Visual rehabilitation of patients with Stargardt's disease.

OBJECTIVE To assess the role of low vision devices in visual rehabilitation of patients with Stargardt's disease. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY The Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan, from June 2003 to June 2005. PATIENTS AND METHODS Patients diagnosed as having Stargardt's disease and confirmed by two senior ophthalmologists clinically and after fluorescein fundus angiography and Electro-Retinogram (ERG) when needed, were included in the study. Patients with fundus pathologies other than Stargardt's disease were excluded. Each subject underwent an ophthalmic examination. Visual acuity was tested with a logarithm of the minimum angle of resolution chart; Feinbloom chart and Snellen type. Low vision assessment was performed on all individuals. SPSS version 10 was used for analysis of the data regarding the severity of visual impairment, visual acuity and devices used for aiding vision. Chi-square test was used for comparison of proportions. RESULTS Of this cohort of 64 patients, 72% were aged between 7 to 15 years and 28% were 16 to 32 years. Using WHO low vision criteria, the percentage of visually impaired, severe visually impaired and blind (at the time of presentation) were 56.3%; 31.3% and 9.4% respectively. Among those patients, 3.1% had distance visual acuity of 6/18 or better in the better eye and 53% had normal near visual acuity of 1M (0.8 print size). Telescopes were prescribed to 53% patients for enhancement of distance visual acuity to meet their needs. CONCLUSION Stargardt's patients respond well to magnification. Simple bifocal glasses may be used in the early stages. Visual rehabilitation can help Stargardt's patients to learn independence in their activities of daily living.