Implementation of an Evidence-Based Guideline for the Referral of Adults who are Visually Impaired in the Netherlands: Potential Barriers

Individuals, members of consumer organizations, and personnel of rehabilitation centers have all pointed out that referrals for rehabilitation services for adults who are visually impaired could be more efficient. Given the prevalence of visual impairment in the Netherlands, CBS is likely to be more common than many well-recognized eye disorders, such as acute glaucoma, ocular toxoplasmosis, and presumed ocular histoplasmosis, which ophthalmologists would consider important diagnoses. Three potential barriers were found: an external barrier (time) with regard to the recommendation about the delivery of bad news, the lack of agreement with the recommendation on Charles Bonnet syndrome, and the lack of motivation to change the referral process by not perceiving a problem with it.