Can’t you See???

By Janelle J Brown, OD

Limited sight does not equate to a limited life. According to a poll by the American Foundation for the Blind, people fear vision loss more than cancer, HIV/AIDS, stroke, heart disease, diabetes and other serious health problems. Even with the earliest intervention and best treatment available, sometimes vision loss is unavoidable. This is where a low vision evaluation by an optometrist comes in to play. Once we understand a patient’s remaining vision and their visual goals, we can recommend devices, filters, and adaptations to maximize the remaining vision to maintain a high-quality life.
Since there are many misconceptions about vision loss, here are some basic facts:
1. “Visually impaired” is the preferred term instead of “blind.”
2. Low vision has varying degrees. In fact, most people who are visually impaired have some useful vision versus a smaller percentage that are classified as legally blind. Even those with “legal blindness” can often see large text, shape outlines, or movement. Legal blindness is defined by the better-seeing eye being unable to read any letters on the 20/100 line or peripheral vision less than 20 degrees in the better eye.
3. Visual acuity isn’t everything! Two people can read the same line on the acuity chart, yet function very differently in real-life situations due to variations in blind spots, side vision, distortion, contrast, and glare.
4. Many causes of vision loss are preventable and can be slowed by early intervention. One of the leading causes of visual loss is uncontrolled diabetic eye disease which is treated with systemic and ocular intervention. Detecting & treating glaucoma early minimizes loss of side vision. Additionally, close monitoring and treatment with injections for wet macular degeneration can maintain or even restore vision.
5. Some hereditary eye diseases may cause progressive loss of vision that can’t currently be treated. In these cases, vision loss may occur earlier in life, so in-depth training from a vision therapist is extremely beneficial to patients’ success in school and the workforce. These individuals are well served by the use of guide canes, guide dogs, Braille, and modern computer and magnifying software.
What can a low vision evaluation and treatment program achieve for you or your loved ones?
An in-depth history is taken to assess the patient’s goals: whether it’s wanting to read the newspaper or gaining more independence with household tasks. Then, entering vision and best corrected vision is tested and the optometrist determines if a glasses change for distance or near is beneficial.
Once the prescription is determined, we demonstrate how magnification can help patients reach their visual goals. The optometrist will choose several of the following devices to show the patient in-office: hand held magnifiers, fixed-distance stand magnifiers, high powered reading glasses, hobby-based headsets/fitovers, portable electronic magnifiers, and larger desktop-sized computer magnifiers. Low vision optometrists precisely calculate the magnification needed for each individual based on their current vision and what size text they would like to read. By choosing the appropriate power in a magnifier with good optics and backlighting, the patient will be able to read more quickly and accurately with less glare compared to a standard magnifying glass purchased at a store.
Alternatively, telescopes can be used to magnify for spotting signs or menu boards at a distance. In special circumstances, these telescopes can be mounted onto glasses, which may allow the patient to receive a special class of driver’s license for daylight driving. Additionally, telescopes may be utilized in reverse to expand side vision for those with decreased peripheral vision.
Finally, a well-versed optometrist can recommend other non-visual resources. This includes subscribing to the Library of Congress’ talking books program and maximizing a smart phone’s accessibility features to zoom, read text aloud, or utilize a variety of low vision applications. Also, an optometrist can spend time counseling on proper lighting & positioning, availability of large-print items for the home, and computer programs that improve accessibility.
Vision impairment certainly changes how tasks are completed; however, “limited sight does not equate to a limited life.”