Impact of low vision on quality of life of patients with low vision visiting the low vision center of the Eastern Regional Hospital, Ghana.

Abstract

Introduction: Low vision impacts quality of life and more so when the vision loss is severe. Persons living with low vision have reduced functionality and psychosocial well-being with the potential for high dependence on others in carrying out everyday activities. Decreased quality of life and psychosocial well-being affect both the individual and the community economically as the productive labour force is affected. Low vision may also increase morbidity and mortality. Although the relationship between low vision and quality of life has been extensively studied in other parts of the world, with documented evidence of the adverse effect of low vision on a person’s quality of life, very little has been done in Ghana to understand the specific setbacks and challenges low vision brings to the patients in spite of the fact that there are such patients living in the country for which reason a center has been set up to manage and treat them. Understanding specific vision and functional challenges is important in ensuring management that is tailored to the needs of patients with low vision. This study aims to investigate the impact of low vision on quality of life, and as well to establish the relationship between severity of vision loss and level of impact on quality of life of subjects with low vision visiting the low vision center of the Eastern Regional Hospital in Ghana. Method: A descriptive case control study involving 41 cases and 41 controls was conducted. The cases were stratified into three categories of low vision namely moderate, severe and profound. The National Eye Institute Visual Function Questionnaire (NEI VFQ-25) which consists of twenty five questions was used in the collection of data. Descriptive statistics and logistic regression analysis were conducted to determine associations between various variables. Results: Case subjects had statistically significantly lower quality of life compared to control subjects (cases, median=46.09, IQR= 30.84-66.00, n=41), (controls, median= 98.09, IQR=94.94-100.00-, n=41), p<0.001). The functional and psychosocial subscales (driving, near and distance activities, social function and mental health) produced the lowest quality of life scores. There was, however, no statistically significant difference in the ocular pain and discomfort subscale between cases and controls ((cases; median= 87.50, IQR= 71.88-100), (controls; median= 87.50, IQR= 87.50-100), p=0.098). Regression analysis showed no significant relationship between demographic profile and quality of life. Cases with profound low vision were 0.49 (95% CI= 0.46-0.71) times less likely to have good quality of life compared to subjects with normal vision. Quality of life worsened with decreasing vision Conclusion: Quality of life is impacted by low vision especially in areas of functionality and psychosocial well-being. The degree of impact of low vision on quality of life is influenced by the severity of vision loss. Incorporation of social support services counseling and rehabilitation protocols that focus on improving functionality may be a step in the right direction in assisting persons with low vision adapt to their vision loss and improve their quality of life.