Telerehabilitation may be effective alternative to in-office care for low vision
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In-home telerehabilitation improved reading acuity and speed in adults with low vision and newly prescribed magnifiers and may be a feasible alternative to in-office rehabilitation, according to research in Optometry and Vision Science.
“This pilot study provides some insight about the potential benefits of telerehabilitation training to improve the reading ability of adults with low vision using magnifiers, to spur future work with larger groups,” Ava K. Bittner, OD, PhD, FAAO, of the Stein Eye Institute at the University of California, Los Angeles, and colleagues wrote. “Telerehabilitation services can be implemented clinically to facilitate access to follow-up care for low vision.”
The multicenter study included 14 adults with low vision who received a new magnification device (handheld or optical magnifier or portable electronic magnifier) and underwent two at-home training sessions with their vision rehabilitation provider — who was located in office — up to 4 months later. A loaner smartphone was given to patients to access Zoom videoconferencing.
In each 1-hour telerehabilitation session, the vision rehabilitation provider used the Minnesota Low-Vision Reading test and Lighthouse continuous text card to assess participants’ reading acuity and speed with the magnification device.
According to study results, the mean reading acuity of participants was 0.17 logMAR before training at the first telerehabilitation session. A few weeks later, at the second session, it significantly improved to 0.09 (P = .047). In addition, the logarithm reading speed for the reading acuity level improved significantly from session one to two by an average of 0.18 log words per minute (P = .002).
“Our participants who did not improve in reading acuity with the magnifier had worse general health,” Bittner and colleagues wrote. “We hypothesize that they may require more than two training sessions because of other comorbidities that might limit rehabilitation. Reduced general health may be associated with reduced dexterity.”
Further, 71% of participants gained at least 0.1 log unit in reading acuity in session two, while 50% improved by more than 0.01 in log reading speed. All participants with increased reading speed also improved in reading acuity (P = .02), researchers reported.
“Our preliminary data support that telerehabilitation can enhance reading ability and efficiency with newly prescribed magnifiers as an alternative to in-office care for vision rehabilitation,” Bittner and colleagues concluded. “Future work as a randomized, controlled trial with a larger sample size should compare the effects of training for new magnifiers that is provided in-office vs. telerehabilitation for improvements in reading acuity and/or speed, as well as reading ability assessed with a patient-reported outcome measure.”
Perspective
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Now, more than ever, patients and providers have become more equipped and comfortable with telehealth as an option for care. Patients and their family members are often more open to the idea of receiving care and connecting with their providers using their phones or computers. In certain instances, patients have sometimes even preferred telehealth due to the many scheduling and transportation challenges that exist in families. That, and other factors that sometimes do not allow for in-person visits, is why this article was informative and important for health care providers to acknowledge.
The authors provided great reminders about the significance of ongoing training for this group of patients and specifically showed enhancements possible with telerehabilitation.
It would be wonderful to see more studies with larger sample sizes to follow from this group of authors and others in health care. It will continue to help bring much-needed attention to this topic and help appropriately shape the future of health care.
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