Low Vision among Adults: Etiology, Risk Factors and Management Outcomes at a Tertiary Eye Care Centre in Bangladesh

Abstract

Purpose: To identify the causes and risk factors of low vision in adults and to assess visual outcomes following the provision of optical and non-optical low vision management at a tertiary eye care centre.
Methods: A hospital-based prospective study was conducted on 110 adult low vision patients (aged 18 years and above) attending the low vision clinic of CEITC, Chattogram, between September 2023 and August 2024. Patients were selected purposively. Each underwent a comprehensive ocular and low vision assessment including distance and near visual acuity (LogMAR and N notation), refraction, contrast sensitivity, colour vision, visual field, and intraocular pressure. Optical and non-optical low vision devices were trialled and prescribed. Data were analysed in SPSS v16.0; a paired t-test was used to compare outcomes, with p<0.05 considered significant.
Results: The mean age was 33.22 ± 12.69 years and most patients (38.2%) were aged 18–27 years; 61.8% were male. Most were literate (73.6%) and from rural areas (72.7%). Macular dystrophy (25.5%) was the leading cause, followed by retinitis pigmentosa (16.4%) and pathological myopia (10.9%); retinal disease accounted for 68.2% of cases overall. Compound myopic astigmatism (30%) was the commonest refractive status. After spectacle correction and distance device trial, 12.7% of eyes reached near-normal acuity (6/6–6/18); improvement in distance acuity was statistically significant (p<0.001). Spectacles were prescribed to about 90% of patients, near devices to 42%, and distance devices to 14.5%.
Conclusion: Low vision predominantly affected young rural adults, with hereditary retinal disease chiefly macular dystrophy as the leading cause. Optical correction and low vision devices significantly improved visual function, underscoring the need for early detection, awareness and accessible rehabilitation in underserved communities.