Authors' objectives:

This review aims to assess the effectiveness of optical devices for adults with low vision.

Authors' recommendations: - Vision loss in adults is associated with many comorbidities, activity limitations and lower quality of life. The prevalence of vision loss both in the general and veteran populations is projected to increase dramatically over the next 20 years. With this trend is a growing need for low vision services targeted at detecting visual impairment and mitigating the functional consequences associated with age-related vision loss to improve quality of life. - Provision of low vision services, including low vision devices, to veterans is a priority for VA. Popular among veterans and practitioners are electronic optical devices such as closed circuit TV (CCTV), computer assistive technologies, and non-electronic hand held models. However, advocates for visually impaired veterans have expressed concern over the quality of scientific evidence supporting the use of many low vision devices, particularly newly emerging electronic devices. - A multidisciplinary task force of VA vision care experts has been charged with developing a process for evidence-based new technology evaluation and dissemination of information in VA. To inform the task force, this systematic review identified: 1) the existing evidence of effectiveness of optical low vision devices from the peer-reviewed published literature; 2) knowledge gaps, and; 3) evidence-based tools for assisting data collection and clinical decision-making. - This review reveals a paucity of high quality evidence in the peer-reviewed published literature to inform choices about provision of optical low vision devices in VA. The best evidence consisted of seven small, prospectively controlled clinical studies comparing the performance of optical low vision devices for reading tasks at various distances in a controlled indoor setting. Evidence of preferences and use were anecdotal. Sustained use of these devices in the subject.s life setting, resources required in terms of costs and training associated with each alternative, and the link between device use and health related quality of life were unknown. - In the absence of compelling evidence from published research and a standar taxonomy of desired outcomes, clinicians must continue to rely on industry data, clinical observations, patient self-reporting, and real-world trials in determining appropriate provision of low vision aids. - Future research is needed to determine the appropriate candidacy for low vision devices, suitable prescription of these devices, and outcome measures that define the quality of life in subjects with age-related visual impairment along the continuum of visual impairment and disability. TAP encourages using an evidence-based framework in evaluating evidence of effectiveness, partnering with industry and consumers to carry out evidence-based technology evaluation, and seeking out systematic information that can improve and standardize current prescription practices.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/OpticalDevicesAdultsLowVision2003tm.pdf

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: Technology Assessment Unit, Office of Patient Care Services, US Department of Veterans Affairs (VATAP)