Biomedical subjects
Publications and source records attributed to E E Faye.
Patients with irreversible vision loss are understandably distressed, but physicians can help guide them to successful independent living. In this practical article, Dr Faye discusses the causes of low vision, offers tips for working with visually impaired patients in the office setting, and describes rehabilitation programs for such patients. A list of resources on low vision is also included.
Normal changes in the lens, retina, and vitreous accompany aging, but loss of vision in late life is not an inevitable consequence of aging. Cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration (ARMD) account for most vision loss in the older population. Visual impairment reduces older patients' ability to function independently and increases their risk of depression and of injury due to falls. When older persons have a visual complaint, they tend to blame it on being old and do not tell their physicians. In the primary care office, simple screening questions and examination of the dilated eye can often reveal a need for further examination and/or referral.
Research is pointing the way to new therapies for the eye diseases of aging. A gene that appears related to glaucoma has been identified, and a safe and effective inhibitor for aldose reductase is being sought for patients with diabetic retinopathy. Refinements in cataract surgery continue to improve the high success rate of this procedure. Physicians can educate their patients to participate in vision protection, through control of blood sugars, compliance with glaucoma medications, and the use of the Amsler grid by those at risk for macular degeneration. When vision cannot be corrected to the normal range, low vision rehabilitation offers magnification and new high-tech devices for optimizing independent patient function.
Explore the source record for details and available documents.
There are many children who have subnormal vision in spite of successful cataract surgery and aphakic spectacle lenses. There are children who have lens opacities for whom the state of aphakia would not be an improvement. Careful evaluation of functional vision, careful refraction, and the prescription of high adds or other optical devices are part of complete ophthalmological care for every one of these children. The dioptric strength of the reading add is determined by the functional reading vision and the calculation of the reciprocal of the visual acuity. It is also important to realize that many children who have lens opacities do not require special aids; functional vision is adequate until their accommodative reserve wanes with age. Continuous-wear contact lenses may eventually replace spectacle corrections for the aphakic child.
The low vision patient's ultimate function and ability to profit from his rehabiliation are influenced by his eye disease. A discussion of low vision patient management uses as a basis the observation that greater success is evidenced when the low vision patient is treated in the context of his eye disease, visual acuity and his subsequent adjustment problems. The diagnosis, visual acuity and the visual field are explored as elements of a functional classification. The author classifies eye diseases according to the pattern of visual field loss: no loss of visual field; central or macular field loss; peripheral or perimacular field loss. Visual characteristics are then elaborated and case management is suggested in the context of each category.
Explore the source record for details and available documents.
1. The ophthalmologist and staff are ultimately responsible for identifying low vision patients. 2. Most low vision patients who have a professional low vision evaluation are able to use vision enhancing devices. 3. In addition to optical magnifyers, new computer and television technology enhances use of residual vision.
Explore the source record for details and available documents.