Self-reported health and social well-being of adults living with vision loss during the COVID-19 pandemic.

COVID-19 disproportionately affects vulnerable individuals, such as those living with disabilities.1Patel JA Nielsen FBH Badiani AA et al.Poverty, inequality and COVID-19: the forgotten vulnerable.Public Health. 2020; 183: 110-111Crossref PubMed Scopus (431) Google Scholar The blind and vision-impaired (BVI) community is particularly vulnerable to COVID-19 complications and at increased risk of physical injuries (i.e., falls and fractures) and lower quality of life.1Patel JA Nielsen FBH Badiani AA et al.Poverty, inequality and COVID-19: the forgotten vulnerable.Public Health. 2020; 183: 110-111Crossref PubMed Scopus (431) Google Scholar This study is the first to quantify the self-reported effect of COVID-19 on the health conditions of BVI Canadians.2Bubbico L Bellizzi S Ferlito S et al.The impact of COVID-19 on individuals with hearing and visual disabilities during the first pandemic wave in Italy.Int J Environ Res Public Health. 2021; 18: 10208Crossref Scopus (2) Google Scholar, 3Rodríguez-Fernández CA Varela-Agra M Pérez-Roldán L et al.Impact of COVID-19 on eye care in Spain during the first phase of the pandemic.J Clin Med. 2021; 10: 4087Crossref Scopus (3) Google Scholar, 4Koh A Chen Y Perspective from Singapore and China on the COVID-19 pandemic: the new world order for ophthalmic practice.Ophthalmology. 2020; 127: e49-e50Abstract Full Text Full Text PDF Scopus (0) Google Scholar, 5Shalaby WS Odayappan A Venkatesh R et al.The impact of COVID-19 on individuals across the spectrum of visual impairment.Am J Ophthalmol. 2021; 227: 53-65Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar We discuss the key concerns identified in our COVID-19 Impact Survey and recommend strategies to address these issues. The COVID-19 Impact Survey is a bilingual cross-sectional survey (English and French) designed by the Canadian National Institute of the Blind (CNIB, https://cnib.ca/). With ethics approval, the survey was open to all clients and administered via SurveyMonkey (San Mateo, Calif.) or telephone. Responses were collected between April 14, 2020, and May 18, 2020. Exclusion criteria included being unable to provide informed consent, providing incorrect contact information, and being younger than 18 years of age. Subsections of the COVID-19 Impact Survey (CIS), “About You” and “Healthcare,” were analyzed. The “About You” section contained 14–9 questions and queried participants’ sociodemographic status (Appendix 1, available online). The “Healthcare” section contained 1–35 questions and queried participants about their concerns about health care as a result of the COVID-19 pandemic (Appendix 2, available online). Analyses were conducted using IBM SPSS Statistics, version 22 (IBM Corporation, Armonk, NY), and descriptive statistics were applied. Seven hundred and ninety-eight participants consented to this study, and 724 responses were collected (Table 1). Females represented 56% of the responses. Among the participants, Ontario was the most common province represented (42%), followed by Quebec (20%) and British Columbia (18%). In a subpopulation of 325 respondents, 91% self-reported as white.Table 1Characteristics of the 724 survey respondents living with eye diseases.CharacteristicResult, n (%)Age, years 35–64485 (67) 18–34, 65+239 (33)Age of sight loss Birth to 2 years256 (35.4) 2–18 years83 (11.5) 18–24 years62 (8.6) 25–44 years132 (18.2) 45–64 years105 (14.4) 65+ years77 (10.6) Unknown9 (1.2)Extent of sight loss Normal or mild visual impairment36 (5) Moderate visual impairment311 (43) Severe visual impairment or registered blind203 (28) Not mentioned174 (24)Sex Female405 (56%) Male297 (41) Not mentioned22 (3)Ethnicity*This was based on 325 responses of people who agreed to respond to extra demographic questions. White298 (91.7) BAME10 (3.1) Not mentioned17 (5.2)Eye conditions†This was based on 341 responses because some individuals reported living with more than one eye condition. Cataract94 (27.6) AMD94 (27.6) Glaucoma84 (24.6) Retinal diseases‡Retinal diseases include diabetic retinopathy, inherited retinal diseases, and others.36 (10.6) Corneal diseases§Corneal diseases include corneal infection, keratoconus, Fuchs corneal endothelial dystrophy, and others.24 (7.0) Others9 (2.6)BAME, black, Asians, and minority ethnicity; AMD, age-related macular degeneration This was based on 325 responses of people who agreed to respond to extra demographic questions.† This was based on 341 responses because some individuals reported living with more than one eye condition.‡ Retinal diseases include diabetic retinopathy, inherited retinal diseases, and others.§ Corneal diseases include corneal infection, keratoconus, Fuchs corneal endothelial dystrophy, and others. Open table in a new tab BAME, black, Asians, and minority ethnicity; AMD, age-related macular degeneration Two hundred and seventy respondents completed the health conditions subsection. Of these, 47% reported becoming visually impaired at birth or during childhood, 47% in adulthood, and 6% at the age of 65 or older. The severity of sight loss was reported as significant in 36% and moderate in 43%. The most common comorbid conditions in this group were diabetes (32%), deafness (27%), heart disease (18%), and mobility or physical impairments (18%). More than half the respondents (53%) felt that their underlying health conditions rendered them particularly vulnerable to COVID-19. This concern was more commonly reported by people over the age of 65 years with significant or total sight loss and those who said that they were deaf or hard of hearing. Among the 51% of respondents (n = 270) who indicated that they had concerns about their health-care related to the COVID-19 pandemic, 80% completed the full questionnaire. Sixty-eight percent of respondents indicated concerns about touching things in public (Table 2). Additionally, 59% of respondents were concerned about access to current, accurate information. Fifty percent of respondents were concerned about the potential need to access emergency health services, and 48% were concerned about maintaining social distances in public. Finally, 44% had concerns about not being allowed to access their regular caregiver if hospitalized for COVID-19.Table 2Major health concerns of 270 respondents.n (%)Concern184 (68%)Touching things in public (e.g., elevator panels, self-serve kiosks, restroom doors to check signage)• Higher in those under age 65 years, those with total and significant sight loss, and those with no other conditions162 (59%)Getting access to accurate and current information about those who may be infected in their area135 (50%)Concern that they may need to access emergency medical services as a result of the pandemic130 (48%)Maintaining social distance in public• Higher in those with total or significant sight loss and those with no other conditions119 (44%)If hospitalized with COVID-19, will not be allowed caregiver who would usually assist with accessibility issues in hospital (44%)• Slightly higher in those under age 65 years, those with total sight loss, those not employed, and those with no other condition Open table in a new tab Our findings complement those of previous authors who have advocated for protected health care access for marginalized individuals, but this comparison is challenged by different national health care systems.4Koh A Chen Y Perspective from Singapore and China on the COVID-19 pandemic: the new world order for ophthalmic practice.Ophthalmology. 2020; 127: e49-e50Abstract Full Text Full Text PDF Scopus (0) Google Scholar,5Shalaby WS Odayappan A Venkatesh R et al.The impact of COVID-19 on individuals across the spectrum of visual impairment.Am J Ophthalmol. 2021; 227: 53-65Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar These results further highlight the need to consider systemic comorbidities on the perceived experience of individuals with vision loss during the pandemic. Ideally, the data gathered from this study may contribute to advocacy for individuals with vision loss to ensure their consideration during the development of new community health policies. Further, initiatives prioritizing safe physical distancing, personal hygiene, and access to health care information remain a priority for the BVI community. Online-only material: This article includes online-only material. Appendixes 1 and 2 can be found on the CJO web site at http://pubs.nrc-cnrc.gc.ca/cjo/cjo.html. They are linked to this article in the online contents of the xxx 2023 issue. The authors have no proprietary or commercial interest in any materials discussed in this correspondence. Download .docx (.02 MB) Help with docx files Download .docx (.02 MB) Help with docx files