Recomendaciones basadas en la evidencia para el diagnóstico, el tratamiento, la rehabilitación y el seguimiento de personas mayores de 7 años con baja visión

Purpose: To develop evidence-based recommendations for the diagnosis, functional rehabilitation, and follow-up of people with low vision between 7 and 18 years of age and over 18 years of age. Method: A development group was formed with the participation of patients. A systematic search was performed, and the quality of the studies and the body of evidence were evaluated. Recommendations were made using the Grade Evidence to Decision Framework, which were validated with national experts. Results: In the diagnostic section, the quality of the evidence regarding visual acuity and visual field was low; in these tests, a weak recommendation was generated in favor of the use of the Early Treatment Diabetic Retinopathy Study and Microperimetry primer, respectively. Regarding contrast sensitivity, the quality of the evidence was very low and a weak recommendation was given in favor of the use of the Pelli-Robson test. As for treatment, the quality of evidence regarding electronic optical aids was moderate and a weak recommendation is given in favor of their use. Regarding manual and electronic magnifiers, telescopes and tablets, the quality of evidence was very low and a weak recommendation in favor of their use is given. In the section on rehabilitation, the quality of the evidence regarding this aspect for persons over 16 years of age was moderate, and there is a strong recommendation in favor of multidisciplinary and multicomponent rehabilitation. On the other hand, the quality of the evidence regarding rehabilitation for people between 7 and 16 years of age was low, and there is a strong recommendation in favor of its use. The quality of evidence for occupational therapy interventions was low and a weak recommendation is given in favor of its use. Regarding psychology, the quality of the evidence for interventions of this type was low and a strong recommendation is given in favor of their use. Finally, the quality of evidence for the use of follow-up scales was high and strong recommendation is given in favor of the use of the National Eye Institute Visual Function Questionnaire-25. Conclusions: The recommendations issued allow giving a general guideline for the comprehensive management of low vision, reducing unwanted variability in diagnosis, rehabilitation, and follow-up.