Causes of Missed Referrals to Low-Vision Rehabilitation Services: Causes in a Tertiary Eye Care Setting.

<bold>Purpose: </bold>To identify the referral pattern and identify causes of missed referrals to low-vision services in a tertiary eye care center. <bold>Methods: </bold>A retrospective review of all the hospital records of patients seen from September-December 2012 was done to identify patients with visual impairment. Low vision was defined as has a best-corrected visual acuity (BCVA) in the better eye of <20/60 to light perception (as per WHO definition); or a visual field of <20° from the point of fixation. The frequency of referrals in this database was used to identify referral patterns of physicians and also causes for missed referrals for these patients. <bold>Results: </bold>Of 14,938 hospital medical records reviewed during the period, 499 patients missed low-vision services with a mean age of 46 ± 18.2 years, including 158 females. Among those missed, 12.07% were in the age group 0-15 years, while 30.9% of the patients were >60 years, with 157 requiring rehabilitative services and training. Causes for missed referrals were clear misses or non-referrals by the physician (39%), non-acceptance of services by the patient (53%), loss from appointment desks (4.5%), and loss to follow-up (3.5%). <bold>Conclusion: </bold>Missed referral to low-vision services in tertiary centers can be considerable; these need to be identified for optimal utilization and delivery of these services to patients with low vision. [ABSTRACT FROM AUTHOR]