Many optometrists offer special low-vision services to patients with severely reduced vision, poor contrast sensitivity, or a restricted visual field. These services can include training on adaptive techniques, using devices to assist with activities, or coordinating referrals to other special services.
For most eye conditions, low vision services are not indicated as there is a high potential for recovery, but for conditions with poor prognosis for improvement, this offers the best treatment and management. Conditions such as age-related macular degeneration, severe glaucoma, strokes, and many others can all benefit from low vision services.
What Is Low Vision?
The term low vision is used to describe anyone who has reduced vision that is not correctable to better than 20/60 with glasses or contact lenses.
This term is not synonymous with legal blindness, as the standard for legal blindness is not seeing 20/100 which is significantly worse than 20/60.
Low vision also incorporates reduced contrast sensitivity levels or constricted visual fields into consideration.
For many doctors who offer low-vision services, there is no necessity to dictate exactly what level of visual impairment is needed to discuss and utilize the services. Instead, it is based on lifestyle improvements that can be made.
Who Offers Services for Low Vision?
Usually, low vision services are provided by an optometrist who has special training in the area and may be assisted by other professionals such as an occupational therapist, career counselor or driving rehabilitation specialist.
To obtain a measurement and prognosis of the condition, a consultation with an optometrist is often the first step to attaining any low vision services.
Vision Impairment from Macular Degeneration
The most common condition which leads to low vision services being required is age-related macular degeneration.
This is a progressive condition that affects the elderly population.
In macular degeneration, the central vision will begin to get blurry or fuzzy, as the condition worsens, there may be an area in the center of the vision that begins to go completely black or gray.
Since this affects the center of the vision, tasks such as reading, driving, and distinguishing faces are often the most difficult.
Low vision can offer techniques to fixate on the typical visual axis, provide magnifiers for reading, and offer in-home help to improve daily living.
Low Vision from Severe Glaucoma
Most cases of glaucoma do not progress to the point of needing low vision services thanks to treatment using eye drops and surgeries, however, if glaucoma advances to a severe stage, it may necessitate low vision services.
With glaucoma, the vision begins to constrict in the periphery before impacting the center of vision.
These changes lead to “tunnel vision” and may cause difficulties with driving, navigating new places, or bumping into things frequently.
Low vision services for severe glaucoma can include training on new mobility techniques, the use of lenses as a visual field expander, or referral to an orientation and mobility specialist.
Low Vision Services for Strokes
A stroke can impact the area of the brain responsible for the vision and cause vision deficits on one side of the visual field.
Usually, this leads to a complete loss of vision on the left side of the field.
In some cases, low vision services can work on regaining part of this vision loss, otherwise, the goals include learning new techniques to scan to the side with the vision loss, using prisms for changing fixation, or referring for specific care to alter the home or work environment.
