Low vision practice and service provision among Optometrists in Ghana: a nationwide survey

Aim To characterize practice patterns of low vision services among Optometrists in Ghana. Methods The nationwide cross-sectional survey identified entities through the Ghana Optometrists Association (GOA) registry and utilized a semi-structured questionnaire to consolidate survey information that comprises practitioners’ demographics, available services, diagnostic equipment, barriers to service provision and utilization, and interventions. Results 300 Optometrists were identified, with 213 surveyed (71% response rate). About fifty percent (52.6%) were in private practice, and more than two-thirds (77%) did not provide low vision services. Most (≥ 70%) established lack of assistive devices, and basic eye care examination kits as the main barriers to low vision service provision. Similarly, practitioners reported unawareness of the presence of low vision centres (76.1%), and high cost of low vision aids (75.1%) as the prime perceived barriers for patients to utilize low vision services. Continuous professional development and public education (89-90%) were suggestive interventions to improve the uptake of low vision services. After statistical adjustment, private facility type (Adjusted odds ratio [AOR] = 0.35, p = 0.010) and lack of basic eye examination kits (AOR = 0.32, p = 0.002) were significantly associated with reduced odds of low vision service provision. Conversely, 15-19 years of work experience (AOR = 8.49, p = 0.022) were significantly associated with increased odds of low vision service provision. Conclusion Overall, the results indicate inadequate low vision coverage and service delivery. Government policies must be directed towards equipping practitioners with equipment and subsidize patient cost of treatment to optimize low vision care. What is already known on this topic? Fewer past studies have reported poor low vision service delivery in selected regions and hospitals in Ghana. However, this evidence is an under-representation of the coverage of low vision service delivery in the country and warrants a more robust design to obtain comprehensive estimates. What this study adds The current study extends the existing literature by providing extensive evidence on the practice pattern of low vision services, barriers, and interventions in Ghana. How this study might affect research, practice, or policy? The unmet needs of low vision service delivery for residual vision necessitate institutionalizing pragmatic strategies to augment low vision service delivery, uptake, and delivery in the region. Synopsis/Precis This paper highlights the scope of low vision practice in Ghana. The findings show an unmet low vision coverage, significantly influenced by practice settings, years of work experience, and rudimentary eye examination equipment.