Perceived environmental barriers and supports for people with low vision due to diabetic retinopathy

According to the CDC, 7% of the U.S. population had diabetes in 2005 with increasing prevalence rates each year. As diabetes becomes more common, so will the number of people who are living with complications of the disease, such as diabetic retinopathy, which is the leading cause of new cases of blindness for those ages 20 to 74. As a result, it is essential that health care professionals understand the needs of these people, including how they interact with the environments surrounding them. The purpose of this qualitative descriptive study was to examine the environmental supports and barriers for eight people with diabetic retinopathy, and the adaptations they made in order to function with low vision. Data were obtained through individual interviews and observations in people's homes and through focus groups. Despite interview questions being focused on the physical environment, participants talked about environment in a much broader way, discussing the supports and barriers in the social environment as well. Based on this finding, results were organized using the categories of environment defined by the International Classification of Functioning (ICF): Products and Technology; Natural Environment; Support and Relationships; Attitudes; Services, Systems and Policies. Data that fell into the ICF category of Body Function: Emotional Functions were also included as they had a major impact on participants' adaptation to vision loss and interaction with the environment. Recommendations for health care providers include always keeping a holistic perspective of clients, such as looking in depth at both the physical and social environment; recognizing the importance of peer support; conducting more rehabilitation in the community; and understanding that adaptation to vision loss includes a grieving process. By helping clients learn how to adapt to their changing vision and overcome barriers in both the physical and social environment, health professionals can assist clients in achieving improved participation in meaningful activity.