Referral to Low Vision Services by Optometrists

Background: Only a small percentage of people with low vision in Australia receive comprehensive low vision rehabilitation services. In an attempt to examine reasons for this under-utilisation of low vision services, the referral criteria used by Australian ophthalmologists and optometrists were investigated. This paper reports the results for optometric referrals; the results for the ophthalmological referrals have been reported elsewhere. Method: A survey was sent to a random sample of 800 optometrists in Australia. Information requested included the vision loss criteria used for referral of patients to services for visually impaired people, the frequency of prescription of low vision devices (LVDs), frequency of referrals and perceptions of the availability and quality of low vision services. Results: The response rate was 36 per cent. Optometrists reported that only 4.7 per cent of their patients have low vision. Optometrists frequently prescribe LVDs but the majority infrequently refer patients to low vision or rehabilitation services. The rate of referral is influenced by their referral criterion and the perceived availability and quality of low vision services. Conclusions: Optometrists do not manage many patients with low vision because the patients are usually referred to ophthalmologists for management of the underlying eye disease. However, many optometrists could adopt a lesser degree of vision loss as their referral criteria for low vision services and encourage ophthalmologists to do the same. With improved communication between the eye care practitioners and low vision services, patients will be referred to low vision services earlier, before vision loss severely affects their daily lives