Impact of living with bilateral central vision loss due to geographic atrophy – qualitative study

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BMJ Open. Jul 29, 2021; 11 (7): e047861. doi: 10.1136 / bmjopen-2020-047861.

ABSTRACT

OBJECTIVE: Geographic atrophy (GA), a type of age-related dry macular degeneration, affects vision in the form of central vision loss (CVL). The challenges faced due to bilateral CVL in the activities of daily living and the strategies taken to overcome these challenges are not very well understood in the Indian population. This qualitative study aims to understand the impact on activities of daily living and associated coping and coping strategies in people with long-standing bilateral CVL due to GA in India.

DESIGN, PARTICIPANTS, BACKGROUND AND METHODS: A qualitative study using a semi-structured face-to-face interview was conducted on 10 people with bilateral CVL after obtaining written informed consent. The interviews were audio-recorded and were transcribed verbatim. A thematic analysis was carried out to understand the challenges encountered and the methods of adaptation due to the impact of CVL.

RESULTS: Ten participants (50% male) with a median age (IQR) of 72 (70, 74) years were interviewed. All participants had better corrected visual acuity of ≤ 6/60 in the better eye and reported absolute central scotoma with the Amsler chart at home. The qualitative thematic analysis identified four main themes: the challenges of everyday life (difficulty in identifying the face, reading), the challenges related to lifestyle and socialization (driving, cooking, reading longer, watching the television, social inactivity), psychological implications (depression, poor self-esteem, fear of poor vision) and strategies for overcoming challenges (voice identification, technological support).

CONCLUSION: GA has a severe negative impact on the quality of life of people with CVD. The inability to recognize faces was the main reason for dependence on others and social disconnection. The results will help clinicians provide better rehabilitative care.

PMID:34326049 | DO I:10.1136 / bmjopen-2020-047861


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