Low Vision Rehabilitation

Frequently Asked Questions

What is low vision?

What are common causes of low vision?

How many people are affected by low vision?

What is a low vision examination and how does it differ from a regular eye examination?

What kinds of devices are available to individuals with low vision to better-enable them to conduct their activities of daily living?

Low Vision Resources

National Eye Institute Resource List for Low Vision
www.nih.gov/lowvision

Topeka & Shawnee County Public Library Red Carpet Service
www.tscpl.org

University of Kansas Audio Reader Program
www.reader.ku.edu

What is low vision?
Low vision is a condition which can result from any number of eye diseases. Despite the use of glasses, contact lenses, medicine or surgery, individuals with low vision have vision that is too poor to allow them to do the things that they normally do during the day. Many individuals in our country with low vision are elderly.

What are common causes of low vision?
Age-related macular degeneration (ARMD), diabetic retinopathy, glaucoma, congenital eye disease and trauma are all causes of low vision. The leading causes of vision loss in our country are age-related macular degeneration and diabetic retinopathy.

How many people are affected by low vision?
Millions of Americans have low vision. Over the age of 65, ARMD is the most common cause. Approximately 750,000 Americans are legally blind from ARMD. Diabetic retinopathy is the leading cause of reduced vision in Americans between the ages of 18 and 60, affecting approximately 5.3 million Americans. Diabetics have a 25-fold increase in the risk of developing vision loss compared to the normal population.

What is a low vision examination and how does it differ from a regular eye examination?

Low Vision Test Chart

A low vision examination differs entirely from a normal eye examination. A complete medical and ocular history is done and thoroughly reviewed to determine if other physical barriers exist to completing the low vision rehabilitation process. The history will include questions about your visual abilities with specific daily tasks. Some of this will be completed over the phone prior to the examination.

The purpose of the history is to determine what difficulty the patient is having and to set specific goals for the rehabilitation process. The low vision examination begins with eye charts that are very different from the normal projected charts that are typically used during an eye examination.

Low vision eye charts are designed to be easy to see for people with vision problems. The glasses prescription is measured using these charts and hand-held lenses that allow the patient to see differences between choices more easily.Special measurements are made of the patient's contrast sensitivity capabilities, and recommendations are made about appropriate glare filters and room lighting.

Contrast Sensitivity Chart

The nature and location of any blind spots or visual field losses are mapped. Sometimes patients can be instructed to use more functional areas of their visual field through a process called eccentric viewing therapy. Following a thorough examination of the eye, the patient is shown magnifiers and other aids which will bridge the gap between what they can see and what they need to be able to get done. Magnifiers, CCTV’s, or non-visual aids are accordingly prescribed for the patient based on their specified goals. Many times, patients will be seen by an occupational therapist immediately following the low vision examination for in-depth training with the prescribed visual aids or rehabilitation techniques.

Dr Nelson or the occupational therapist is able to evaluate the patient’s activities of daily living and train them to use the prescribed devices to accomplish daily tasks. Many patients appreciate an in-home visit where appliances can be marked for easier visualization and lighting can be evaluated. Dr. Nelson will see most patients for a low vision follow-up appointment several weeks after the initial low vision examination. This will give the patient and Dr. Nelson the opportunity to address secondary goals and progress on initial goals.

What kinds of devices are available to individuals with low vision to better-enable them to conduct their activities of daily living?

Magnification can be provided in strong reading glasses which require a very close reading distance. There are a variety of lighted and unlighted handheld magnifiers which are particularly good for reading.
	A Lighted Stand Magnifier

	There are many electronic devices that use a camera and television in combination with zoom features which allow the patient to magnify text or distance objects. Optelec Compact+
A CCTV

There are also numerous telescopic devices for distance magnification. Kansas is one of several states which allow drivers to where a small telescope mounted in the upper portion of the eyeglasses for driving. These bioptic telescopes are prescribed in particular driving situations where patients are very close to legal limits and functional capabilities, but need an occasional boost in vision.
	BiopticTelescopes