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Andrew R. Webster - One of the best experts on this subject based on the ideXlab platform.
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benefit of an electronic head mounted low Vision Aid
Ophthalmic and Physiological Optics, 2019Co-Authors: Michael D. Crossland, Sandra D. Starke, Piotr Imielski, James S. Wolffsohn, Andrew R. WebsterAbstract:PURPOSE To evaluate the efficacy of electronic head-mounted low Vision Aid (e-LVA) SightPlus (GiveVision, UK, giveVision.net) and to determine which people with low Vision would see themselves likely using an e-LVA like this. METHODS Sixty participants with low Vision aged 18 to 93 used SightPlus during an in-clinic study session based on a mixed methods design. Visual acuity (ETDRS), contrast sensitivity (Pelli-Robson) and reading performance (MNREAD) were measured binocularly at baseline (no device), with the device in 'normal' mode (zoom only), and with preferred enhanced mode (zoom and one of four digital image enhancements). At the end of the session, a short questionnaire recorded willingness to use an e-LVA like SightPlus, potential use cases, positive/negative comments and adverse effects. RESULTS Binocular distance visual acuity improved significantly by 0.63 logMAR on average (p < 0.0001) to 0.20 logMAR. Contrast sensitivity improved significantly by 0.22 log units (p < 0.0001) to 1.21 log units with zoom only and by 0.40 log units to 1.37 log units with zoom and preferred image enhancement. Reading performance improved significantly for near visual acuity and critical print size (p < 0.015), although reading speed significantly decreased (p < 0.0001). Nearly half (47%) of the participants indicated they would use an e-LVA like SightPlus, especially for teleVision, reading and entertainment (e.g. theatre). Multivariate logistic regression showed that proportion of lifetime affected by sight loss, baseline contrast sensitivity and use of electronic LVAs explained 41% of the variation in willingness to use. CONCLUSIONS SightPlus improves visual function in people with low Vision and would be used in its current form by one half of the people who tried it. Adverse effects were infrequent and resolved when the device was removed. Future work should focus on comparing e-LVAs through repeatable real-world tasks and impact on quality of life.
David Mcleod - One of the best experts on this subject based on the ideXlab platform.
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randomised controlled trial of an integrated versus an optometric low Vision rehabilitation service for patients with age related macular degeneration study design and methodology
Ophthalmic and Physiological Optics, 2001Co-Authors: W Russell, Robert Harper, Barnaby C Reeves, Heather Waterman, David B Henson, David McleodAbstract:A number of studies have measured the outcomes of low Vision care but these have usually been longitudinal case series, thus constituting very low quality of evidence for effectiveness. To date, there have been no randomised controlled trials (RCTs) which have evaluated the effectiveness and cost effectiveness of different models of care in low Vision. The size of the low Vision population and the paucity of systematic evaluation have created a pressing need for evidence about cost-effectiveness in order to inform service developments for low Vision rehabilitation. This paper describes the study design and methodology of a three-arm RCT currently under way in Manchester. The baseline population recruited is also described. A traditional hospital-based optometric service is being compared with an integrated service (comprising the addition of community-based rehabilitation officer input) and with more generic community input (which is non-integrated and is not Vision specific). A wide range of outcome measures are being assessed at recruitment and 12 months post-intervention, including low Vision specific and generic quality of life measures, patterns of low Vision Aid use, and task performance. The rationale for the trial is discussed and the main study outcomes are described.
Michael D. Crossland - One of the best experts on this subject based on the ideXlab platform.
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benefit of an electronic head mounted low Vision Aid
Ophthalmic and Physiological Optics, 2019Co-Authors: Michael D. Crossland, Sandra D. Starke, Piotr Imielski, James S. Wolffsohn, Andrew R. WebsterAbstract:PURPOSE To evaluate the efficacy of electronic head-mounted low Vision Aid (e-LVA) SightPlus (GiveVision, UK, giveVision.net) and to determine which people with low Vision would see themselves likely using an e-LVA like this. METHODS Sixty participants with low Vision aged 18 to 93 used SightPlus during an in-clinic study session based on a mixed methods design. Visual acuity (ETDRS), contrast sensitivity (Pelli-Robson) and reading performance (MNREAD) were measured binocularly at baseline (no device), with the device in 'normal' mode (zoom only), and with preferred enhanced mode (zoom and one of four digital image enhancements). At the end of the session, a short questionnaire recorded willingness to use an e-LVA like SightPlus, potential use cases, positive/negative comments and adverse effects. RESULTS Binocular distance visual acuity improved significantly by 0.63 logMAR on average (p < 0.0001) to 0.20 logMAR. Contrast sensitivity improved significantly by 0.22 log units (p < 0.0001) to 1.21 log units with zoom only and by 0.40 log units to 1.37 log units with zoom and preferred image enhancement. Reading performance improved significantly for near visual acuity and critical print size (p < 0.015), although reading speed significantly decreased (p < 0.0001). Nearly half (47%) of the participants indicated they would use an e-LVA like SightPlus, especially for teleVision, reading and entertainment (e.g. theatre). Multivariate logistic regression showed that proportion of lifetime affected by sight loss, baseline contrast sensitivity and use of electronic LVAs explained 41% of the variation in willingness to use. CONCLUSIONS SightPlus improves visual function in people with low Vision and would be used in its current form by one half of the people who tried it. Adverse effects were infrequent and resolved when the device was removed. Future work should focus on comparing e-LVAs through repeatable real-world tasks and impact on quality of life.
Walter Wittich - One of the best experts on this subject based on the ideXlab platform.
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Measuring changes in device use of a head-mounted low Vision Aid after personalised telerehabilitation: protocol for a feasibility study
BMJ open, 2019Co-Authors: Marie-céline Lorenzini, Walter WittichAbstract:Introduction A recent trend in low Vision (LV) has been towards the use of portable head-mounted displays (HMDs) to enhance residual Vision. The decision process around the (non-)use of such devices have been identified as multifactorial. Among important barriers identified in the context of magnifying LV Aids were transportation issues and insufficient training. In recent years, telerehabilitation has become of growing interest in healthcare because it allows individuals to remain at home while receiving rehabilitation services. A recent pilot study indicated encouraging outcomes; however, very few applications of telerehabilitation for LV have been tested systematically. Methods and analysis To help guide evidence-based practice recommendations for this modality, we will carry out a feasibility study to assess the recruitment, retention, accessibility and acceptability of an eventual fully randomised trial of telerehabilitation for people with LV using HMDs. We will recruit 60 participants aged 18+ years among prospective eSight Eyewear owners, randomised 1:1 into two parallel groups. The active intervention will be the telerehabilitation operated by a LV therapist; the control arm will be the current self-training standard provided by the device vendor. The primary feasibility outcome measures will be: time to recruit participants, loss to follow-up, accessibility and acceptability of the telerehabilitation (satisfaction of the users and LV therapist). Exploratory outcomes will be the impact of telerehabilitation on eSight Eyewear use behaviour (discontinuance rate), and validated measures of assistive-technology-related quality of life. Ethics and dissemination The study was approved by the Ethics Review Board of the Centre de Recherche Interdisciplinaire en Readaptation de Montreal metropolitain (CRIR# 1286–1217). Dissemination is planned via local, national and international healthcare conferences and peer-reviewed journal publications.
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Factors related to the use of magnifying low Vision Aids: a scoping review
2019Co-Authors: Marie-céline Lorenzini, Walter WittichAbstract:Background: The decision process around the (non-)use of assistive technologies is multifactorial. Its determinants have previously been classified into personal, device-related, environmental and interventional categories. Whether these categories specifically apply to the use of magnifying low Vision Aids was explored here, using this classification. Methods: A scoping review (Embase, MedLine, Cochrane, ERIC ProQuest, CINAHL, NICE Evidence, Trip Database) was conducted to summarize the extent, range, and nature of research regarding the categories that are associated with low Vision Aid (non-)usage. A combination of key words and MeSH terms was used based upon the identified core concepts of the research question: low Vision, assistive technology and adherence. Inter-rater reliability for the selection process was considered acceptable (kappa = 0.87). A combination of numerical and qualitative description of 21 studies were performed. Results: Studies report high variability rates of people possessing devices but not using them (range: 2.3–50%, M = 25%, SD = 14%). We were able to replicate the conceptual structure of the four categories that had previsouly been identified with other devices. Age, diagnosis and visual acuity demonstrated contradictory influence on optical low Vision Aids usage. Change in Vision, appropriate environment, consistent training, patient’s motivation and awareness of low Vision services, emerged as contributor factors of use. Conclusion: This review provides evidence that clinicians should not rely on traditionally available clinical factors to predict device use behavior. Worsening Vision and low motivation appear as predictors of device nonuse and should be considered from the clinician's point of view. Education about potential facilitating factors and promotion of innovative care are strongly encouraged.Implications for rehabilitationInvestigation of the factors predicting (non-)use of magnifying low Vision Aids is important. These findings can help clinicians to identify patients with a higher risk of non-use of low Vision Aids as well as provide evidence for interventions designed to improve use.Knowledge of low Vision services and types of magnifying low Vision Aids available to patients appears as fundamental in the process of device use and needs to be supported by more educational programs.Psychological factors predicting (non-)use of low Vision Aids need to be considered in the choice of rehabilitation and follow-up strategies by a multidisciplinary team, focusing more in mechanisms of adaptation and patient’s motivation.Training intensity should play a central role in the development of innovative intervention programs to reduce device abandonment. Investigation of the factors predicting (non-)use of magnifying low Vision Aids is important. These findings can help clinicians to identify patients with a higher risk of non-use of low Vision Aids as well as provide evidence for interventions designed to improve use. Knowledge of low Vision services and types of magnifying low Vision Aids available to patients appears as fundamental in the process of device use and needs to be supported by more educational programs. Psychological factors predicting (non-)use of low Vision Aids need to be considered in the choice of rehabilitation and follow-up strategies by a multidisciplinary team, focusing more in mechanisms of adaptation and patient’s motivation. Training intensity should play a central role in the development of innovative intervention programs to reduce device abandonment.
T S Sreeshma - One of the best experts on this subject based on the ideXlab platform.
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pattern of visual disability and type of low Vision Aid rehabilitation in a tertiary eye care referral center a descriptive study
Kerala Journal of Ophthalmology, 2017Co-Authors: G S Kalaimathi, Anantharaman Giridhar, S J Saikumar, Bindu Rajesh, T S SreeshmaAbstract:Purpose: The aim of this study is to review the pattern of visual disability and the type of low Vision rehabilitation done in patients who attended the low Vision clinic at a tertiary eye care referral center in Kerala between May 2015 and April 2016. Materials and Methods: This is a retrospective, hospital-based review of 200 medical records of patients who attended a tertiary eye care center in Kerala between May 2015 and April 2016. Criteria for low Vision were defined as best-corrected visual acuity binocularly (BCVA) for distance by logarithm of minimum angle of resolution chart was >0.4 and for near was N8 with + 4.00 DS addition with near Vision test types. The data collected included age, gender, diagnosis, BCVA for distance and near, improvement of near Vision after low Vision Aid (LVA), and the type of LVA preferred by the patient. Results: Two hundred patients were reviewed. Of these, 64% were males and 36% were females. The age group was between 5 and 90 years. Fifty-one percent low Vision was because of proliferative diabetic retinopathy (PDR) with or without maculopathy, 5% central serous retinopathy, 1% venous occlusions, 12% age-related macular degenerations, 6% retinal detachment, 3% macular hole, 19% other retinal diseases, 1% glaucoma, and 2% others. BCVA binocularly for distance was between 0.4 and 0.7 in 46%, 0.8–1 in 44%, and >1 in 10% and near Vision with +4.00 add was between N8–N12 in 56% and N18–N36 in 44%. With LVA, 62% improved to N6, 35% N8–N10, and 3% N12–N18. Nearly 61% of patients preferred prismatic spectacles. Conclusion: Patients with PDR with or without diabetic maculopathy who had low Vision in spite of maximum treatment formed the largest group in our study. The BCVA for near improved to N6 in 62% of the patients. Prismatic spectacles were the LVA most commonly preferred for near Vision.
