Low vision assessments as a routine normally include case history and psychophysical measurements. By adding mental health state and low vision quality of life questionnaires during case history, a better quality of low vision rehabilitation can be offered to low vision patients. Low vision rehabilitation is very rewarding because much can be offered to assist the low vision patients. We report a 43-years old female who had tractional retinal detachment secondary to diabetic retinopathy and how low vision rehabilitation can be improved by adding simple steps incorporating mental health state and quality of life questionnaire which can be measured objectively during case history in low vision assessment. As this case report shows, recognition of the mental health and quality of life impact on visual impairment is very critical to institution of appropriate rehabilitation and referral for low vision patients.
Currently, low vision assessment routine normally involved mainly the case history which includes the patient’s main complained, patient’s requirements, patient’s ocular history, patient’s general health plus medication, family history of ocular diseases and general health. The psychophysics measurement such as visual acuity (VA), refraction, visual field measurement, contrast sensitivity function test, assessment of anterior and posterior part of the eyes were the common examination conducted during low vision assessment (Jackson & Wolffsohn 2007). However, mental health state i.e The Depression Anxiety Stress Scales (DASS) (Ramli et al. 2007) and Low Vision Quality of Life Questionnaires (LVQoL) (Walffsohn & Cochrane 2000) are not routine in case history during low vision assessment at Low Vision Clinic, Universiti Kebangsaan Malaysia (LVC UKM).
Mental health state can be objectively measured by DASS (Appendix 1) Dass classify mental health to depression, anxiety and stress. Each of these mental health problems are divided into mild, moderate, severe and very severe depending on the scores obtained from the questionnaires. The classification of DASS is shown in Table 1.
Whereas, Quality of life can be measure objectively using the LVQoL assessment questionnaire on a scale of 0 - 125 where 0 measures no quality of life and 125 measures the best achievable quality of life (Appendix 2). The LVQoL score 1). Normal score 94 to 125 2) Mild score 63 to 93 3) Moderate score 32 to 62 and 3) Severe score 0 to 31. The category of LVQoL Score is summarized in Table 2. The LVQoL is a reliable and fast method for measuring the quality of life among the visually impaired in a clinical setting. The LVQoL assessment questionnaire also will able to quantify the quality of life of those with low vision pre and post low vision rehabilitation.
Low vision thus not only affects the daily activities and quality of life but it has also been proved to have effect on mental health (John & Crew 2004). Previous study by Noran et al. 2009...