Severe Vision Impairment in Hospitalized Patients

I get most of my paper ideas from a free service call Practice Update. When you sign up, you enter in what you are interested in, and they send you a list of links everyday. They all have some commentary, but I enjoy reading them myself. Only about half are fully accessible. The other half are behind paywalls or require purchase. I don’t buy any as that can get expensive. However, I at least read the abstracts to see what they are about. I only write about ones on this site that I have full access to.

At any rate, the article Severe Vision Impairment and Blindness in Hospitalized Patients: A Retrospective Nationwide Study from the June 2021 issue of BMC Ophthalmology was recommended by frequent Practice Update contributor Paul Freeman, OD, FAAP, FCOVD. He deemed it his 2021 Top Story in Eye Care.

The study compares the outcomes of normally sighted vs visually impaired/blind patients in hospital settings. The results are quite depressing. Visually impaired patients had a higher mortality rate and lower odds to be discharged to home as opposed to a tertiary care facility.

The paper doesn’t really go into why this is the case. However, the thought is that hospitalized patients may just be more complicated. If the visual impairment was from severe diabetic retinopathy, the patient is probably going to have comorbidities that will make their hospital stay more complex. Perhaps they had cardiovascular disease that caused an ocular vascular occlusion.

The importance of this paper is to draw attention to this population in the hospital setting. Attending physicians should be ordering low vision consultations for these patients in order to fully take care of them. The conclusion to the paper puts it best.

Patients with severe vision impairment or blindness have worse clinical outcomes and higher resources utilization when hospitalized compared to those without this disability. Hospital-based healthcare providers should recognize this vulnerability and consider how to optimally care for and serve this group of patients.