Visão subnormal : apresentação de um modelo de atendimento e caracterização das condições de diagnostico e tratamento em um serviço universitario do Brasil

AUTOR(ES)
DATA DE PUBLICAÇÃO

1993

RESUMO

PURPOSE: The purposes of this study are to describe the SVSN-UNICAMP in the assistencial, educative and rehabilitative aspects as contribution to creation of similar services in University Medical Schools in Brazil and to analise the results of the medical attendances of the patients between 1982-1991.METHODS: The SVSN-UNICAMP is described since their begining in 1979, after transformed in an compreensive service with a multidisciplinary team in 1982 and the sucessive modifications until today. The Low Vision Service is described in respect the tecnical fundaments, the organization, the role of the professionals, the equipments, the optical and nonoptical aids, the instruction programs for the patient, the family and the school, the training programs for Medical students, Ophthalmology residents and medical assistants. To analise the results of the SVSN-UNICAMP we did a retrospective study of the 836 cases attended between 1982-1991. The low vision population is caracterized in respect to age, sex, age of perception of the problem, age of first ophthalmological examination, age of the exam at the SVSN-UNICAMP, previous low vision examination, condition considered primarily responsible for low vision, kind of low vision aids prescribed in relation to ocupational activity and school grade, improvement of visual acuity, educative and rehabilitative orientation programs. RESULTS: The children and young until 19 years of age were 56 % of the population and the ageing above 60 years of age were 15.5%. In the produtive age, between 20-59 years of age, only half received fimincial earn for the activity developed. We found 2.6% of the cases between 7-14 years of age still without school by the visual deficiency. The previous low vision examination was low and ocurred in 6.2 % for prescription of low vision aids, 5.4% for training of the use, 4.9% had effective use of the aids prescribed and 1.8% had received rehabilitative orientation programs. We detected a delay in visual rehabilitation. The low vision cases were almost 7 times more frequent than the blindness ca ses. The most frequent diagnose was congenital bilateral macular corioretinitis presumible for toxoplasmose with 27.4 % of cases. Afier we found optic atrophy with 11.7%, agerelated macular degeneration with 9.4%, pigmentar retino se with 8.3% and congenital cataracts with 7.8 % of cases. The telescope was prescribed for students in 90 cases (65.2% of the telescopes prescribed). The near aids were distributed in the occupations categories equitative. Low magnifications were enough for the majority of cases beeing 83 % of aids prescribed unti14X magnification. Simple, inexpensive and nationallow vision aids were supplied for a high proportion of the cases. The variation of visual acuity before and after the low vision aids like telescopes, asferic, esferoprismatic and microscopics lenses was statistical significant. In the follow-up cases attended between 1989-1991 we found that 16% did not used the prescribed aids beeing the reasons lack of aquisition in 7.4 %, r~jection in 7.4 % and worst of visual acuity in 1.2 %. The low number of rejentions was due to the training programs with educative and rehabilitative managements adopted by the multidisciplinary team. CONCLUSION: This work shows the creation of a Low Vision Service in a University General Hospital, the excelent program developed, its progressive adequation to reality with crescent number of patients, the description of the low vision population, the caracteristics of the attendances with the medica!, educative and rehabilitative manegement. The final recomendations are about thé role of the University in attending the patient, teaching and training for Medical students and Ophthalmology residents and in research, always aiming the welfare community

ASSUNTO(S)

oftalmologia - pesquisa cegueira hospitais universitarios disturbios da visão

ACESSO AO ARTIGO

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