关键词: 视力残疾, 助视器, 康复, 弃用原因, 低视力患者生活质量量表

Abstract: Objective  To investigate the causes of visual disability patients in low vision clinic, and evaluate the usage effectiveness and reasons for discontinuation of low vision aids and the effectiveness in improving visual acuity and quality of life. Design  Prospective cohort study. Participants  The study was conducted on 150 patients with visual disability recruited from Beijing Tongren Hospital during the period of January 2025 to May 2025, including 81 females. Methods  Far and near low vision aids were prescribed for visual disability patients. The low vision acuity chart and the Chinese-version low vision quality of life questionnaire（CLVQOL） were applied to evaluate and compare the improvement of visual acuity and quality of life in visual disability patients before and one month after fitting low vision aids. The effectiveness and the reasons for abandonment of low vision aids were also evaluated. Main Outcome Measures  Etiology of visual disability, best-corrected visual acuity (BCVA), the rate of visual acuity relieved from blindness (number of eyes with BCVA≥0.05/total number of blind eyes ×100%), the rate of visual acuity relieved from visual disability (number of eyes with BCVA≥0.3/total number of eyes with low vision×100%), effectiveness rate of visual aids (number of visual aids that improved visual function and can satisfactory or basically complete visual tasks/tatal number of visual aids), reasons for discontinuation, CLVQOL scores. Results The main causes of visual disability patients (aged 8~76 years) were macular degeneration (34.0%), optic neuropathy (24.67%), retinal pigment degeneration (14%), respectively. After fitting distance optical low vision aids, BCVA of visually disability patients improved from 1.3±0.4 to 0.8±0.3 (t=43.65, P<0.001). The rate of visual acuity relieved from blindness and from visual disability were 82.22% and 38.10%, respectively. The efficacy rates of optical low vision aids and electronic vision enhancement devices were 71.3%、100%, respectively, with the differences being statistically significant（?字2=14.95，P=0.01）. Electronic vision enhancement devices demonstrated superior effectiveness compared to +10 D，+12 D，and +16 D optical magnifiers（?字2=7.78, 8.82, 10.16; P=0.02, 0.006, 0.002）. The discontinuation rates for far and near optical low vision aids were 9.85% and 15.65%, respectively. The main reasons for discontinuation of low vision aids were minimal visual improvement, close working distance, and poor usability while walking, with the differences being statistically significant (?字2=8.60，P=0.006). The discontinuation of low vision aids were associated with the underlying etiology but independent of gender and educational attainment. Among 150 patients, 132 patients completed the CLVQOL scale before and after low vision aids fitting. After fitting low vision aids, the overall score of CLVQOL has significantly improved compared to before fitting low vision aids, the quality of life scores increased from 74.94±10.41 to 88.5±13.86（t=37.36，P<0.001）. The scores of the dimensions of light perception, distant vision and mobility, psychological adjustment, reading and fine work, and daily activities in CLVQOL scale have significantly improved compared to before fitting low vision aids, with a statistically significant difference(all P<0.001). There was no significant correlation between gender, educational level and CLVQOL scores（P=0.06, 0.38）. Conclusions Fundus diseases and optic neuropathy have become the main causes of visual disability in low vision clinic. The personalized fitting and proper utilization of low vision aids could enhance its effectiveness, reduce discontinuation rates, and improve the quality of life in visual disability patients. 

Key words:  Visual disability, Low vision aids, Rehabilitation, Reasons for discontinuation, Low vision quality of life questionnaire