Low vision rehabilitation services in the Republic of Moldova: current landscape and future directions

Abstract

Introduction: The Republic of Moldova, with a population of approximately 2.42 million, has a significant vision impairment issue, with a 19.5% prevalence in individuals over 50, according to a 2012 RAAB survey. Since the LOW VISION Center’s establishment in 2009, it has made substantial progress in addressing low vision needs through various services. Aim of the Study: The study aims to review the current state of low vision services in the Republic of Moldova, highlight recent advancements, and discuss future directions, including the necessity for a national center to provide comprehensive services for visually impaired people and prevent avoidable blindness. Methods and Materials: The effectiveness and reach of the LOW VISION Center’s services from 2009 to June 2024 were analyzed. The study examined various aspects of the Center’s operations, including comprehensive assessments, assistive product provision, outreach services, equipment support, training, academic development, advocacy actions, and preventive measures. Results: • Service Reach: The Center has conducted 14478 consultations, including 3772 for children, reflecting its significant impact. • Assistive Products: The Center has distributed a variety of optical and nonoptical aids (7986), including magnifying glasses, telescopes, and closed-circuit television systems, at no cost to patients. These devices significantly enhanced daily functioning and opportunities for education and employment. • Outreach Services: Programs have been implemented to extend services to rural and remote areas, addressing access disparities. • Equipment Support: Through Norwegian partnerships, 45 hospitals and polyclinics have been equipped with primary eye care tools, and 9 hospitals have received advanced ophthalmological equipment. • Training and Education: The Center has organized 43 training seminars and educational workshops for 1424 ophthalmologists, optometrists, students, teachers, public authorities to enhance their understanding of low vision rehabilitation and encourage the referral to complementary services. • Academic Development: On September 1, 2017, in partnership with the Norwegian NGO, the University of Southeast Norway, and the State University of Medicine and Pharmacy “Nicolae Testemitanu” launched an academic program for optometrists. The Center represented through years a professional resource for the optometry education. • Legislative Advocacy: Advocacy has resulted in key legislative changes, including regulations for technical aids (GD No. 567/2011) and support for prosthetics and assistive devices (Law No. 116/2021). • Preventive Measures: Annual screenings for diabetic retinopathy and World Sight Day celebrations emphasize the commitment to preventing avoidable blindness. Conclusions: The LOW VISION Center has significantly advanced low vision care in the Republic of Moldova through comprehensive assessments, provision of assistive devices, outreach, and equipment support. Its contribution to improving eye care infrastructure, professional training, and policy advocacy have been transformative. Despite these achievements, there are ongoing challenges such as ensuring sustainable service delivery and expanding outreach. Establishing a National Center for the Visually Impaired is crucial to centralize and enhance service provision, ensuring coordinated care for all visually impaired individuals in the country. The Center’s work has set a strong foundation for future advancements in low vision care, serving as a model for comprehensive and impactful rehabilitation services.