RESUMO
El objetivo de este trabajo fue caracterizar epidemiológica y sociodemográficamente a las personas atendidas en la Unidad de Baja Visión y Rehabilitación Visual del Hospital Clínico de la Universidad de Chile. El método utilizado fue un estudio descriptivo, transversal y retrospectivo de los registros clínicos de las personas atendidas en la Unidad, entre marzo de 2015 a octubre de 2016. Para el análisis se utilizó el software MS Excel, calculando las frecuencias relativas y medidas de posición central y dispersión. En los resultados se observaron un mayor número de pacientes de sexo femenino (55,5%), y adultos mayores de 60 años o más (53,3%). El 73,3% de los pacientes pertenecieron al sistema de salud público y un 35,6% poseían menos de 8 años de estudio. El 80 % de las personas atendidas se encuentra en edad laboral, de éstos un 63,9% se encontraban laboralmente inactivos. Las enfermedades oftalmológicas con mayor frecuencia correspondieron a las enfermedades genéticas del ojo (22,2%) y la degeneración macular relacionada con la edad (17,8%). Un 57,8% de los pacientes presentó alguna patología sistémica asociada a baja visión. Sólo un 6,0% recibió rehabilitación visual anteriormente. Se concluyó que la mayor prevalencia de enfermedades oculares asociadas al envejecimiento como la degeneración macular relacionada con la edad y enfermedades genéticas del ojo, sumado a las características sociodemográficas y en particular a que un 94% de los pacientes no habían tenido acceso a rehabilitación visual, constituyen un perfil que desafía al desarrollo de medidas de salud pública que resguarden la prevención, acceso y rehabilitación, siendo la formación de equipos multidisciplinarios especialistas una necesidad imperiosa.
This work aimed to do a characterization, epidemiological and socio demographical, to the people attended in a Low Vision and Rehabilitation Unit from a Clinical Hospital of the Universidad de Chile. A descriptive, transversal and retrospective method was used for the clinical registers of the people attended in the Unit, between March 2015 to October 2016. For the analysis, a MS Excel software was used, calculating the relative and measured frequencies of central position and dispersion. In the results, a greater number of feminine patients (55. 5%) were observed, and seniors of 60 years or more (53.3%). 73.3% of the patients belonging to the Public Health Care System and 35.6% had less than 8 years of studies. The 80% of attended patients were in working age, from this 63,9% were unemployed. The ophthalmological diseases with more frequency belonged to eye genetic diseases (22.2%) and macular degeneration related to age (17.8%). 57.8% of the patients presented a systematic pathology associated with low vision. Just 6.0% received previous visual rehabilitation. We concluded that the greater prevalence of ocular diseases associated to aging such as macular degeneration related to age and eye genetic diseases added to the sociodemographic features and particularly a 94% of the patients did not have access to visual rehabilitation, represent a profile that challenges the development public health care measures that safeguard the prevention, access, and rehabilitation, being an imperative need the making of specialist multidisciplinary teams.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Baixa Visão/reabilitação , Baixa Visão/epidemiologia , Fatores Socioeconômicos , Transtornos da Visão/reabilitação , Transtornos da Visão/epidemiologia , Comorbidade , Chile/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologiaRESUMO
Visual rehabilitation in people with irreversible Low Vision (LV) aims to optimize the use of remaining vision to execute visual tasks. Conventional rehabilitation exploits the visual potential through training using the remaining visual function, with or without visual aids, to improve performance on specific tasks. However, there is no consensus about the impact of this approach in the long term and on the quality of life of patients. On the other hand, visual neuro-rehabilitation has long-term advantages that can be complementary to conventional strategies and is based on the generation of scotoma awareness and training in the systematic use of extrafoveal regions for fixation and for use as oculomotor reference. These regions called preferred retinal loci (PRL) are established spontaneously in the peripheral retina that still retain visual function and constitute evidence of a high degree of plasticity of the visual system. There is wide evidence of the efficacy of visual neuro-rehabilitation strategies on performance in specific visual tasks, but their impact on the overall visual performance and quality of life of patients is still pending. (AU)
Assuntos
Humanos , Masculino , Feminino , Baixa Visão/reabilitação , Baixa Visão/terapia , Plasticidade Neuronal , Transtornos da Visão/reabilitaçãoRESUMO
INTRODUCTION: A low-vision (LV) rehabilitated child can receive comprehensive education. Objec tive: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. PATIENTS AND METHOD: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. RESULTS: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. CONCLUSION: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.
Assuntos
Transtornos da Visão/reabilitação , Baixa Visão/reabilitação , Acuidade Visual , Adolescente , Criança , Pré-Escolar , Chile , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos da Visão/epidemiologia , Transtornos da Visão/fisiopatologia , Baixa Visão/epidemiologia , Baixa Visão/fisiopatologia , Adulto JovemRESUMO
INTRODUCCIÓN: Un niño con baja visión (BV) rehabilitado puede tener una educación integral. Objetivo: Estudiar el perfil de los escolares derivados para evaluación a un Proyecto de Rehabilitación en un organismo de apoyo social. PACIENTES Y MÉTODO: Estudio transversal descriptivo de beneficiarios evaluados entre septiembre 2015 y septiembre 2016 en JUNAEB. Se consideró diagnóstico de derivación, agudeza visual monocular (AV) con corrección óptica para lejos (cartillas Feinbloom) y cerca (cartillas Zeiss). Se clasificaron según AV y perimetría. Se consideró éxito de tratamiento lograr AV > 0,4 para le jos y/o cerca con ayuda óptica. RESULTADOS: Se evaluaron 278 escolares. 153 (55%) fueron hombres, 121(43,5%) entre 10 a 14 años. Catarata congénita bilateral, distrofias retinales, alta miopía, atrofia óptica y nistagmus congénito fueron las patologías más frecuentes. 224 (80,6%) se habilitaron con ayudas. 85 (37,9%) presentaron BV moderada y 63 (28,6%) BV severa. 122 (54,5%) presentaban perimetría normal, 68 (30,4%) campo visual (CV) tubular, 19 (8,5%) defecto sectorial del CV y 15 (6,7%) compromiso central del CV. 198 (88,4%) escolares lograron éxito visual de lejos y todos lograron éxito visual de cerca. 48 (17,2%) escolares no pudieron ser rehabilitados, estando asocia dos a una afección neuroftalmológica (41,7%), alto error refractivo (16,6%) o glaucoma congénito (10,4%). 6 (2,2%) casos mejoraron su AV con nueva corrección óptica. CONCLUSIÓN: El éxito obtenido demuestra la necesidad de habilitar visualmente a escolares con BV. Nuestro desafío es mantener este programa y educar al oftalmólogo prestador para una derivación oportuna.
INTRODUCTION: A low-vision (LV) rehabilitated child can receive comprehensive education. OBJECTIVE: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. PATIENTS AND METHODS and Method: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. RESULTS: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. CONCLUSION: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Transtornos da Visão/reabilitação , Acuidade Visual , Baixa Visão/reabilitação , Transtornos da Visão/fisiopatologia , Transtornos da Visão/epidemiologia , Chile , Baixa Visão/fisiopatologia , Baixa Visão/epidemiologia , Estudos TransversaisRESUMO
PURPOSE: Patients with visual impairment are constantly facing challenges to achieve an independent and productive life, which depends upon both a good visual discrimination and search capacities. Given that visual search is a critical skill for several daily tasks and could be used as an index of the overall visual function, we investigated the relationship between vision impairment and visual search performance. METHODS: A comprehensive search was undertaken using electronic PubMed, EMBASE, LILACS, and Cochrane databases from January 1980 to December 2016, applying the following terms: "visual search", "visual search performance", "visual impairment", "visual exploration", "visual field", "hemianopia", "search time", "vision lost", "visual loss", and "low vision". Two hundred seventy six studies from 12,059 electronic database files were selected, and 40 of them were included in this review. RESULTS: Studies included participants of all ages, both sexes, and the sample sizes ranged from 5 to 199 participants. Visual impairment was associated with worse visual search performance in several ophthalmologic conditions, which were either artificially induced, or related to specific eye and neurological diseases. CONCLUSIONS: This systematic review details all the described circumstances interfering with visual search tasks, highlights the need for developing technical standards, and outlines patterns for diagnosis and therapy using visual search capabilities.
Assuntos
Baixa Visão/fisiopatologia , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Pessoas com Deficiência Visual , Humanos , Baixa Visão/reabilitaçãoRESUMO
Se realizó una búsqueda en la literatura digital. Se revisaron artículos en español y en inglés que resultaron significativos de la temática en estudio, con el propósito de identificar los referentes teóricos acerca de baja visión y la rehabilitación visual. La baja visión es una condición que deriva en una reducción importante de la visión de la persona y en este contexto representa un reto mundial. Las principales causas son el glaucoma, la maculopatía miópica, la degeneración macular relacionada con la edad y la retinopatía diabética. La rehabilitación visual implica un conjunto de procesos encaminados a obtener el máximo aprovechamiento visual de un paciente con baja visión, en aras de lograr su reincorporación a la sociedad. Las causas que provocan la baja visión son múltiples. En Sancti Spíritus las más frecuentes son el glaucoma, la maculopatía miópica, la degeneración macular relacionada con la edad y la retinopatía diabética. Se teoriza el proceso de rehabilitación visual, que garantiza el uso del resto útil de la visión que conserva el paciente, con el empleo de las ayudas ópticas y no ópticas(AU)
Digital literature review was made to review Spanish and English articles that were significant in the study subject, with the objective of identifying the theoretical referents on low vision and visual rehabilitation. Low vision is a condition that results in significant reduction of a person´s vision and thus it represents a challenge worldwide. The main causes are glaucoma, myopic maculopathy, age-related macular degeneration and diabetic retinopathy. Visual rehabilitation involves a set of processes aimed at obtaining the maximum visual utilization from a patient with low vision, with a view to achieving his/her re-incorporation into the society. The causes of low vision are varied. The most common ones in Santi Spiritus province are glaucoma, myopic maculopathy, age-related macular degeneration and diabetic retinopathy. The article theorized about the visual rehabilitation process that assures the use of the remaining useful vision that a patient preserves, by using optical and non-optical aids(AU)
Assuntos
Humanos , Literatura de Revisão como Assunto , Baixa Visão/reabilitaçãoRESUMO
We conducted a literature review of tools used to evaluate functionality in children with low vision with the aim of analyzing the applicability, advantages, and disadvantages for children <6 years of age, an age at which visual development is mostly complete. Publications in Portuguese, English and, Spanish describing functional evaluation tools for children aged 0-18 years with low vision in the following databases were included: Web of Science, Virtual Health Library, Cochrane, Scielo, and PubMed. A total of 181 articles were collected, 15 of which were included in this review. Thirteen tools were identified, nine of which evaluated overall functionality and quality of life through questionnaires. The other 4 instruments, using a observational test model, evaluated functionality and they were elected. Observational tests chosen for their accuracy and lower selection bias were used to evaluate visual functionality. Of these, the Functional Vision Assessment up to 6 years seems to be promising. In conclusion, we observed a lack of tools for evaluating functionality in children with low vision. This type of evaluation is necessary for planning visual rehabilitation to improve quality of life in children with low vision.
Assuntos
Avaliação da Deficiência , Baixa Visão/reabilitação , Criança , Humanos , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
ABSTRACT We conducted a literature review of tools used to evaluate functionality in children with low vision with the aim of analyzing the applicability, advantages, and disadvantages for children <6 years of age, an age at which visual development is mostly complete. Publications in Portuguese, English and, Spanish describing functional evaluation tools for children aged 0-18 years with low vision in the following databases were included: Web of Science, Virtual Health Library, Cochrane, Scielo, and PubMed. A total of 181 articles were collected, 15 of which were included in this review. Thirteen tools were identified, nine of which evaluated overall functionality and quality of life through questionnaires. The other 4 instruments, using a observational test model, evaluated functionality and they were elected. Observational tests chosen for their accuracy and lower selection bias were used to evaluate visual functionality. Of these, the Functional Vision Assessment up to 6 years seems to be promising. In conclusion, we observed a lack of tools for evaluating functionality in children with low vision. This type of evaluation is necessary for planning visual rehabilitation to improve quality of life in children with low vision.
RESUMO Realizada revisão bibliográfica dos instrumentos de avaliação da funcionalidade da criança com baixa visão analisando sua aplicabilidade, vantagens e desvantagens, principalmente entre crianças abaixo de 6 anos de idade, período de grande importância para a reabilitação visual. Publicações descrevendo instrumentos para avaliação funcional nas bases de dados Web of Science, Biblioteca Virtual em Saúde, Cochrane, Scielo e Pubmed; em crianças (0-18 anos) com baixa visão, nos idiomas português, inglês e espanhol. Recuperaram-se 181 artigos, sendo 15 incluídos na revisão. Foram identificados 13 instrumentos, sendo nove para avaliar funcionalidade global e qualidade de vida, em modelo de questionário. Os demais, (4 instrumentos), em modelo de testes observacionais, avaliavam funcionalidade visual e foram eleitos. Para avaliar funcionalidade visual foram utilizados testes observacionais, eleitos por serem precisos e com menos viés de seleção. Destes, o AVIF-2 a 6 anos mostrou-se um instrumento promissor. Concluindo, observou-se escassez de instrumentos para avaliar funcionalidade em crianças com baixa visão. Essa avaliação é necessária para planejamento da reabilitação visual e melhora na qualidade de vida de crianças com baixa visão.
Assuntos
Humanos , Criança , Baixa Visão/reabilitação , Avaliação da Deficiência , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
ABSTRACT Objective: Identify levels of self-perception of occupational performance and quality of life of individuals with visual impairment and subsequent analysis of the interrelationship between the indices found. Methods: Descriptive cross-sectional survey with people with visual disabilities enrolled in visual rehabilitation program. COPM was applied to measure the self-perception of occupational performance, the SF-36 for quality of life measurement and a socio-demographic questionnaire to describe personal characteristics. Results. Twentythree subjects were included in the sample: 74% with low vision, 52.2% were female and mean age of 46.7 years. The self-perception of performance and emotional aspects domains of participants with low vision were better than those with blindness. The greater the time of visual impairment, worse was the self-perception of pain. The vitality domain showed statistical significant relationship with the domains general health, performance and satisfaction as well as the mental health domain were related to general health, pain, performance and vitality. Conclusion: The best were the mental health index, the better were the evaluations of physical, functional and social areas, a fact that indicates the importance of considering mental health in visual rehabilitation programs. The COPM and the SF-36 address the issue of functionality in different ways and their results are not compatible.
Objetivo: Identificar níveis de autopercepção de desempenho ocupacional e qualidade de vida de indivíduos com deficiência visual e posterior análise de inter-relação entre os índices encontrados. Métodos: Estudo descritivo de corte transversal junto a pessoas com deficiência visual inscritas em programa de reabilitação visual. Foram utilizados os questionários COPM para mensuração da autopercepção de desempenho ocupacional, SF-36 para mensuração de níveis de qualidade de vida e questionário de investigação sociodemográfico e perfil dos sujeitos. Resultados: Vinte três sujeitos compuseram a amostra, sendo 74% com baixa visão, 52,2% do gênero feminino e média de idade de 46,7 anos. A autopercepção de desempenho e aspectos emocionais dos participantes com baixa visão foram melhores do que os com cegueira. Quanto maior era o tempo de deficiência visual, pior era a avaliação da dor. O domínio vitalidade apresentou relação estatisticamente significativa com os domínios estado geral de saúde, desempenho e satisfação, assim como o domínio saúde mental apresentou relação com estado geral de saúde, dor, desempenho e vitalidade. Conclusão: Quanto melhores foram os índices de saúde mental, melhores foram as avaliações dos domínios físicos, funcionais e sociais, fato que indica a importância de considerar a saúde mental em programas de reabilitação. A COPM e a SF-36 abordam a questão da funcionalidade de maneiras distintas e seus resultados não são compatíveis.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Qualidade de Vida , Autoimagem , Atividades Cotidianas , Pessoas com Deficiência Visual/psicologia , Pessoas com Deficiência Visual/reabilitação , Cegueira/psicologia , Cegueira/reabilitação , Baixa Visão/psicologia , Baixa Visão/reabilitação , Epidemiologia Descritiva , Estudos Transversais , Inquéritos e Questionários , Terapia Ocupacional , Avaliação da Deficiência , Vida Independente , Relações InterpessoaisRESUMO
Aim: To evaluate life quality of elderly people with acquired low vision before and after hearing and speech intervention. Methods: This was a descriptive cross-sectional study. The study was made with 52 elderly people with acquired low vision. Two questionnaires that measures life quality were used in this study. The first was Low Quality of Life Vision (LVQOL) and the second the National Eye Institute Visual Function Questionnaire (NEIVFQ-25). The study included people with more than 60 years with acquired low vision and who accepted to participate signing the consent form. The hearing and speech therapy were made into three months, one meeting a week. The questionnaires were applied in the first and last day of the intervention. Results: The age ranged between 60 and 91 years. The macular disorder (38%), such as age-related macular degeneration, macular hole and high myopia were the main causes of visual loss. Although the tests show superior performance after the intervention, there was no statistically significant difference. On the question about difficulties seeing in general, 17 participants answered that they had much more difficulty before the intervention and only 5 participants have reported having much difficulty after the intervention. Conclusion: The intervention trended to positive results, and after the meetings, participants showed improvements in aspects of the two questionnaires used in the study, decreasing the degree of difficulty in performing activities.
Objetivo: Avaliar a qualidade de vida de idosos com baixa visão adquirida antes e depois de intervenção fonoaudiológica. Métodos: Foi realizado um estudo descritivo e transversal. A população do estudo foi constituída por 52 idosos com baixa visão adquirida. Dois questionários que mensuram qualidade de vida foram aplicados neste estudo. O primeiro foi Low Quality of Life Vision (LVQOL) e o segundo the National Eye Institute Visual Function Questionnaire (NEIVFQ-25). Foram incluídos na pesquisa sujeitos com mais de 60 anos, portadores de baixa visão adquirida e que assinaram o Termo de Consentimento Livre e Esclarecido. A intervenção fonoaudiológica tinha duração de três encontros, um por mês. Os questionários foram aplicados no primeiro e no ultimo dia da Intervenção. Resultados: A idade variou entre 60 e 91 anos. A alteração macular (38%), como degeneração macular relacionada à idade, buraco macular e alta miopia foram as principais causas da perda visual. Apesar dos testes mostrarem um desempenho superior após a intervenção, não houve diferença estatisticamente significativa. Na questão sobre dificuldades de ver em geral, 17 sujeitos responderam que tinham muita dificuldade antes da intervenção, e após a intervenção somente 5 sujeitos relataram ter muita dificuldade. Conclusão: A intervenção tendenciou à resultados positivos, e após os três encontros, os idosos apresentaram melhoras em aspectos avaliados nos dois questionários usados no estudo, diminuindo o grau de dificuldade na realização de atividades.