The importance of improving the quality of life for visually impaired patients
New Orleans, La. — A variety of eye diseases lead to visual impairment, low vision, and eventual blindness. For many of these diseases, cures have unfortunately not been developed. Many patients rely on vision rehabilitation, diverse treatments, or nothing at all. Three studies presented this week at the 2023 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in New Orleans, La. assess a collection of these conditions, the symptoms, and potential treatments to discuss innovative approaches to improve patients’ quality of life and collaborative actions required to do so.
Using the findings from the Flemish to create applicable core sets for the world
The World Health Organization (WHO) developed the International Classification of Functioning, Disability and Health (ICF) as an international framework to identify and measure disability and health. Even though the ICF has Core Sets (CS) for a variety of health conditions, there are still some conditions that need to be tackled. Lorenzo Billiet and the team decided to develop evidence-based ICF core set for vision loss in adults and the elderly. Their hopes were that the findings from their study could be used as a practical tool worldwide.
Billiet and team focused their study on the people of Flanders, Belgium who were either blind or living with visual impairment. Their qualitative study comprised of online focus group meetings with participants who had 11 different eye disorders. 409 concepts were connected to the ICF. They found that elderly people and adults mostly experienced challenges and needs related to housekeeping, self-care and mobility. They also pointed out how healthcare professionals, friends and family played a crucial role “in their functioning in society.” With these findings, Billiet and team noted the importance of further research in all WHO regions to determine if other places produced similar conclusions, leading to proper contribution and expansion of culturally relevant CS. They next plan to focus on healthcare professionals and researchers’ perspectives.
“This study gives a first impression of the problems and needs of blind or visually impaired patients in Flanders.” Billiet stated, “These findings will be included in a larger study on the development of an International Classification of Functioning, Disability and Health core set vision loss.”
- Abstract title: What are the activity and participation needs for persons with vision loss in Flanders?
- Presentation start/end time: Sunday, April 23, 12:00 – 1:45pm CT
- Location: Exhibit Hall
- Posterboard number: C0611
Mental well-being in patients with ocular conditions
Mental well-being came to the forefront when the COVID-19 pandemic occurred. Psychologists and other mental health practitioners were sought after to give professional advice to every industry worldwide as this became an increasingly pressing issue. The relationship between patients affected by ocular conditions and visual impairment and the possibility of them developing mental health conditions like anxiety or depression is still not well understood. Thus, a study was carried out to identify the prevalence of mental health conditions in patients with uveitis, glaucoma, retinal vein occlusion (RVO), age-related macular degeneration (AMD) and diabetic retinopathy (DR) with or without visual impairment (defined as limited vision and/or blindness).
Neha Sharma, BA, MPH, and her researchers conducted this cross-sectional study using a U.S. database called TriNetX Analytics Network. This database utilizes de-identified patient health information on more than 87 million patients within the United States. Patients with these ocular diseases who had a visual impairment were identified and evaluated for a mental health condition. The mental health conditions of interest were anxiety, depression, and suicide attempt or ideation. Gender and race were also considered.
They discovered that patients with an ocular condition along with visual impairment had a greater risk for mental health conditions, especially depression and anxiety. Patients with DRhad increased odds of depression and suicide at all time points in the study compared to the control group, while patients with glaucoma had increased odds of all mental health conditions, with appreciable higher odds of suicide and/or suicide ideation. White females with DR were shown to have increased odds of depression and Hispanic female patients with RVO had increased odds of depression as well. Lastly, Black female patients and Hispanic female patients with neovascular and non-neovascular AMD were increasingly affected by anxiety.
Sharma concluded, “Our research evaluates how multiple ocular conditions increase the prevalence and odds of having a mental health condition. Certain patient populations are disproportionately affected by these mental health conditions, which showcases an increased need to screen minority patients who have higher odds of depression and anxiety.”
- Abstract title: Characterization of the prevalence of visual impairment, ocular comorbidities, and mental health conditions in the United States
- Presentation start/end time: Monday, April 24, 4:00 – 4:15pm CT
- Location: R06
- Presentation number: 1908
Increasing awareness for Charles Bonnet Syndrome
Charles Bonnet syndrome (CBS) is a condition where those with low vision are affected by visual hallucinations. The hallucinations are not caused by dementia or mental health conditions. CBS is frequently tied to patients with central vision loss such as AMD, but can occur in a wide range of low vision patients regardless of the underlying diagnosis. It is still not well understood amongst professionals and patients, leading to underreporting in clinics. This study examined CBS patients’ hospital records, “practice patterns in patients reporting symptoms,” and treatments.
Lee Jones, PhD, lead researcher and team looked at medical records from an eye clinic in London, United Kingdom to compare the number of cases before and during the COVID-19 pandemic. They found that there was no significant difference in the number of new cases of CBS before and during the pandemic. CBS was most commonly diagnosed in medical retina clinics. Women were more likely to have a record of CBS than men. Fewer people were registered as visually impaired during the pandemic, but during this period, details of management methods were more likely to be documented. Jones and the researchers also surveyed military veterans with CBS and found that the hallucinations were usually bothersome, negatively affected their mood and caused fear.
In their conclusion, Jones said “this snapshot of how Charles Bonnet syndrome (CBS) is reported in hospital eye clinics gives important insights for clinical services and may help to prioritise resources, education and training to maximise the efficiency of case finding and patient support. Prospective screening of CBS among visually impaired military veterans will help to ensure accurate and timely diagnosis which will reduce costs and lead to swifter positive healthcare outcomes.”
- Abstract title: Clinical features and practice patterns in managing patients with Charles Bonnet syndrome and characterising psychological outcomes of visual hallucinations in military veterans
- Presentation start/end time: Wednesday, April 26, 10:30am – 12:15pm CT
- Location: Exhibit Hall
- Posterboard number: C0186
The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include approximately 10,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders. Learn more at ARVO.org.