Low Vision Services
Low vision is a term used for patients whose vision cannot be improved with regular eyeglasses, medicine, or surgery. Low vision is the result of partial but irreversible vision loss often due to eye diseases such as glaucoma, diabetic retinopathy, and macular degeneration. These patients are not blind, but need help learning how to make the most of their remaining sight and maintain independence.
Helping people with low vision is a specialty service Dr. Michael Katich provides at Eye Care Specialists. Through instruction and special low vision aids, Dr. Katich teaches patients how to best utilize their remaining vision to accomplish daily tasks.
What is low vision
Low vision is a loss of eyesight that makes everyday tasks difficult. A person with low vision may find it difficult or impossible to accomplish activities such as reading, writing, shopping, watching television, driving a car, or recognizing faces.
When vision cannot be improved with prescriptive glasses, medicine, or surgery, people with low vision need help to learn how to make the most of their remaining sight and keep their independence. Losing vision does not mean giving up activities, but it does mean applying new ways of doing them. Special low vision devices can be used to help watch television, read a newspaper, see faces, read a book, and for some, even possibly to drive.
Patients at risk for low vision
Though most often experienced by the elderly, people of all ages may be affected by low vision. Low vision can be caused by eye injuries or eye diseases such as:
These conditions can occur at any age but are more common in older people. However, normal aging of the eye does not lead to low vision. Low vision may also result from cancer of the eye, albinism, or a brain injury. Patients with these disorders or are at risk for them, are also at greater risk for low vision.
What to expect at the first exam
A Low Vision Assessment at Eye Care Specialists is typically 1 to 1 1/2 hours. Dr. Katich will conduct a detailed exam involving the following:
- Illumination Testing
- Sunlight Testing
- Contrast Sensitivity Testing
- Detailed Refraction
- Functionality At Home
This comprehensive exam helps determine what low vision devices will best enhance daily activities. Low vision devices used for sewing may not be what should be used for reading. Dr. Katich will also asses what daily activities are affected by impaired vision such as sorting the mail, seeing the thermostat, playing cards, operating the stove. Low vision devices or environmental adjustments made at home may be available to aid independence and activities.
Diagnosing low vision
With low vision, it is difficult to see well enough to do everyday tasks — even with regular glasses, contact lenses, medicine, or surgery. There are many signs of vision loss: finding it difficult or impossible to read, write, shop, watch television, drive a car, pick out and match clothes, or recognize faces. It may be difficult to set dials or manage glare. The lights may seem dimmer than they used to, making work or household chores more difficult.
When someone suffers from low vision, many dimensions of vision may be affected:
- Central vision
- Peripheral vision
- Contrast sensitivity
- Depth perception
- Visual processing
The detailed vision used when looking directly at something. Macular degeneration (AMD) affects central vision. Diabetic retinopathy can affect central or peripheral vision.
The less detailed vision used to see everything around the edges. Glaucoma affects peripheral vision first. Strokes can affect one side of the peripheral vision.
The ability to distinguish between objects of similar tones like milk in a white cup or to distinguish facial features. All eye problems can decrease contrast sensitivity.
The ability to judge the position of objects. New vision loss in one eye can affect depth perception
The lens in the eye focuses light rays onto our retina. The retina converts these light rays into signals that are sent through the optic nerve to the brain, where they are interpreted as the images we see. A problem with any of these processes affects vision in various ways.
An ophthalmologist can tell the difference between normal changes in an aging eye and those caused by eye diseases.
Treating low vision
Low vision is a permanent loss of vision that cannot be improved with eyeglasses, medicine, or surgery. There is no treatment that will restore the lost vision. Instead, patients with low vision need to learn new ways to use the remaining vision to complete everyday tasks and maintain a quality of life.
Making things brighter
Improve lighting: Using a gooseneck lamp directed onto a task; carrying a penlight or flashlight.
Reduce glare: Indoors––cover shiny wood tables and counters with a cloth; wear yellow clip-on or fitover glasses; avoid sitting in front of a window. Outdoors––wear dark yellow or amber glasses; visors can be useful indoors or out.
Increase contrast: Use a black ink gel or felt pen, not a ballpoint, for a thicker line. Use a white cup for black coffee, for example.
Making things bigger
Move closer: Sit as close as necessary to the TV, and up front at performances.
Enlarge: Get large-print checks, calendars, books, playing cards, bingo cards and crossword puzzles. Get phones, TV remote control,s and computer keyboards with extra large buttons and keys.
Magnify: Magnifiers come in many powers and types, suited to different people and different tasks: hand-held for price tags and menus, stands and video magnifiers (CCTVs or closed circuit TVs) for reading newspapers and other materials, and even a magnifying computer mouse.
Organizing Designate spots for the items in your refrigerator, and for your keys and wallet, so you can find them easily. Minimize clutter. Separate black clothes from blue in different drawers.
Mark thermostats and dials with high contrast markers; label medications with markers or rubber bands; safety-pin the labels of similar-colored clothing.
Get books and magazines on tape or CD. Use talking watches, clocks, calculators, glucometers, and computers. Use reading services.
Stay involved with social groups. Some activities may require using more lighting, large print cards, and a magnifier. Ask for help when needed. There is nothing independent about staying home in order to avoid asking for help.
Pick times and map routes carefully. Consider yellow or amber sunglasses for glare. If unable to drive safely, consider hiring a driver, share a car, arrange for a taxi, buy gas for a friend who drives, or use senior and public transit systems.
For Family and Friends
Loved ones with vision loss need to be empowered to do as much as possible independently. Recognize the challenge of vision loss, but don't take over their tasks. Instead, help identify the adjustments needed to make the most of their independence.