Effectiveness of low vision rehabilitation on visual function and quality of life in Sub-Saharan Africa: a systematic review.
Kwadwo Owusu Akuffo, Sylvia Agyekum, Sylvester Kyeremeh and 9 others
PMID 42718717WHAT IT FOUND
Low-vision services that provided assessment, devices, and sometimes training were associated with better distance acuity and vision-related quality of life in one of three small studies, but a reading-rate gain was not supported and evidence was low.
Key findings
01Only three studies met the review criteria, and all evaluated optical low-vision devices as part of the rehabilitation intervention.
02In the Ghana study, 22 participants followed up after low-vision assessment and optical device provision had significant improvements in 8 of 10 vision-related quality-of-life subscales and distance acuity improved from 1.04 to 0.83 logMAR, an average two-line gain.
03In the South Africa study, reading rate increased from 59.3 to 67.1 correct words per minute with optical devices plus basic training, but the change was not statistically significant (p = 0.087).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only three studies met the review criteria, and none were randomised controlled trials, so the review could not combine the results or rule out bias. All included studies evaluated optical devices within low-vision services, so this review does not test non-optical rehabilitation such as visual skills training, environmental modification, assistive technology, or counselling. The Ghana study followed up only 22 of the 25 participants who received devices, and the South Africa study included only 15 children, so the findings are small and may not generalise. The two quasi-experimental studies had no control group, so it is not possible to know how much of the change was due to the devices rather than time, assessment, or usual care. The Kenya and Uganda study was cross-sectional and had unclear inclusion criteria and no control of confounding, so it cannot show that devices caused improvement. Only one study measured vision-related quality of life, and the studies used different outcome measures, so the overall evidence is heterogeneous. The search was limited to English-language publications, so relevant studies in other languages may have been missed. The authors note that publication bias is possible because studies with positive findings are more likely to be published. The review notes that the studies focused on school-aged participants and that adult populations were not studied.
Declared interests
The authors declared that financial support was received for the work or its publication. The study was funded by the Else Kröner-Fresenius Stiftung Foundation through the HM KNUST Low Vision Project (Grant ID 2022_EKHA.141), awarded to KA and WE.
The easy way to misread this
Do not read this as proof that optical magnifiers alone improve vision or quality of life. The included studies also involved low-vision assessment and, in one study, basic device training, had no control group, and were small, so the contribution of any single component cannot be separated.