Low Vision Care Research Articles

The Developmental History and an Evaluation of the Queensland Low Vision Care Centre

: The decisive shift in attitute from partial blindness and conservation of residual vision towards partial sightedness and maximal use of residual vision in the last fifteen years has resulted in low vision care being a relatively new field of particular concern to health care professionals. In Australia, the first multi‐disciplinary clinic providing a comprehensive low vision service was established at the Association for the Blind, Kooyong, Victoria in 1972. Since then, a number of low vision clinics in a variety of locations have developed throughout Australia, with the establishment of the Low Vision Care Centre in Brisbane, Queensland occurring in 1979. This paper describes the developmental history of this service and evaluates the comprehensive low vision care which this clinic provides to the Queensland population. The effectiveness and future considerations of this service are also discussed.

An Overview of Low Vision Care: Accomplishments and Ongoing Problems

An Overview of Low Vision Care: Accomplishments and Ongoing Problems

The Optometric Management of the Child with Low Vision

In recent years, optometrists have taken a greater interest in paediatric optometry, yet the optometric management of the child with low vision has received little attention. Optometrists have the fundamental training, clinical expertise and attitudes to manage the paediatric low vision patient effectively. Although visually handicapped children receive specialist medical care from birth or at a very early age, referral to other low vision services frequently does not occur until the child enters the education system. Optometrists in private practice can bridge the gap between medicine and education and improve the quality of paediatric low vision care by understanding the rationale for improvement of efficiency in visual functioning and developing a sincere commitment to extending their involvement with these children beyond the provision of low vision aids.

Recent advances in clinical low-vision care.

In the past decade there has been a growth in the awareness of the impact that low vision has on the individual and on society in general. The clinical eye-care professions have become more conscious of their responsibility to assist partially sighted patients and low-vision care is becoming a specialty area within optometry and ophthalmology. This paper reviews recent advances in the optical devices and prescribing procedures that have contributed to improving the care that is available to assist low-vision patients with distance-vision tasks, near-vision tasks and visual-field problems.

Evaluation and Modification of Low Vision Aids

Many optical appliances provided for 2. the low vision patient are selected from a limited range of aids made available to the profession in Australia through local distributors. There is evidence to support the view that some of these aids have not been designed with the geriatric low vision patient in mind. The versatility and usefulness of some aids can be improved by means of relatively minor modifications. It is suggested that such modifications will provide the practitioner with a freedom to prescribe specifically for the patient. This is preferable to selecting the most suitable aids from a predetermined array followed by counselling the patient on ways of obtaining maximum benefit from them. It is anticipated that such an approach to low vision care will result in a simpler instruction code for the patient and a minimum of after care.

Paediatric Low Vision – A Survey

This paper reports the results of a survey conducted at a paediatric low vision clinic, of all children examined in the eight year period 1974 to 1981. The data provide a unique opportunity to identify the ophthalmic characteristics of children with low vision. The major cause of low vision in these children has been identified, examined and compared with the results of similar studies. Other characteristics studied are distance and near vision, the type of low vision aids used and the nature of primary education undertaken by the children. The results are discussed to provide information to improve paediatric low vision care.

Prismatic Scanning Method for Improving Visual Acuity in Patients with Low Vision

Frequently, patients with macular lesions and others who are visually handicapped do not receive adequate low vision care by ophthalmologists if a routine trial of low vision aids has no gratifying results. This paper describes for the first time a technique in which functional vision was achieved with the aid of prismatic scanning in patients for whom the usual low vision aids had proved ineffectual. The procedure in which prisms are used to achieve functional vision in patients with macular lesions is uncomplicated, inexpensive, and rapid; indeed, it can be used by an ophthalmologist in routine office practice with existing equipment.

Low Vision Services: An Interdisciplinary Approach to Quality

Problems in the delivery of comprehensive low vision services include an insufficient number of facilities, lack of funding, and limited training for professionals in low vision. The three approaches to provision of low vision services are (1) cafeteria-style, (2) isolationism, and (3) interdisciplinary service. Good-quality low vision care is provided best by an on-going interdisciplinary service. Settings and sources of funds for low vision services are discussed.

Low Vision Care in Canada

Low Vision Care in Canada

Low Vision Care—Two Case Reports

Two patients are discussed and their similarities and differences are noted. Both lost an eye as a result of military service. One had low vision in the remaining eye because of a retinal problem with generally clear media. The other had an essentially normally functioning retina but light transmission was compromised because of a developing cataract. It was demonstrated that visually impaired or legally blind persons can be helped and they do not always need sophisticated devices to achieve useful vision. I described the devices prescribed and the advice given.

Low Vision Care for the over 80's

The records of patients attending the Association for the Blind Low Vision Clinic at Kooyong in the years 1977–1980 were surveyed and the results compared with previous studies of patients of this clinic. As many of the patients were elderly and as this group showed an increase as a proportion of the whole sample, a more detailed study was conducted on 100 consecutive patients aged 80 or over. As well as ocular factors, details of social and demographic characteristics which were obtainable from patient record cards were considered. Other areas related to ageing, but not included on patient records, were also considered.

Rehabilitation: An Essential Component of Low Vision Care

This paper reviews the concept of rehabilitation in the delivery of care to the low vision patient. It defines low vision in functional terms and suggests that a multidisciplinary approach to management is necessary. The personal, psychological, educational and vocational factors in the successful management of a patient are discussed. Improvements in the delivery of future care are suggested.

Understanding the Low Vision Patient

Over the past decade, the role of optometry in low vision care has steadily increased. Unfortunately many optometrists feel they lack the skills to fully service these patients. A functional classification of the visual losses and the aids prescribed for low vision patients has been prepared to encourage and assist the practitioner dealing with such patients.

The American Approach to Low Vision Patient Management

The difficulties faced by the low vision patient in a sighted world are many and varied. Any attempt to assist the patient to resolve these difficulties can best be met by a multi-disciplinary team approach from practitioners, professional groups and agencies involved with low vision care and rehabilitation. The emphasis on and approach to the care, advice and prescribed aids differ from country to country, place to place. The paper will discuss the optometrical assessment of patients, the major optical aids used, and the role of the optometrist in the team as observed in two centres in America.

The Provision of Low Vision Services

The dispensing of low vision aids has historically been handled through eye care personnel in largely isolated low vision clinics. Recently there have been moves to involve rehabilitation workers and teachers to achieve a more integrated diagnosis and prescription of low vision optical and non‐optical aids that will best meel the needs of low vision people.The identification of those who would benefit from low vision services needs to be considered in regard to the limitations imposed by factors such as the definition of legal blindness. Better means of describing the service and developing more knowledgeable referral channels are important needs. The consideration of alternative and regional locations for provision of low vision care is necessary in the development of comprehensive low vision services.Legislation in the United States that requires all visually handicapped children to have the right to be education in a regular school is creating a greater awareness of the difficulties involved in assuring that children received the best help possible in developing their low vision functional potential. Children and adults' full capabilities, both physically and psychologically must be considered in any low vision care program regardless of where it is provided. Follow up and evaluation of ail services is necessary for individual adjustment to problems that develop with changing circumstances.

The Low Vision Patient of Tomorrow

Our definition of low vision has been in terms of visual acuity, occasionally with reference to visual field restriction; a concept which tends to produce ‘seeing’ and ‘non-seeing’ groups without giving an indication of the way an individual may see himself or perform in everyday life. Definitions of low vision which encompass a continuum from perfect sight to total blindness provide a more realistic foundation for low vision care. The current patient population of the Association for the Blind Low Vision Clinic has been analysed by age, sex and eye condition and attempts are made to predict changes which will be brought about by more effective treatment, earlier recognition of eye disease and changes in the general population structure. Advances in technology will mean new optical and electronic devices as well as improvements in familiar ones and optometrists must be prepared to bring these to their patients. Changing life styles over the next twenty-five years will create challenges for all but the impact of these changes may be even greater for those with reduced visual functions.

Comprehensive Low Vision Care: Part Two

Between July 1970 and July 1973, a total of 1,118 patients were seen at the Vision Rehabilitation Clinic, a part of the Gundersen Eye Clinic, Boston University Medical Center. The visual function of approximately 75 percent of all patients was significantly improved with visual aids and counseling. This high rate of success was the result of innovative programs of social service and counseling integrated into a multidisciplinary approach to low vision care. Although operating the clinic in a hospital setting results in high overhead, the participation of residents in ophthalmology in the activities of the clinic was found to be so important as to warrant its continuation there.

The Role of the Low Vision Assistant in the Care of Visually Impaired Persons

Low vision assistants are critically needed to fill the manpower shortage in low vision care if complete services are to be available to all visually impaired persons. It is important that formal training programs provide these paraprofessionals with the knowledge basic to low vision care. Assistants must be qualified to perform at least half of the necessary diagnostic procedures, take case histories, train the patient to use the low vision aid and provide follow-up care, write reports, and make referrals to other agencies when needed. Professionals and paraprofessionals work as a team toward improved low vision care.