85
J Gandhara Med Dent Sci
October - December 2026
ORIGINAL ARTICLE
How to cite this article
EFFECTIVENESS OF LOW VISION AIDS AS REHABILITATIVE SERVICES GIVEN TO LOW VISION
PATIENTS AT KHYBER TEACHING HOSPITAL, PESHAWAR, PAKISTAN
unaid,
, S
,
,
Natasha J
1
Kashif Ur Rehman Khalil
2
adaf Bilal
3
Faiza Akber
3
Muhammad Dawood Khan
3
Junaid N, Khalil KUR, Bilal S, Akber
F, Khan MD.
Effectiveness of Low
Vision Aids as Rehabilitative Services
Given to Low Vision Patients at
Khyber Teaching Hospital, Peshawar,
Pakistan. J Gandhara Med Dent Sci.
2026;13(4): 85-89.
Date Submission:
03-08-2026
Date Revised:
10-09-2026
Date Acceptance:
14-09-2026
1
Assistant Professor, Department of
Community Medicine, Khyber
Medical College, Peshawar
3
Lecturer, Department of Community
Medicine, Khyber Medical College,
Peshawar
Correspondence
2
Kashif Ur Rehman Khalil, Associate
Professor, Department of Community
Medicine, Khyber Medical College,
Peshawar
:
+92-345-9411704
:
kashif.rehman@kmc.edu.pk
ABSTRACT
OBJECTIVES
This
study
aims
to
determine
the
effectiveness
of
various
low
vision
aids
provided to low vision patients and to observe their impact on quality of life.
METHODOLOGY
A cross-sectional study was conducted to collect data from low vision patients
visiting
the
Eye
OPD,
Khyber
Teaching
Hospital,
Peshawar,
using
a well-
structured
questionnaire.
We
estimated a
total
sample
size
of
100
using
a
formula
and
collected
data
through
non-probability
convenience
sampling.
Informed consent was obtained. We analyzed the data using SPSS version 20.
RESULTS
Of
the
100
participants,
74%
were
male,
and
26%
were
female.
36%
of
participants were aged 5-15 years, whereas 64% were 16-80 years old. 98%
already used low vision aids, and 2% did not. Of these, 66% used telescopes,
16% used magnifiers, and 18% used both. After the use of low vision aids, 40%
of participants had a visual acuity in the range of 6/6 and 6/9, 24% had between
6/18 and 6/12, 21% between 6/24 and 6/18, 11% had between 6/60 and 6/36,
3%
had
between
1/60
and
3/60
and
1%
between
4/60
and
5/60.
Of
100
participants, 51% had average effectiveness, 38% poor effectiveness, and 11%
excellent effectiveness. Participants' quality of life improved significantly. 40%
of
participants
had
slightly
improved
quality
of
life,
38%
had
moderately
improved quality of life, and 22% had significantly improved quality of life.
CONCLUSION
Use of low vision aids has significantly improved vision and quality of life in
low vision patients. The dependency on others to perform various daily tasks
has
greatly
decreased
for
a
vast
majority
of
patients.
Hence,
our
study
concludes that low vision aids have proved to be really effective as a visual
rehabilitative service for low vision patients.
KEYWORDS:
Low Vision Aids, Visual Acuity, Quality of Life
INTRODUCTION
Visual
impairment
and
disability
are
important
public
health issues.
Visual impairment is a decreased ability to
see to an extent that causes problems that cannot be fixed
by
conventional
methods
such
as
wearing
glasses
or
using medication.
1
It is the limitation of the actions or
functions of the visual system, which can include loss of
visual
acuity
or
visual
field,
perceptual
difficulties,
diplopia, photophobia, or
a combination of
the
above.
The
major
causes
of
visual
impairment
include:
uncorrected
refractive
error,
cataract,
retinal
degeneration,
glaucoma,
diabetic
neuropathy,
corneal
opacity,
neurological
disorders.
2
The
WHO
characterizes levels of visual debilitation based on visual
acuity
or
potential
visual
field
restriction,
and
defines
visual
impairment
as
a
significant
hindrance
(this
can
refer to visual deficiency in one eye or impairment in the
individual).
3
The
WHO
defines
visual
impairment
as
visual acuity under 20/400 and a visual field of less than
10 degrees in the better eye. Visual sharpness of 20/70 to
20/400
(comprehensive)
is
viewed
as
moderate
visual
disability or low vision.
4
According to WHO, 191-285
million
people
worldwide
have
vision
impairment,
39
million blind and 246 million with low vision. About 80
million people worldwide need low vision care. Of these,
6 million are children, 4.8 million of whom live in low-
and middle-income countries.
5
According to research, an
estimated 727,00 adults in Pakistan have functional low
vision.
The
standardized
prevalence
of
functional
low
vision
and
total
blindness
is
1.7%
and
0.2%,
respectively. Globally and in Pakistan, management of
visually impaired individuals has largely been focused
on rehabilitation through assistive technologies, training,
rehabilitation
services
and
education.
6
Visual
rehabilitation
aims
to
restore
functional
ability
and
improve
quality
of
life
after
vision
loss.
Visual
rehabilitation
services
include
Visual
Assessment,
in
which a low-vision eye exam is done to check residual
function.
7
Providers may prescribe eyeglasses and other
visual aids, such as magnifiers, telescopes, and filters.
Visual
skill
training
in
which
eyes
are
trained
to
use
visual aids and strategies.
8,9
Environmental
Adaptation
http://doi.org/10.37762/jgmds.13-4.979
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J Gandhara Med Dent Sci
October - December 2026
includes
lighting
recommendations,
contrast
enhancements,
labeling,
organization,
and
glare-
reduction
techniques.
10
Adaptive
communication
techniques
include
Braille,
computer
and
handwriting,
listening
and
recording
techniques,
low
vision
technology, and math and keyboarding. Low vision aids
include magnifiers, reading spectacles, telescopes, glare-
control
devices,
and
enlarged
products.
11
Home
skills
training includes communication skills, self-care skills,
personal
management,
socialization
skills,
vocational
training,
education,
and
recreation
activities.
12
The
present study is very helpful as it will assess the effect of
low vision aid devices and their impact on the quality of
life of visually impaired people.
METHODOLOGY
A cross-sectional descriptive study was carried out from
January
2024
to
April
2025
at
the
Eye
OPD,
Khyber
Teaching Hospital, Peshawar. Data were collected after
ethical approval (Ref No. 819/DME/KMC, dated 27-09-
2023 ) from the Ethics Committee of Khyber Medical
College, Peshawar. Before data collection, we informed
patients about the study and obtained consent. We then
used a well-structured proforma to gather information on
the underlying cause of low vision and the performance
of daily activities such as reading a newspaper or mail,
watching
television,
recognizing
people,
signing
documents, driving, walking up stairs, etc., after using
low-vision
aids
to
assess
their
effectiveness.
Simultaneously, visual acuity tests were also performed
using a Snellen eye chart. We calculated a sample size of
approximately 100 using OpenEpi online software, with
a 95% confidence interval, a 5% margin of error, and an
anticipated
frequency
of
low
vision
of
7%
from
a
previous study. The present study included children and
adults
aged
5
to
60
years.
We
collected
data
using
a
structured proforma and used a Snellen chart to measure
visual acuity. Data were analyzed using SPSS version 26
for Windows. Quantitative variables were summarized
as mean ± SD, and qualitative variables were presented
as percentages and frequencies. All data were presented
in tables and graphs.
RESULTS
A total of 100 participants were included in the study. Of
these, 36 (36%) were children aged 5–15 years and 64
(64%) were adults aged 16–60 years. Most participants,
98
(98%),
reported using
a
low-vision
aid,
whereas
2
(2%)
did
not use
any
low-vision
aid.
Among
the
100
participants,
telescopes
were
the
most
frequently
used
low-vision
aid,
reported
by
66
(66%)
participants.
Magnifiers alone were used by 16 (16%), while 18 (18%)
participants
used
both
a
telescope
and
a
magnifier
(Figure 1).
Figure
1:
Distribution
of
Low-Vision
Aids
Used
by
Study
Participants (N=100)
Before using low-vision aids, the largest proportion of participants, 64
(64%),
had
visual
acuity
between
6/60
and
6/36.
Ten
(10%)
participants
had
visual
acuity
between
1/60
and
3/60,
11
(11%)
between 4/60 and 5/60, and 13 (13%) between 6/24 and 6/18. Only 2
(2%) participants had visual acuity between 6/18 and 6/12 (Figure 2).
Figure 2: Distribution of Visual-Acuity Categories before Use of
Low
-
Vision Aids
(n=100)
Following use of low-vision aids, visual acuity shifted toward better
acuity
categories.
Forty
(40%)
participants
achieved
visual
acuity
between 6/9 and 6/6, 24 (24%) were between 6/18 and 6/12, and 21
(21%)
were
between
6/24
and
6/18.
The
remaining
15
(15%)
participants were reported in lower visual-acuity categories; however,
the
available
data
did
not
provide
a
further
breakdown
of
these
participants (Figure 3).
Figure 3: Distribution of Visual-Acuity Categories after Use of
Low-Vision Aids (n=100)
Effectiveness of Low Vision Aids as Rehabilitative Services
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J Gandhara Med Dent Sci
October - December 2026
The mean coded visual-acuity score increased from 2.86 ± 0.84 before
use of a low-vision aid to 4.82 ± 1.27 after use. The reported two-tailed
significance
value
was
<0.001,
indicating
a
statistically
significant
improvement in visual acuity following use of low-vision aids (Table
1).
Because
the
available
output
provides
only
the
coded
means,
standard deviations, standard errors, and p-value, the corresponding
test statistic and confidence interval are not reported here.
Table 1: Comparison of Coded Visual-Acuity Scores Before and
After Use of Low-Vision Aids.
Visual-acuity
assessment
Mean
N
SD
SE
p-value
Without low-
vision aid
2.86
100
0.841
0.084
With low-
vision aid
4.82
100
1.266
0.127
<0.001
Note: The p-value is reported as p<0.001 rather than
p=0.000.
The
analysis
should
be
identified
in
the
Methods
as
a
paired-samples
test
if
the
same
participants
were
assessed
before
and
after
the
intervention.
Based
on
the
study’s
effectiveness
grading,
51
(51%)
participants rated the effectiveness of low-vision aids as
average, 38 (38%) as poor, and 11 (11%) as excellent
(Figure 4).
Figure 4. Participant-Rated Effectiveness of Low-Vision Aids
(n=100).
Participants also reported improvement in quality of life
after
using
low-vision
aids.
Forty
(40%)
participants
reported
slight
improvement,
38
(38%)
reported
moderate
improvement,
and
22
(22%)
reported
significant
improvement
(Figure
5).
Thus,
all
participants
reported
at
least
some
improvement
in
quality
of
life,
although
the
degree
of
improvement
varied across participants.
DISCUSSION
The present study showed that visual acuity significantly
improved with the use of visual aids in both children and
adults. The quality of life of about 38% of participants
improved
moderately,
while
22%
showed
significant
improvement. International studies on the effects of low
vision aids also showed benefits. A study by Erginturk
Acar showed that patients with low vision due to macular
degeneration
had
a
statistically
significant
increase
in
overall vision, distance activities, and social functioning.
In
the
rehabilitation
group,
statistically
significant
increases were found in the overall composite score, and
general
vision,
near
and
distance
activities,
social
functioning,
mental
health,
role
difficulties,
and
dependency subscale scores of the NEI-VFQ-25 quality
of life scale after low vision rehabilitation (p=0.009 for
general vision, p < 0.001 for others). Overall quality of
life improved significantly.
13
Our results align with the
cited
study
and
showed
that
quality
of
life
greatly
improved
after
using
low
vision
aids.
Interventional
studies
also
evaluated
the
effectiveness
of
low
vision
aids. A non-randomized controlled trial by Nisha et al.
showed
that
the
intervention
group
had
significant
improvement in vision-related quality of life, including
daily tasks. The use of LVAs improved reading and near
visual
acuity
by
3.57 ± 1.76
and
2.25 ± 2.79
lines,
respectively. The percentage of patients able to read font
size 2 increased
from 2.7% to 53.0% after using
near
vision aids. The results showed that low vision aids can
be
a
good
option,
but
compliance
with
the
aid
is
a
necessary factor.
14
Our findings showed that quality of
life improves with aid use, but this cross-sectional study
only shows a baseline association. A study from Nigeria
showed that visual aid use in rehabilitation of visually
impaired patients improved outcomes among those with
good
compliance.
Compared
with
children,
adults
showed
significant
improvement.
15
The
use
of
LVAs
improved reading and near visual acuity by 3.57 ± 1.76
and
2.25 ± 2.79
lines,
respectively.
The
percentage
of
patients able to read font size 2 increased from 2.7% to
Figure 5: Reported Improvement in Quality of Life Following
Use of Low-Vision Aids (n=100)
53.0% after using near vision aids. In the present study,
age was not significantly associated with quality-of-life
improvement. A cross-sectional study from Saudi Arabia
evaluated
the
quality
of
life
of
patients
previously
diagnosed
with
keratoconus.
The
participants reported
significant
improvement
after
using
low
vision
aids.
16
Our study showed mixed improvement with low vision
aids.
Various
studies
in
Pakistan
have
examined
the
importance of visual aids in visually impaired patients.
A
study
by
Fatima
Zahid
showed
significant
improvement in patients' mobility after using visual aids.
The
most
common
devices
used
in
this
study
were
Effectiveness of Low Vision Aids as Rehabilitative Services
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J Gandhara Med Dent Sci
October - December 2026
Another study by Ansa et
magnifiers(38.5%).
17
Our
study
found
that
16%
of
patients used magnifiers.
al.
showed that 51.8% preferred telescopes for low vision
Aids.
Visual
acuity
improved
significantly
(p-value
<
0.05)
after
using
low
vision
Aids
18
.In
our
study,
telescopes
and
magnifiers
were
the
preferred
devices.
Similarly, visual acuity improved after using low vision
aids. Regarding awareness of low vision aids, a study by
Sharqa
et
al.
showed
that
58.8% of
patients
had
poor
awareness of low vision aid devices. Those already using
devices
showed
beneficial
effects,
as
reflected
in
improved
quality
of
life.
19
Similarly,
our
study
also
found a lack of awareness about devices, and those who
used them showed improved quality of life. Numerous
other studies in Pakistan showed that the patient's quality
of life significantly improved with the use of low vision
devices.
These
studies,
including
the
present
study,
provide strong evidence that these devices are effective.
The main reasons for not using them are their cost and
lack
of
awareness.
20,21,22
The
present
study
has
limitations, including a small sample size and a single-
center
design.
This
topic
can
be
further
extended
to
assess patients' barriers and knowledge regarding the use
of low vision aids.
LIMITATIONS
This study has several limitations. The relatively small
sample
size
and
single-center
design
may
limit
the
generalizability of the findings to the wider low-vision
population.
The
use
of
non-probability
convenience
sampling
may
have
introduced
selection
bias.
Furthermore, the cross-sectional design and absence of a
control or comparison group limit the ability to establish
a causal relationship between the use of low-vision aids
and
improvements
in
visual
acuity
or
quality
of
life.
Quality-of-life improvement was based on participant-
reported responses rather than a validated standardized
quality-of-life
instrument.
Future
multicenter
studies
with
larger
samples,
standardized
assessment
tools,
longer follow-up, and appropriate comparison groups are
recommended to confirm these findings.
CONCLUSIONS
Low vision aids are significantly effective in improving
vision
and
the
social
life
of
low
vision
patients.
Our
results
indicate
that
patients'
visual
acuity
improved
substantially with these aids as a rehabilitative measure.
Moreover, we assessed these patients' quality of life after
they were prescribed and used low vision aids. We can
successfully
conclude
that
the
inclusion
of
aids
has
positively
affected
them
socially
and
physically
by
decreasing
their
dependency
on
others
and
mentally
rendering them free from depression and frustration that
came with not being able to do their daily tasks on their
own.
These
patients'
working
efficacy
has
improved
tremendously after use. Furthermore, almost all patients
recommended using low vision aids.
CONFLICT OF INTEREST:
None
FUNDING SOURCES:
None
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Sci.
2023;4(6):258-262.
doi:10.54393/pjhs.v4i06.879.
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Natasha Junaid
-
Concept & Design; Data Acquisition;
Data
Analysis/Interpretation;
Critical
Revision;
Supervision;
Final
Approval
Kashif
Ur
Rehman
-
Concept
&
Design;
Data
Analysis/Interpretation; Drafting Manuscript;
Final Approval
Sadaf
Bilal
-
Concept
&
Design;
Data
Acquisition;
Critical
Revision;
Final Approval
Faiza Akber
-
Concept & Design; Data Analysis/Interpretation;
Critical Revision;
Final Approval
Muhammad
Dawood
Khan
-
Concept
&
Design;
Data
Acquisition;
Data
Analysis/Interpretation;
Critical
Revision;
Final Approval
AUTHORS CONTRIBUTION
The authors accept responsibility for all aspects of the work
and will ensure that any concerns regarding the accuracy or
integrity of any part are properly investigated and resolved.
Effectiveness of Low Vision Aids as Rehabilitative Services
