According to one optometrist, your vision doesn’t have to have deteriorated to a specific level in order to benefit from vision rehabilitation.
Low vision is often defined as a condition in which visual acuity is 20/70 or poorer in the better-seeing eye and cannot be corrected or improved with regular eyeglasses.
But a recent presentation from Dr. Delaram Shirazian O.D., Assistant Clinical Professor at SUNY College of Optometry, at a Glaucoma Foundation webinar argued that low vision rehabilitation does not require a specific level of vision loss. The purpose of low vision therapy is to maximize the vision you have remaining.
Legal blindness is another category of vision loss, that is used by the U.S. government to determine who may be eligible for certain state benefits. It is defined as visual acuity of 20/200 or less in the better or stronger eye with best correction, or, as a restricted field of vision of 20 degrees or less in the better or stronger eye.
While eligibility for some state services may require a patient to be legally blind, Dr. Shirazian stressed that when low vision begins to interfere with daily activities, that’s the time to have a low vision exam.
“I may see a patient who has 20/20 vision but has enormous sensitivity to light or glare, and needs help with determining what tint is best for glare control,” she said. “Or, someone who needs to read small print, or does needlework, and may be struggling with acuity loss.”
A low vision exam is different from a regular eye exam for glaucoma, which focuses on making sure your disease is well-controlled. “We want to know how you are functioning with the vision that you have — it’s a goal-based exam,” she said.
The exam looks carefully at the patient’s medical and ocular history, and at how the patient deals with activities of daily living: Can you read your mail, cook without burning yourself, take public transportation? It also measures different facets of acuity, with charts for contrast sensitivity, various distances etc., as well as visual fields. The goal is determining the best prescription for your needs.
Low vision individuals may be at increased risk for depression and anxiety and these stresses are also assessed during a low vision examination. Referrals are made to mental health resources. In New York, the Lighthouse Guild has mental health providers who work with patients with vision loss. Support groups are also really important and beneficial.
Beyond eyeglasses, there are many devices available today to help meet a patient’s needs. Dr. Sherazian noted built-in magnifiers on IOS smartphones that can change contrast and font size; VoiceOver, a built-in screen reader on iPhones; and Seeing AI, a free iPhone app that uses artificial intelligence that enables reading text out loud.
Devices range from hand-held and standing magnifiers with adjustable magnification and contrast levels for prolonged reading to the hands-free Optivisor headband magnifier, glasses with a telescope attached, and hand-held monoculars for spot reading and spot tasks.
While Medicare typically will pay for a low vision exam by an eye doctor, it does not reimburse for low vision devices. And some hi-tech devices come at a high cost. For instance, there’s new wearable technology like the Orcam device that uses a scanner on the side of your eyeglasses to read text out loud to the wearer. For example, at the supermarket, it could scan product labels.
How does one find a low vision specialist? The first step is to ask your regular eye doctor. In New York State low vision specialists are certified and there is a website that lists providers – www.primarycareopt.com.
For more information, please visit: Patient Resource Center – The Glaucoma Foundation.
Dr. Shirazian’s webinar can be accessed in full on the TGF website at Events – The Glaucoma Foundation.
