The state of low vision care in Ontario between 2009 and 2015
Author Disclosure Block: A. Basilious: None. A. Basilious: None. A. Mao: None. C. Hutnik: None.
Abstract Body:
Purpose: Little is known about how low vision services by ophthalmologists are being accessed and provided. The aim of this study was to analyze the patterns of provision and utilization of vision rehabilitation services in Ontario, Canada from 2009 to 2015.
Study Design: Retrospective population-based study between 2009 and 2015.
Methods: Data associated with vision rehabilitation billing codes was obtained from the Ontario Health Insurance Plan (OHIP) database. All ophthalmologists (N=92) who billed for vision rehabilitation services through OHIP between 2009 and 2015 in Ontario and the patients (N=8949) who received these services were included in this study.
Results: The patient population that received vision rehabilitation services between 2009 and 2015 was comprised mostly of individuals older than 60 years old (79%) and more females (61%) than males. While patient and provider geographic distributions overlapped in the areas with largest patient populations, many regions lacked services. Over the seven-year period analyzed, the majority of these patients (71%) made only one vision rehabilitation visit. A small subset of patients (11%) made more than two visits. In 2010 to 2012, follow-up visits were more common than initial assessments. However, in 2009 and 2013 to 2015, initial assessments were more common. Only nine providers practiced low vision for seven years, while 43 provided services for only one year. In 2015, the most common diagnostic services provided to low vision patients were Optical Coherence Tomography (OCT) of the retina, OCT retina for laser or intravitreal (IV) injection and OCT retina for laser or IV for neovascularization (NV). The most common therapeutic services were IV for wet age-related macular degeneration (AMD), paracentesis, and IV for non-AMD.
Conclusions: Although low vision services increased steadily between 2009 and 2015, it is estimated that in any given year, 5% or less of those living with low vision accessed these services. There were inequities in ability to access these resources based on age, sex, and geographic location. There is a significant need to increase number of providers, service locations, and access for patients.
