Modifying the environment for a patient with low vision

Modifying the environment(Non-optical strategies & lighting)Content prepared by Dr Meri Vukicevic

Reference

Scheiman M, Sheiman M & Whittaker SG.Low Vision Rehabilitation: a practical guide for occupational therapists (2007) Slack Inc.

Successful rehab intervention● Poor response to low vision intervention is experienced

by some patients● Contributing factors:

○ Vision○ Psychosocial issues

● Improve/optimise your patient’s response to intervention by educating him/her

Treatment plan1. Education2. Therapeutic activities3. Modifying the environment4. Non-optical devices5. Optical devices6. Computer technology7. Resources

Watson GR. Functional assessment of low vision for activities of daily living. In: Silverstone B et al The Lighthouse Handbook on Vision Impairment and Vision Rehabilitation. (2000) Oxford Uni Press

How can you modify the patient’s environment?

Modern Kitchen by Pbrocks13 from Wikimedia Commons

Make things bigger● Use principle of relative size magnification ● Double the size of an object

○ The angle it subtends on the retina also doubles ● This is most useful for patients with moderate vision

impairment

Manipulate colourPrinciples of colour manipulation1. Use bright colours 2. Use lighting to increase colour visibility3. Colour is useful as a warning cue

Duffy MA, Huebner K & Wormsley DP. Activities of daily living and individuals with low vision. In Scheiman M. Understanding and managing vision deficits. Slack Inc.

Lighting● Lighting preference varies● Be aware of glare

○ Inc. lighting = Inc. glare● Use directional light, with shade,

from the side

Lighting assessment● Evaluate current lighting● Light meter assessment of specific work areas● Demonstrate various types of light/globes

Types of lights - daylight

Types of lights - Incandescent

Types of lights - fluorescent

Types of lights - halogen

Which type of light to suggest?● No significant interactions between the type of AMD and spectral

radiance for any measures of reading performance. ● No difference between the lamps and no difference on any other

outcome measures. ● “Spectral radiance of localised light sources is not an important

factor when deciding on the type of lamp to use for reading”.

Eperjesi, Maiz-Fernandez and Bartlett. Reading performance with various lamps in AMD. Ophthalmic and Pysiological Optics 2007 Jan 27(1)

Modifying contrast

Modifying contrast