Health Services and Epidemiology

Patient-Centered Outcomes in Severe Peripheral Field Loss 

Vision rehabilitation may improve patients’ quality-of-life functional abilities through the use of assistive devices and educational strategies. However, the effectiveness of rehabilitation options for patients with peripheral vision loss is poorly known since most prior research has focused on patients with central vision loss. In order to evaluate and compare the effectiveness of low vision rehabilitation strategies for patients with peripheral vision loss, a valid and reliable method for measuring vision-dependent functioning is needed. The proposed research will use the insights of patients with glaucoma and retinal dystrophy, their caregivers and their vision care providers to develop a patient-reported outcome measure that assesses functioning in patients with severe peripheral vision loss. Our ultimate goal is to use this outcome measure in future work to determine the effectiveness of low vision services, rehabilitation strategies and models of care delivery. 

Grant Support

NIH/NEI 1K23EY027848
Role: PI
09/01/2017 – 08/31/2022
Addressing Low Vision due to Severe Peripheral Field Loss: Development and Validation of a Patient-Centered Outcome Measure

Aging with Vision Impairment 

As we confront an aging population, the prevalence of vision impairment (VI) will continue to increase. We are interested in understanding the relationship between VI and physical problems such as frailty and falls; socioemotional problems like isolation and decreased quality-of-life; and functional impairment. To understand these issues, our team is using an array of health services research methodologies, ranging from big data to survey research to qualitative interviews. Our hope is that the insights we gain will allow us to address specific barriers to eye care among older adults and to better deliver patient-centered care that meets the needs of an aging population.

Grant Support

• NIH/NIA, 2R01AG051125, Role: Co-I, 9/1/20 – 4/30/25, Harmonized Diagnostic Assessment of Dementia (DAD) for Longitudinal Aging Surveys in India (LASI)
• NIH/NIA, U01AG032947, Role: Co-I, 6/1/19-3/3/24, National Health and Aging Trends Study

Children (n=179) who failed routine, state-mandated vision screening in 11 Wayne County schools have been randomized to receive the standard of care follow-up administered by the Wayne County Department of Health staff, or an enhanced follow-up protocol, in order to evaluate the beneficial impact that enhanced follow-up will have on obtaining examination by an eye care provider to address the reason the child failed vision screening.

This project is supported by a grant from the Kellogg Foundation (Paul Lee, MD, JD, principal investigator), and is being conducted in collaboration with the Wayne County Department of Health, Veterans, and Community Wellness and the State of Michigan Department of Health and Human Services (Rachel Schumann, PhD, RN).

To decrease the prevalence of preventable blindness due to glaucoma, we need to: 1) screen high risk people from vulnerable populations, and 2) ensure people with glaucoma from these vulnerable populations receive and adhere to treatment. Community clinics are key resources to utilize for providing glaucoma screening and care coordination. In the Michigan Screening and INtervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) Progarm, we are leveraging tele-health to provide comprehensive glaucoma screening, education, and follow-up care through the community clinics to provide a sustainable approach to glaucoma care for the vulnerable populations these clinics serve.

Website: https://sightstudies.org/about/university-of-michigan/

Supported By

• Centers for Diseases Control U01 DP006442-01 “Sustainable community clinic telemedicine-based glaucoma screening”