LOW VISION LOW VISION REHABILITATIOREHABILITATIO

NNTips for Tips for

IndependenceIndependenceAvani Patel, O.D., F.A.A.O.Avani Patel, O.D., F.A.A.O.

Private Practice: Los Alamitos, CAPrivate Practice: Los Alamitos, CA

(562) 430-6161(562) 430-6161

Hospital: Long Beach Memorial Med. CenterHospital: Long Beach Memorial Med. Center

(562) 933-0123(562) 933-0123

July is UV Awareness July is UV Awareness MonthMonth

Ultra-violet exposure is linked to eye Ultra-violet exposure is linked to eye damage including: Cataracts, Age-damage including: Cataracts, Age-Related Macular Degeneration, Related Macular Degeneration, Pterygium, Photokeratitis, Pterygium, Photokeratitis, Melanomas.Melanomas.

Make sure all sun wear has UV-A Make sure all sun wear has UV-A and UV-B protectionand UV-B protection

LOW VISION

Impairment of vision that significantly impairs how an individual functions.

Vision cannot be corrected adequately with medical, surgical therapy or conventional glasses/contact lenses.

Individual may experience loss of central vision, peripheral vision, distorted vision, double vision, glare sensitivity and loss of contrast.

LOW VISION

Low Vision services do not “cure” the problem, but enable an individual to maximize their remaining sight so they can function as independently as possible.

Low Vision care does NOT replace the need for concurrent ophthalmological treatment.

Low Vision Rehabilitation is a collaborative approach to helping individuals.

Low Vision- A Collaborative Low Vision- A Collaborative EffortEffort

MD’s MD’s OD’sOD’s OT’sOT’s O&M, ILS, ,Lighting SpecialistsO&M, ILS, ,Lighting Specialists Technology SpecialistsTechnology Specialists PsychologistsPsychologists Social WorkersSocial Workers Teachers for the Visually ImpairedTeachers for the Visually Impaired Certified Diabetic EducatorsCertified Diabetic Educators Rehabilitation SpecialistsRehabilitation Specialists

The World Health Organization ( WHO ) uses The World Health Organization ( WHO ) uses the following classification of visual the following classification of visual impairments. When the vision in the better eye impairments. When the vision in the better eye with the best possible glasses or contacts lens with the best possible glasses or contacts lens correction is: correction is:

20/30 to 20/60 considered mild vision loss or 20/30 to 20/60 considered mild vision loss or near normalnear normal

20/70 to 20/160 considered moderate20/70 to 20/160 considered moderate

20/200 to 20/400 considered severe20/200 to 20/400 considered severe

20/500 to 20/1000 considered profound20/500 to 20/1000 considered profound

< 20/1000 considered near total blindness< 20/1000 considered near total blindness

NO light perception considered totally blindNO light perception considered totally blind

ALSO: any person not correctable to better ALSO: any person not correctable to better than 20/200 in best eye or with < 20 degrees of than 20/200 in best eye or with < 20 degrees of visual field is considered LEGALLY BLIND.visual field is considered LEGALLY BLIND.

Low Vision RehabilitationLow Vision Rehabilitation

Currently there is no treatment option Currently there is no treatment option to completely restore lost vision.to completely restore lost vision.

For many patients, the hardest For many patients, the hardest challenge is adapting to life with challenge is adapting to life with vision impairment.vision impairment.

However, by retraining the visual However, by retraining the visual system, modifying one’s environment, system, modifying one’s environment, and learning to use low vision and learning to use low vision aids/technology, one can continue to aids/technology, one can continue to maintain their sense of independencemaintain their sense of independence

Common Types of Vision Common Types of Vision ImpairmentImpairment

Loss of Central VisionLoss of Central Vision Loss of Peripheral VisionLoss of Peripheral Vision Glare DisabilityGlare Disability Diplopia (Double Vision)Diplopia (Double Vision) Loss of Contrast SensitivityLoss of Contrast Sensitivity Generalized HazeGeneralized Haze Night BlindnessNight Blindness

Eye Care Professionals

1. Ophthalmologist (M.D.)

2. Optometrist (O.D.)

THE LOW VISION EYE THE LOW VISION EYE DOCTORDOCTOR

Low Vision Specialists are licensed Low Vision Specialists are licensed Doctors of Optometry or Doctors of Optometry or Ophthalmology, who are skilled in Ophthalmology, who are skilled in examining and managing patients examining and managing patients whose vision cannot be corrected whose vision cannot be corrected with conventional means.with conventional means.

Low Vision is a team approach Low Vision is a team approach involving specialists in many areas involving specialists in many areas from vision to rehabilitation.from vision to rehabilitation.

LOW VISION Low Vision doctors may prescribe the following aids: Custom made prescription eyewear Tints/filters to reduce glare or enhance contrast Prisms to reduce double vision Telescopic & Microscopic eyewear, Magnifiers, Electronic adaptive aids, video magnifiers Specialized computer software programs Independent Living Skills, Orientation Mobility Skills, Counseling…

Low Vision Exam- A Critical Low Vision Exam- A Critical ComponentComponent

Not a regular eye exam with reading the Not a regular eye exam with reading the distance eye chart.distance eye chart.

It is a FUNCTIONAL assessment of how It is a FUNCTIONAL assessment of how an individual works with the vision they an individual works with the vision they have (sight at different distances is have (sight at different distances is measured i.e. faces, stove dials, small measured i.e. faces, stove dials, small print, street signs...)print, street signs...)

Evaluate blurry/blindspots in the visual Evaluate blurry/blindspots in the visual field, contrast sensitivity, extent of color field, contrast sensitivity, extent of color vision, glare tolerance, double vision, vision, glare tolerance, double vision, visual/cognitive processing, eye tracking…visual/cognitive processing, eye tracking…

It is tailored to each individual’s needIt is tailored to each individual’s need

The Low Vision ExamThe Low Vision Exam

A. Distance VA A. Distance VA

B. Near VAB. Near VA

C. Visual FieldsC. Visual Fields

D. Depth PerceptionD. Depth Perception

E. Color Vision TestingE. Color Vision Testing

D. Contrast SensitivityD. Contrast Sensitivity

E. LightingE. Lighting

F. Glare SensitivityF. Glare Sensitivity

G. Trial frame refraction G. Trial frame refraction

H. Response to magnification / H. Response to magnification / Determination of AidsDetermination of Aids

I Visual / Perceptual Testing ( if I Visual / Perceptual Testing ( if applicable )applicable )

J. Ocular health examJ. Ocular health exam

LOW VISION AIDSLOW VISION AIDS

A. Spectacle CorrectionA. Spectacle Correction

B. Contact LensesB. Contact Lenses

C. Prisms C. Prisms

D. FiltersD. Filters

E. Telescopes E. Telescopes

- Monoculars - Monoculars

- Binoculars- Binoculars

- Sportoculars- Sportoculars

- Bioptic TS - Bioptic TS

- Galilean VS Keplarian - Galilean VS Keplarian

- Ocutech autofocus- Ocutech autofocus

Electronic Aids Electronic Aids

- Flipper- Flipper

- Jordy- Jordy

- Onyx- Onyx

- Clarity Carrymate- Clarity Carrymate

Near VisualNear Visual

A. SV Near or high addition A. SV Near or high addition bifocal bifocal correctioncorrection

B. Spectacle mounted B. Spectacle mounted microscope or microscope or telemicroscope telemicroscope

C. Hand magnifiersC. Hand magnifiers

D. Stand MagnifiersD. Stand Magnifiers

Near Electronic Aids Stand alone CCTV ( Clearview)

Portable CCTV

Opal

Quicklook

Amigo

Carrymate

Traveler

Prisma

Max

Liberty Solo

Compact

Specialized Computer Software Specialized Computer Software

1. Magnification and Screen Reader1. Magnification and Screen Reader

-Magic-Magic- BigShot- BigShot- Zoomtext 9.0- Zoomtext 9.0- LunarPlus Screen Mag- LunarPlus Screen Mag- WebEyes- WebEyes- WindowEyes- WindowEyes- Hal Screen Reader- Hal Screen Reader- MaxEyes- MaxEyes

2. Reading / Scanning Software2. Reading / Scanning Software

-Sara-scanning/reading program -Sara-scanning/reading program -- KurzeweilKurzeweil 3000 – scanning, 3000 – scanning,

reading and reading and writing writing learning software. learning software.

A text to speech application.A text to speech application.- JBliss – scanning and reading software- JBliss – scanning and reading software

Have You Considered?

1. I-Phone

2. I-Pad

3. E-Reader

NON-OPTICAL, NON-OPTICAL, REHABILITATION REHABILITATION

OPTIONSOPTIONS Orientation And Mobility TrainingOrientation And Mobility Training Independent Living SkillsIndependent Living Skills Lighting EvaluationLighting Evaluation CounselingCounseling Diabetic Support ServicesDiabetic Support Services Educational/Vocational TrainingEducational/Vocational Training Talking Books, Big Button Phones, Talking Books, Big Button Phones,

Large Print Checks, Talking Clocks, Large Print Checks, Talking Clocks, Felt-tip Markers…Felt-tip Markers…

Top 5 Tips

1. Improve lighting 2. Improve contrast 3. Reduce glare 4. Utilize large print 5. Mark appliances