Understanding access challenges to low vision care for age-related macular degeneration in Germany: results from an integrated synthesis based on experiences from affected individuals and care providers
Creators: name: Thier, Anne
name: Wolfram, Christian
name: Witt, Ursula
name: Zeitz, Oliver
name: Himmelsbach, Ines
name: Holmberg, Christine
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Biotechnology
subject: Science Policy
subject: Sociology
subject: FOS: Sociology
subject: Immunology
subject: FOS: Clinical medicine
subject: Infectious Diseases
subject: FOS: Health sciences

description: To understand the reasons for the inconsistent and often arbitrary access to low vision care for people with age-related macular degeneration (AMD), this article examines the challenges of access to low vision care from the perspectives of people with AMD, ophthalmologists, opticians and low vision professionals. This article is based on a mixed-methods study that incorporated narrative semi-structured interviews to explore the experiences of individuals diagnosed with AMD, as well as online surveys to evaluate ophthalmologists’ and opticians’ knowledge of low vision services and expert discussions with low vision professionals. An integrated synthesis approach was employed. Challenges in accessing low vision care can be categorized into four levels: individual, social, infrastructural, and provider. Individual challenges included information needs, perceptions of support services as stigmatizing or unhelpful, and immobility of the affected individuals. Social networks play a crucial role in supporting or hindering access to care. Limited service availability poses a significant infrastructural challenge. Provider-level issues include communication barriers, knowledge gaps, and insufficient collaboration among low vision providers. Our study emphasizes the need for a structured, interdisciplinary rehabilitation approach to improve care for individuals with AMD. Age-related macular degeneration (AMD) involves not just medical care but also low-vision care and rehabilitation.This article presents a comprehensive analysis of the various challenges associated with low vision care in Germany, offering insights from various vantage points.To enhance the quality of low vision care for individuals with age-related macular degeneration (AMD), it is crucial to adopt a structured, interdisciplinary rehabilitation approach that comprehensively addresses the diverse needs of affected individuals.Collaboration among all stakeholders—including ophthalmologists, general practitioners, low vision specialists, rehabilitation trainers, and counselors for the visually impaired—is essential for a cohesive low vision care strategy. Age-related macular degeneration (AMD) involves not just medical care but also low-vision care and rehabilitation. This article presents a comprehensive analysis of the various challenges associated with low vision care in Germany, offering insights from various vantage points. To enhance the quality of low vision care for individuals with age-related macular degeneration (AMD), it is crucial to adopt a structured, interdisciplinary rehabilitation approach that comprehensively addresses the diverse needs of affected individuals. Collaboration among all stakeholders—including ophthalmologists, general practitioners, low vision specialists, rehabilitation trainers, and counselors for the visually impaired—is essential for a cohesive low vision care strategy.