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Basic concepts and terms for low vision rehabilitation.

As the involvement of occupational therapists in the rehabilitation of people with visual impairments increases, it is important for all professionals involved to communicate clearly by using the most accurate terminology. This article suggests the most appropriate use of terms and concepts. It recommends that the distinctions between the various aspects of vision loss be recognized and that the old dichotomy of legally blind versus legally sighted be replaced by the more detailed classification of the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), which recognizes multiple levels of visual performance.

Aged↗

Considerations in evaluation and treatment of the child with low vision.

Habilitation of infants and children with visual impairments should be based on a thorough understanding of their visual capabilities and limitations. Comprehensive evaluation of visual function includes measurement of visual acuity, contrast sensitivity, visual field, color vision, adaptation, visual sphere, accommodation, and oculomotor functions. It is best completed through a team approach that uses therapists, special educators, and physicians. A complete evaluation also includes examination of the effect of other motor functions on the use of vision. Nearly all aspects of a child's vision can be measured in play situations with tests that are easy to use. However, further education of nonphysician team members in refractive errors, optics, and function of optical devices may be necessary to ensure an accurate and thorough evaluation.

Adaptation, Ocular↗

A comparison of the recognition distance of several types of pedestrial signals with low-vision pedestrians.

Although approximately 80-85% of the legally blind population has some residual vision, little research has examined the relative conspicuity of various types of visual pedestrian signals currently used by cities with this group of pedestrians. This research compared the relative conspicuity of an incandescent WALK sign, a white LED WALK sign, a blue LED WALK sign, and white and blue LED WALK signs that included an animated "eyes" display with legally blind participants who had some vision. All WALK signals were equated for brightness with the use of a N.I.S.T.-certified illuminance meter. Participants had to discriminate whether the test stimulus was a blue/white WALK sign or a blue/white DON'T WALK sign. Test stimuli were presented in randomized blocks of trials, and recognition distances were determined by having participants approach the test stimuli until they could identify them. Results indicated that there were no significant differences between the incandescent and LED signals without the animated eyes or between the blue and white LED signals. However, Tukey's method showed a significant contrast between the signals with the animated eyes display and signals without this display (F=149.88, P value<0.0001). Participants could identify the Walk signal 62% further away when it also contained the animated "eyes" display. These results show that the addition of an animated "eyes" display to the WALK sign significantly improves recognition distance for a large segment of persons with visual impairment.

Accident Prevention↗

A caregiver's eye on elders with low vision.

Vision loss is ranked third behind arthritis and heart disease as the most common condition causing a need for assistance with activities of daily living (ADLs) for persons 70 years and older, but is often overlooked in the home care setting when treating patients for other conditions. Visual impairments lead to patient depression, anxiety, increased passivity, decreased confidence, and feelings of social isolation. Vision rehabilitation can play a dramatic part in keeping these patients healthy and functioning at their maximal level.

Activities of Daily Living↗