (before the Low Vision intervention). The primary outcome measure was change in visual disability as evaluated by the seven-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). Change was measured on the same cohort at three separate time points, and comparisons were made between these: baseline–3 months; 3–18 months; baseline–18 months. Secondary outcome measures included: use of Low-Vision aids (LVAs) and satisfaction with the Service provided. Results Questionnaires were sent to 281 participants (whose visual disability had been measured at baseline and 3 months) at 18 months postintervention. Responses were received from 190 (67.6%) people; 24 were deceased. Self-reported visual disability was significantly reduced (Wilcoxon Signed Rank (WSR) test: p Conclusions This study provides evidence that the effect of the LVSW persists over a period of 18 months; disability is reduced from baseline, and use of LVAs remains high.
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How effective is the new community-based Welsh Low Vision Service?
The British journal of ophthalmology, 2010Co-Authors: Helen Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims To determine if there was a significant difference between user-centred and clinical outcomes in people with Low Vision who attended a new community-based Low Vision Service (CLVS) or the hospital-based Low Vision Service (HBLV). Methods A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82 years) and from the HLVS (n=145; 55 male, 90 female; median age 80 years). The primary outcome measure was change (baseline to 3 months) in visual disability as evaluated by the seven-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ). Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS, respectively. Conclusion This study provides strong evidence that CLVS and HLVS are effective methods of Service proVision in Wales.
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The newly established primary care based Welsh Low Vision Service is effective and has improved access to Low Vision Services in Wales
Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2010Co-Authors: Barbara Ryan, Helen Court, John Millington Wild, Sean White, Thomas Hengist MargrainAbstract:Aim: The aim of this study was to determine whether the new, primary care based, Welsh Low Vision Service (WLVS) improved access to Low Vision Services in Wales and was effective. Method: The impact of the WLVS was determined by measuring the number of Low Vision appointments; travel time to the nearest Service provider; and waiting times for Low Vision Services for 1 year before, and for 1 year after, its establishment. Change in self-report visual function (using the 7 item NEI-VFQ), near visual acuity, patient satisfaction and use of Low Vision aids were used to determine the effectiveness of the Service. Results: FolLowing instigation of the WLVS, the number of Low Vision assessments increased by 51.7%, the waiting time decreased from more than 6 months to less than 2 months for the majority of people, and journey time to the nearest Service provider reduced for 80% of people. Visual disability scores improved significantly (p < 0.001) by 0.79 logits and 97.42% patients found the Service helpful. Conclusions: The extension of Low Vision rehabilitation Services into primary care identified a considerable unmet burden of need as evidenced by the substantial increase in the number of Low Vision assessments provided in Wales. The new Service is effective and exhibits improved access.
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Measuring Low Vision Service outcomes: Rasch analysis of the seven-item National Eye Institute Visual Function Questionnaire.
Optometry and vision science : official publication of the American Academy of Optometry, 2008Co-Authors: Barbara Ryan, Helen Court, Thomas Hengist MargrainAbstract:Purpose. To describe a short, functional visual disability instrument capable of measuring the outcomes of a government funded country-wide multicenter LowVision Service in Wales and to determine if postal implementation might lead to response bias. Methods. Seven items from the National Eye Institute Visual Function Questionnaire (NEI VFQ), which have previously been shown to be responsive to Low Vision Service intervention, were incorporated into a postal questionnaire which was given to patients before they attended the all Wales Low Vision Service. Rasch analysis was used to describe the instrument’s psychometric properties. Results. Rasch analysis of 490 completed questionnaires showed that all seven questions worked together to form a unidimensional scale. By combining the first two response categories, category utilization and targeting was improved. There were no significant differences in the age (p 0.29), gender (p 0.75), distance binocular Visual Acuity (VA; p 0.86), living situation (p 0.34) or prevalence of macular degeneration (p 0.31) between those who returned a completed questionnaire and those who did not. Conclusions. The seven-item National Eye Institute Visual Function Questionnaire is an appropriate and precise outcome measure that is acceptable to patients and easy to administer. It measures aspects of near, reading, and distance visual disability that have been shown to be amenable to Low Vision Service proVision and, therefore, it should be highly responsive to this intervention and facilitate inter-Service assessment. We found no evidence to suggest that postal implementation results in response bias. The instrument is an appropriate measure of patient based outcomes for a large-scale, multicenter Low Vision Service. (Optom Vis Sci 2008;85:112–121)
Jill E. Keeffe - One of the best experts on this subject based on the ideXlab platform.
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A Global Survey of Low Vision Service ProVision
Ophthalmic epidemiology, 2011Co-Authors: Peggy Pei-chia Chiang, Patricia Mary O’connor, Richard Le Mesurier, Jill E. KeeffeAbstract:Purpose: To conduct a global survey of Low Vision Services to describe the needs, priorities, and barriers in proVision and coverage.Methods: Data were mainly derived from a survey and from some secondary sources. The survey was distributed to Vision 2020 contacts, government, and non-government organizations (NGOs) in 195 countries during 2006–2008. Themes in the survey were: epidemiology of Low Vision, policies on Low Vision, proVision of Services, human resources, barriers to Service delivery, equipment availability, and monitoring and evaluation of Service outcomes. Contradictory and/or incomplete data were returned for further clarification and verification. The Human Poverty Index was used to compare the findings from developed and developing countries.Results: Service availability was established for 178/195 countries, with 115 having some Low Vision Service. Approximately half the countries in the African and Western Pacific regions have no Services. Few countries have >10 Low Vision health profes...
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Identifying the Critical Success Factors in the Coverage of Low Vision Services Using the Classification Analysis and Regression Tree Methodology
Investigative ophthalmology & visual science, 2011Co-Authors: Peggy Pei-chia Chiang, Jing Xie, Jill E. KeeffeAbstract:Purpose To identify the critical success factors (CSF) associated with coverage of Low Vision Services. Methods Data were collected from a survey distributed to Vision 2020 contacts, government, and non-government organizations (NGOs) in 195 countries. The Classification and Regression Tree Analysis (CART) was used to identify the critical success factors of Low Vision Service coverage. Independent variables were sourced from the survey: policies, epidemiology, proVision of Services, equipment and infrastructure, barriers to Services, human resources, and monitoring and evaluation. Socioeconomic and demographic independent variables: health expenditure, population statistics, development status, and human resources in general, were sourced from the World Health Organization (WHO), World Bank, and the United Nations (UN). Results The findings identified that having >50% of children obtaining devices when prescribed (χ(2) = 44; P 3 rehabilitation workers per 10 million of population (χ(2) = 4.50; P = 0.034), higher percentage of population urbanized (χ(2) = 14.54; P = 0.002), a level of private investment (χ(2) = 14.55; P = 0.015), and being fully funded by government (χ(2) = 6.02; P = 0.014), are critical success factors associated with coverage of Low Vision Services. Conclusions This study identified the most important predictors for countries with better Low Vision coverage. The CART is a useful and suitable methodology in survey research and is a novel way to simplify a complex global public health issue in eye care.
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access and utilization of a new Low Vision rehabilitation Service
Clinical and Experimental Ophthalmology, 2008Co-Authors: Patricia M Oconnor, Lisa C Mu, Jill E. KeeffeAbstract:Background: A new Low-Vision Service linking a public hospital and a non-governmental organization was trialled in Melbourne, Australia. The factors associated with Service use were investigated. Methods: A survey was conducted with patients who used the Service, those who accepted referrals but failed to attend and those who refused a referral. Hospital and non-governmental organization representatives were also interviewed. Results: Ninety-eight eligible Vision impaired people who were referred to the new Service were recruited. Less than half (49%) folLowed through with their referral and attended the Service. Proximity and convenience were listed as the main facilitators to Service use while issues relating to transport, needing an accompanying person, lack of information about the Service and poor health were the main barriers. More than a third of the non-compliant and referral refusers spoke a language other than English. Sixty-three per cent of all participants had not previously used Low-Vision Services. Of the two main eye conditions, 81% of referred age-related macular degeneration participants (n = 26) attended the Service, but only 32% of those with diabetic retinopathy (n = 31) did so. Conclusion: As more than 60% of participants in each of the three groups had no prior use of Low-Vision Services, clearly current models of care are not reaching many who could benefit from such Services. This suggests that higher rates of referral are warranted. However, given that substantially more were referred than attended, referral alone is obviously not the answer. Access and attitudinal barriers also need to be addressed.
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Low Vision Services provided by optometrists in Victoria, Australia.
Clinical & experimental optometry, 2008Co-Authors: Hui Yin Lim, Patricia M O'connor, Jill E. KeeffeAbstract:Background: Utilisation of Low Vision Services remains Low in Australia. This study investigates Low Vision Service proVision by optometrists in Victoria and assesses the optometric human resource potential. Methods: An eight-item questionnaire was sent to 1,050 optometrists in Victoria in December 2006. It investigated key characteristics of the optometrists and their practices, the extent of their Low Vision training and Service proVision and the influence of Medicare item 10942 on Low Vision Service proVision. Results: Although only 97 replies were received they represented a significant proportion of optometrists who had undertaken postgraduate training in Low Vision. Almost 86 per cent of respondents worked in private practice settings. Although 87.6 per cent and 30.9 per cent had undergraduate and postgraduate Low Vision training, respectively, only 63.9 per cent of all respondents reported that they provided Low Vision Services. The majority who replied to the impact of Medicare item 10942 question indicated that its introduction had not changed their Low Vision proVision. Those who did not provide Low Vision Services reported referrals to other Low Vision Services as their main reason for not doing so. Conclusions: The majority of respondents represent a potential source of Low Vision Service providers. Further work needs to explore their possible involvement in Low Vision care.
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Low Vision Service proVision: a global perspective
Expert Review of Ophthalmology, 2007Co-Authors: Peggy Pc Chiang, Patricia M O'connor, Jill E. KeeffeAbstract:Changing global population demographics and effective eye care programs are tipping the scale towards an increase in nonpreventable and nontreatable Vision disorders that can lead to Low Vision. Comprehensive Low Vision Services are important to maintain or improve the quality of life of people with Low Vision. However, globally, coverage and access to Services is estimated to be 5–10%. Research regarding the effectiveness of Services has emerged in recent decades. This paper provides an overview of the effectiveness of international Low Vision models of Service delivery. It presents a history of Service evolution, an overview of the epidemiology of Low Vision, and a critique of past and present models concluding with a discussion of models of best practice.
Catey Bunce - One of the best experts on this subject based on the ideXlab platform.
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Effectiveness of the community-based Low Vision Service Wales: a long-term outcome study
The British journal of ophthalmology, 2013Co-Authors: Barbara Ryan, Catey Bunce, Jyoti Khadka, Helen CourtAbstract:Aims To evaluate the long-term effectiveness of the community-based Low Vision Service Wales (LVSW). Methods A long-term observational study of the Government-funded, community-based, Low-Vision rehabilitation Service which operates in over 180 optometry practices in Wales. Participants were recruited from the LVSW (n=342; 246 women; median age 82 years) at baseline (before the Low Vision intervention). The primary outcome measure was change in visual disability as evaluated by the seven-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). Change was measured on the same cohort at three separate time points, and comparisons were made between these: baseline–3 months; 3–18 months; baseline–18 months. Secondary outcome measures included: use of Low-Vision aids (LVAs) and satisfaction with the Service provided. Results Questionnaires were sent to 281 participants (whose visual disability had been measured at baseline and 3 months) at 18 months postintervention. Responses were received from 190 (67.6%) people; 24 were deceased. Self-reported visual disability was significantly reduced (Wilcoxon Signed Rank (WSR) test: p Conclusions This study provides evidence that the effect of the LVSW persists over a period of 18 months; disability is reduced from baseline, and use of LVAs remains high.
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how effective is Low Vision Service proVision a systematic review
Survey of Ophthalmology, 2012Co-Authors: Alison Binns, Catey Bunce, Pat Linck, Robert Harper, Jonathan Jackson, Alan Suttie, Chris Dickinson, Rhiannon Tudoredwards, Margaret Woodhouse, Jennifer LindsayAbstract:Visual impairment is a large and growing socioeconomic problem. Good evidence on rehabilitation outcomes is required to guide Service development and improve the lives of people with sight loss. Of the 478 potentially relevant articles identified, only 58 studies met our liberal inclusion criteria, and of these only 7 were randomized controlled trials. Although the literature is sufficient to confirm that rehabilitation Services result in improved clinical and functional ability outcomes, the effects on mood, Vision-related quality of life (QoL) and health-related QoL are less clear. There are some good data on the performance of particular types of intervention, but almost no useful data about outcomes in children, those of working age, and other groups. There were no reports on cost effectiveness. Overall, the number of well-designed and adequately reported studies is pitifully small; visual rehabilitation research needs higher quality research. We highlight study design and reporting considerations and suggest a future research agenda.
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A profile of Low Vision Services in England: the Low Vision Service Model Evaluation (LOVSME) project.
Eye (London England), 2011Co-Authors: Christine Dickinson, Catey Bunce, Pat Linck, Rhiannon Tudor-edwards, Alison M. Binns, Robert Harper, Jonathan Jackson, Jennifer Lindsay, Alan Suttie, James S. WolffsohnAbstract:In the UK, Low Vision rehabilitation is delivered by a wide variety of providers with different strategies being used to integrate Services from health, social care and the voluntary sector. In order to capture the current diversity of Service proVision the Low Vision Service Model Evaluation (LOVSME) project aimed to profile selected Low Vision Services using published standards for Service delivery as a guide. Seven geographically and organizationally varied Low-Vision Services across England were chosen for their diversity and all agreed to participate. A series of questionnaires and folLow-up visits were undertaken to obtain a comprehensive description of each Service, including the staff workloads and the cost of providing the Service. In this paper the strengths of each model of delivery are discussed, and examples of good practice identified. As a result of the project, an Assessment Framework tool has been developed that aims to help other Service providers evaluate different aspects of their own Service to identify any gaps in existing Service proVision, and will act as a benchmark for future Service development.
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How effective is the new community-based Welsh Low Vision Service?
The British journal of ophthalmology, 2010Co-Authors: Helen Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims To determine if there was a significant difference between user-centred and clinical outcomes in people with Low Vision who attended a new community-based Low Vision Service (CLVS) or the hospital-based Low Vision Service (HBLV). Methods A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82 years) and from the HLVS (n=145; 55 male, 90 female; median age 80 years). The primary outcome measure was change (baseline to 3 months) in visual disability as evaluated by the seven-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ). Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS, respectively. Conclusion This study provides strong evidence that CLVS and HLVS are effective methods of Service proVision in Wales.
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HOW EFFECTIVE IS THE NEW COMMUNITY BASED WELSH Low Vision Service?
British Journal of Ophthalmology, 2010Co-Authors: Helen J Court, Barbara Ryan, Catey Bunce, Thomas Hengist MargrainAbstract:Aims: To determine if there is a significant difference between user-centred and clinical outcomes in people with Low Vision who attend the new Community based Low Vision Service (CLVS) and the Hospital based Low Vision Service (HLVS). Methods: A prospective controlled before and after study. Participants were recruited from the CLVS (n=343; 96 male, 247 female; median age 82) and from the HLVS (n=145; 55 male, 90 female; median age 80). The primary outcome measure was change (baseline-3 months) in visual disability as evaluated by the seven-item NEI-VFQ. Secondary outcome measures included: use of Low Vision aids, satisfaction with the Service provided and change in near visual acuity before and after the proVision of Low Vision aids. Results: There were no significant differences in user-centred and clinical outcome measures between the CLVS and HLVS. Self-reported visual disability was significantly reduced after Low Vision Service intervention for participants in both groups by 0.46 and 0.57 logits in the HLVS and CLVS respectively. Conclusion: This study provides strong evidence that the community and hospital based Low Vision Services are effective methods of Service proVision in Wales.
