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PubMed1995

A novel approach to providing educationally based low vision services and outreach clinical and vision support services to the visually impaired.

BACKGROUND: The Perkins Low Vision Service is affiliated with the New England Eye Institute, the primary teaching clinic of the New England College of Optometry. Low Vision Services for patients of all ages as well as vision services for the multi-impaired are provided on site at the Perkins School for the Blind in Watertown, Massachusetts. RESULTS: Evaluations are provided by the low vision team comprised of specialists with expertise in pediatric and rehabilitative optometry, special education, orientation and mobility training, rehabilitation teaching and the interns at the New England College of Optometry. The full scope of services offered as well as alternative modes of practice employed will be discussed.

Adolescent↗
PubMed1993

Predicting the low vision reading add.

Before evaluating a low vision patient with various optical aids, one should know the strength of the first lens (add) to be tried. The basic concept behind predicting this add is presented. The three most common methods of predicting the add are explained, and it is shown that all of these methods are variations of the basic concept. An analysis of the results of the three methods is given. An addendum discussing acuity notations and some common misunderstandings that occur is also included.

Humans↗
PubMed2006

Perspectives on low vision service in Canada: a pilot study.

BACKGROUND: A review of the literature and current practice patterns for vision rehabilitation care in Canada provide a basis for this pilot study, which was undertaken to explore related issues from the perspectives of older adults and low vision service providers. The pilot study was overseen by a number of collaborators whose names are listed at the end of this paper. METHODS: Thirty people aged 60 years or older who had vision impairments and were clients of the Canadian National Institute for the Blind were surveyed by telephone. Ophthalmologists, optometrists, and opticians completed a mail questionnaire. Vision rehabilitation practitioners and nurses, ophthalmic technicians, and service providers for low vision technical aids were surveyed by e-mail. RESULTS: Ophthalmologists are a primary source of referrals to low vision services, but low functional vision does not always trigger such referrals, nor are referrals always timely. Optometrists are primary providers of low vision services, including dispensing of low vision aids, but such aids are expensive, and inadequate training in their use may contribute to noncompliance. Costs associated with providing low vision assessments and services are higher than compensation to vision service providers, whose capacity to meet increasing demand is limited. In addition, there are disparities between rural and urban areas and among provinces in the availability of, and funding for, services and aids. INTERPRETATION: On the basis of the findings, an emergent theory is proposed on the consequences resulting from lack of planning and standards for vision rehabilitation care. The implications of this study form the basis for further research.

Aged↗
PubMed1990

[Should the ophthalmologist provide low vision counseling?].

The experience gained at the low-vision center of St. Gallen Eye Hospital shows that there is a real need for this service, particularly among the elderly, and that this kind of counseling is very time-consuming. Until now, low-vision counseling in Switzerland has been provided mainly by opticians and other paramedical personnel. In view of these facts the question arises as to whether such services should not also--and primarily--be provided by ophthalmologists and their orthoptists. For more complicated cases it is suggested that low-vision counseling should also be offered at the ophthalmology departments of major hospitals.

Aged↗
PubMed1992

[The 1987 National Epidemiological Survey of Blindness and Low Vision in China].

According to the 1987 National Epidemiological Survey of Blindness and Low Vision, the prevalence of blindness in China was 0.43%, resulting chiefly from cataract (41.06%), corneal diseases (15.38%), trachoma (10.87%), and glaucoma (8.80%); the prevalence of low vision was 0.58%, of which the main causes were cataract (49.83%), ametropia/amblyopia (14.98%), trachoma (9.55%), corneal diseases (8.48%), chorioretinal diseases (6.27%), etc. Among children under 14 years of age, the leading cause of blindness and low vision was hereditary diseases (48.46%), and among the elderly of 60 years and over, the leading cause of blindness and low vision was cataract (73.13%).

Adolescent↗
PubMed2002

The optical functional advantages of an intraocular low-vision telescope.

An implantable miniaturized telescope (IMT) for low vision has recently been developed. Surgically inserted into only one eye of patients with bilateral central visual loss, the IMT provides a nominal magnification of 3.0x and a field-of-view of 6.6 degrees (9.2 degrees for the 2.2x magnification version). Theoretical concerns have been raised regarding the ability of patients to function with a large interocular magnification difference, the impact of the monocular restriction of the field-of-view, and the impact of this design on depth perception. This article addresses these concerns regarding the design of the IMT in comparison with spectacle-mounted telescopes and combined intraocular lens/spectacle (or combined contact lens/spectacle) telescopic systems. The effective field-of-view (as determined by the combination of both the field-of-view and the field-of-fixation), the effects of head motion and the vestibular reflex, and the disruption of stereo depth perception with a monocular device are considered here. Physiological optics considerations of these issues show that the IMT may have important advantages over other designs of magnification devices for patients with age-related macular degeneration.

Depth Perception↗
PubMed1977

A marble used as a low-vision reading aid: a case report.

An unusual low-vision remedy was encountered in which a simple dime-store marble was used in near vision tasks. Although the marble was found satisfactory as a low-vision aid, the patient could be better assisted with a commercially available magnifier of lesser dioptric power. This case serves to demonstrate a patient's ingenuity in independently solving his own low vision problem.

Creativity↗
PubMedDate not supplied

Teaching the stoma care routine to a patient with low vision.

Teaching the patient with a newly formed stoma but who also has low vision to manage his/her stoma independently can be a difficult task. This case study shows how a nurse taught a patient with low vision to become independent in relation to his newly formed stoma, with a view to being discharged home successfully. At the time the stoma care nurse used her past experience and common sense in achieving this aim. After the event the stoma care nurse researched the literature and discovered that there are accessories/devices available to assist patients with low vision to manage their stoma and help improve their vision. On reflection, the stoma care nurse felt she did not have sufficient time preoperatively with the patient, which prevented her from being able to change the course of action. She has now improved her knowledge, which will assist her in the future if she has to care for another patient with low vision who has had a newly formed stoma.

Aged↗
PubMed2006

Need for optical and low vision services for children in schools for the blind in North India.

CONTEXT: Children admitted in blind schools need low vision assessment for improving functional vision (useful residual vision). AIM: To ascertain the need for spectacles and magnifiers as low vision devices (LVD) in children with useful residual vision, attending blind schools. SETTING AND DESIGN: Cross-sectional study conducted in 13 blind schools in Delhi, North India. MATERIALS AND METHODS: Of a total of 703 children (less than 16 years of age) examined, 133 (18.91%) with useful residual vision were refracted and analyzed. High addition plus lenses (range 5-30 diopters) were used as spectacle magnifiers for near LVD assessment. "World health organization (WHO)/ prevention of blindness (PBL) eye examination record for children with blindness and low vision", was used to collect data. SPSS (statistical package for the social science), version 10.0 was used for analysis. RESULTS: Based on the vision of 133 children at initial examination, 70.7% children were blind and 12.0% were severely visually impaired (SVI). 20.3% children improved by at least one WHO category of blindness after refraction. With best correction, 50.4% children were still blind and 13.5% were SVI. Visual acuity in the better eye after refraction in 47 children (35.3%), improved with spectacles. Children with aphakia (17), coloboma (5), refractive error (5) and microphthalmos (4) benefited from spectacles. Of 124 children with low vision but having useful residual vision, 51 (41.1%) were able to read N-10 unaided or with distance spectacles and 30 children (22.6%) improved to N-10 with spectacle magnifiers and were prescribed the same. CONCLUSION: Visually impaired children with aphakia and congenital anomalies of the eye benefit from refraction and low vision services.

Adolescent↗
PubMed1993

Prevalence and causes of low vision and blindness in northern KwaZulu.

A survey of the prevalence of blindness and low vision was conducted in the Ingwavuma district of KwaZulu to assess the effectiveness of existing eye care facilities in the prevention and treatment of impaired vision and blindness. One hundred subjects from each of 60 randomly selected clusters (N = 6,090) were screened. Of these, 293 were identified and referred to an ophthalmologist for examination. Of the 268 (91,5%) examined, 241 were found to have visual impairment. Sixty-one of these people were blind, 85 had low vision, 61 were blind in one eye but had normal vision in the other, and 34 had low vision in one eye but normal vision in the other. The prevalence of blindness was 1,0% (95% confidence interval 0,7-1,2%), and the prevalence of impaired vision was 1,4% (95% confidence interval 1,1-1,7%). Age-related cataract (59,0%) and chronic glaucoma (22,9%) were the two main causes of blindness. Age-related cataract (75,3%), refractive error (10,0%) and chronic glaucoma (4,7%) were the main causes of impaired vision. Existing eye care services for the region have reduced the prevalence of blindness by only 7,0%. The training of ophthalmic nurses and the establishment of a sight-saver clinic in the area are necessary to reduce the prevalence of low vision and blindness.

Adolescent↗
PubMed1994

[Low-Vision Training For Better Usage of Magnifying Visual Aids].

During 1990-1991 263 low-vision aids were prescribed to visually impaired elderly people. 22% of them did not use their magnifying systems. With the help of a low-vision trainer, who taught them how to use their magnifying system correctly, the failure rate could be remarkably reduced. In 1992, low-vision aids were prescribed to 121 of 158 patients; 110 of these patients had low-vision training. Only 3% of them failed to use the magnifying system.

Aged↗
PubMed1981

Low vision practitioner and the paraoptometric.

The low vision patient is a complex individual who requires understanding by not only the optometrist but by the paraoptometric. The paraoptometric in effect can determine the outcome of the optical portion of the evaluation. By setting the stage for the evaluation, and by carrying out the recommendations, the paraoptometric plays an invaluable role in determining the success of the low vision patient.

Adolescent↗
PubMed1976

Training low vision patients.

The importance of training low vision-patients to use low vision aids is discussed. The team approach is emphasized and the advantages of the additional expertise considered. Specific procedures and techniques are are recommended to enhance the chances for success of the training program and it is concluded that training is an important aspect of follow-up care which should be made an intergral part of low vision care.

Aged↗
PubMed1991

Reading speed through different equivalent power low vision devices with identical field of view.

Adequate reading speed is one of the criteria low vision patients may use to assist them when they are comparing and selecting equivalent power low vision devices. Inherently, various optical devices of equivalent power will produce different fields of view. We compared the reading speed of 32 trained, normal observers with 4 commonly prescribed types of low vision devices of +12 D equivalent power (spectacles, hand magnifier, stand magnifier, and telemicroscope) which were modified to provide nearly identical fields of view. Our results show that only the reading speed obtained with the telemicroscope was significantly different from those of the other systems (p less than 0.01). Implications are that the field of view provided by a low vision device is the primary parameter limiting reading speed of equivalent power devices.

Adult↗
PubMed2006

[Development of a low vision aid device].

PURPOSE: To develop the design of a near low vision aid that has esthetic and functional qualities intending to give its user a better life quality. METHODS: To verify low vision people's main needs concerning the current devices for near distance; to identify possible design interventions to make a project that fulfills their main needs. RESULTS: A prototype having a reading stand tied to the end of a magnifier that moves horizontally and vertically permitting the horizontal reading of a text line was developed. CONCLUSIONS: The developed device fulfills low vision people's visual and handling needs for near distance, contributing to the easiness to read and write.

Equipment Design↗
PubMed2002

Measuring low-vision rehabilitation outcomes with the NEI VFQ-25.

PURPOSE: To evaluate the sensitivity of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) to change in visual abilities after low-vision rehabilitation in two different Veterans Administration (VA) low-vision programs METHODS: Seventy-seven legally blind veterans from the Blind Rehabilitation Center (BRC) at Hines VA Hospital and 51 partially sighted veterans from the Visual Impairment Center to Optimize Remaining Sight (VICTORS) program at the Chicago Health Care Network, West Side Division, were administered the NEI VFQ-25 plus supplement in interview format at admission and discharge. Instructions for administration were modified to have study participants answer all the questions as if they were wearing glasses or contact lenses or were using low-vision devices. Interval measures of person ability and item difficulty were estimated from the patients' responses to 34 of the 39 items on the VFQ-25 plus supplement before and after rehabilitation, by the polytomous rating scale measurement model of Wright and Masters. RESULTS: In VICTORS patients, item order by difficulty before rehabilitation agreed with item order for BRC patients. Visual ability scales are used similarly by different patients with different degrees of low vision. Based on prerehabilitation person measure distributions, VICTORS patients were less disabled, as would be predicted by visual acuity, than were BRC patients. After rehabilitation, estimated item difficulty for 4 of the 34 items decreased significantly in both BRC and VICTORS patients. CONCLUSIONS: The present study demonstrates that the NEI VFQ-25 plus supplement can be used to measure the effects of low-vision rehabilitation; however, only 7 of the 34 items tested are sensitive to change after rehabilitation. Targeted activities, such as reading ordinary print, small print, and street signs are easier to perform for graduates of both programs after rehabilitation. The patients' visual ability also shows improvement in both BRC and VICTORS. Improvement in visual ability is independent of change in difficulty of targeted items. Although this was not a controlled clinical trial, the decrease in difficulty of targeted items may reflect the use of low-vision aids and training to make tasks easier. The change in visual ability may reflect positive outcomes of rehabilitation or may be the consequence of patients' overestimates of their functional ability at the time of discharge.

Adult↗
PubMed1991

Binocular contrast sensitivity testing for low vision patients.

Contrast sensitivity testing is often included in primary care and low vision examinations. This test is designed to provide information regarding the quality of a patient's vision. This clinical study provides a method to assess the binocularity of a low vision patient with contrast sensitivity testing. The method allows the practitioner to determine if monocular or binocular conditions are optimal for the use of a near low-vision device.

Adult↗
PubMed2006

Quality of life and visual rehabilitation: an observational study of low vision in three general practices in West Glamorgan.

AIM: To survey low vision in an urban population and assess impact on quality of life, rehabilitation and support. METHODS: In a cross-sectional population survey, 66 patients were identified from databases of three general practices and surveyed by investigator administered questionnaire. Main outcome measures were ocular diagnoses, (US) National Eye Institute Visual Function-Questionnaire (NEI-VFQ) scores assessing visual and nonvisual disability, eligibility for, awareness and receipt of rehabilitation and support. RESULTS: Of 24,420 individuals on the lists of the three study practices, we found 101 registered as blind or partially sighted (prevalence 0.41%). A total of 66 patients participated with ocular diseases of age-related macular degeneration 39 (59%), glaucoma 11 (17%), diabetic retinopathy two (3%), retinitis pigmentosa two (3%), and 12 (18%) 'others'. Better eye visual acuity was counting fingers or worse in 32 (48.5%). NEI-VFQ scores were poor-overall mean 41.5% (SD 23.5). In all, 80% had a social services home visit with one-third of these still in contact. In all, 66% had undergone a low vision aid assessment and 57.6% of these used their aid. The awareness and receipt of benefits arising from registration as visually impaired were lower than for other supportive measures available for reasons unrelated to vision. None had a guide dog. CONCLUSIONS: We found expected patterns of low vision but poorer levels of function and support that may reflect age and deprivation in a population failed by the current systems for identification, registration, and rehabilitation based on legislation overtaken by demographic change and social provision independent of visual status.

Activities of Daily Living↗