Barriers to Low Vision Services Among Optometrists in Saudi Arabia

Introduction: This study identifies the barriers and challenges to the provision of low vision services among practicing optometrists in Saudi Arabia. Methods: In this study, a self-administered online structured survey for practicing optometrists was used. Responses were collected to understand the number and percentage of low vision service providers, level of awareness, and barriers to the provision of low vision services. Results: This study included 154 (79 females and 75 males) practicing optometrists. They were from the five regions of Saudi Arabia (23 cities). The age of the practitioners ranged from 22 to 54 years. They had Bachelor’s, Master’s, and Doctor of Philosophy degrees. Forty-four participants (30%) provided low vision services. The major barriers reported were lack of training (87%), lack of awareness about low vision services (76%), lack of availability of low vision devices (70%), lack of motivation (65%), low vision services being time-consuming (55%), being busy in providing general optometry (65%), and lack of financial sources (31%). Conclusion: Building an efficient model for low vision rehabilitation in Saudi Arabia is needed. Moreover, encouraging more optometrists to be involved in low vision rehabilitation is necessary. There is also a need for more low vision education, national health coverage of patients with low vision, and better collaboration between low vision service providers.

A scoping review of vision rehabilitation services in Canada

Around 1.5 million Canadians live with some form of vision impairment. The demand for vision rehabilitation (VR) services is projected to increase as the number of older adults with age-related vision loss rises. To inform programmes and policies for VR, we aimed to answer two research questions: (1) How are VR services delivered in Canada? and (2) If gaps exist in current delivery of VR services, how can they be characterized? We used Arksey and O’Malley scoping review framework. A comprehensive search of five databases (PubMed, CINAHL/EBSCO, EMBASE, ProQuest, and Global Health) was performed during January 2019 and then updated in March 2021. Index terms and keywords relating to vision loss or impairment and rehabilitation were used. Non-peer-reviewed (grey) literature, in the form of reports and policies on VR in Canada, was sourced via Google/Google Scholar. To be included, sources had to (1) focus on VR services in Canada, (2) be available in English or French, and (3) be published after 2003. Data were extracted and analysed thematically to describe VR services across provinces and to identify gaps in service delivery in Canada. Out of 1311 studies identified, 62 were included. Findings indicate that the structure of VR services as well as provincial funding for assistive devices varies across provinces. The reported gaps at the level of service providers, users, and delivery systems were lack of awareness about the benefits of VR, limited collaboration and coordinated services between eye care and VR services, delayed referral to VR, shortage of specialists, and insufficient funding and training for vision devices. This article describes VR services in Canada and documents important gaps in VR services and research evidence across provincial jurisdictions. Future work to address gaps, and develop and evaluate interventions to facilitate optimal VR services is imperative.

Universal Design and Low-Vision Rehabilitation: The Case for a Holistic Lighting Assessment

Among various approaches to handling friction between (dis)abilities and the built environment, universal design (UD) has emerged as an interdisciplinary field for research and practice. However, while the literature denotes UD as a design concept, practice, and strategy for rehabilitation, its true impact is still largely unknown. To explore the rehabilitative potential of UD and determine how to evaluate its impact, this paper seeks to turn the tables. It investigates a case regarding low-vision rehabilitation, in which a group of consultants developed a holistic lighting assessment (HLA) that embraced the social and the physical contexts of the visually impaired. The lighting assessment was performed using participant observations from 15 consultations, document analysis, and interviews with the low-vision consultants. Based on an actor-network theory (ANT) approach, the analysis reveals the contextual knowledge of participants, environments, and the interaction between them. The combination of quantitative and qualitative methods in HLA enabled a range of different understandings of light: as a quantitative measure, as an individually perceived aspect of the home environment, as something that enables or disables daily activities, and as a social factor of great importance for social practices. While traditional lighting assessments generally resemble the accessibility approach, with its measures of visual acuity translated into recommendations for an overall lux value, the holistic approach more closely resembles the UD methodology. One finding of this paper is that the concepts of rehabilitation and UD are committed to slightly different levels of abstraction. Rehabilitation focuses on specific individuals and specific environments, with patient rehabilitation as the main goal. UD focuses on user groups and design principles, with design and architectural solutions as the main objectives. While the concepts of UD and HLA represent different fields and different levels of abstraction, the two approaches can enhance both respective practices and theoretical frames.