This portion of our web site was generously contributed by Dr. Joseph Fontenot, MD. Dr. Fontenot is a Certified Low Vision Therapist and Medical Director for the Community Services for Vision Rehabilitation in Mobile, Alabama.
What is Low Vision?
Impaired vision, interfering with normal activities, not corrected by standard medical care or glasses.
At what level does low vision begin?
When should vision rehabilitation be provided or the patient referred to low vision services?
The "Smart Sight" initiative of the American Academy of Ophthalmology recommends considering anyone with visual acuity worse than 20/40 in the best eye, especially if there is impaired contrast sensitivity, scotoma or field defect. Those who read a lot, use a computer or have work or hobbies requiring fine vision may have symptoms early. Low vision care should be offered early, before the patient loses a job, hobbies or becomes depressed.
What can be done about low vision?
There are many resources, aids, devices and training available to help those who have low vision. These vary from simple improved lighting and mild magnification to audio devices, electronic magnification, orientation and mobility training, Braille special computer software and much more. Many more resources and devices are becoming available quickly as technology progresses.
The role of the Ophthalmologist in Low Vision Care
As the leader of the Eye care team, the Ophthalmologist should assume leadership in the care of the visually impaired. He should be familiar with the impact of low vision on the individual and ways to ameliorate this impact. The Vision Rehabilitation committee of the American academy of Ophthalmology urges Ophthalmologists to look beyond disease and consider disability, and beyond eyes to consider lives.
What are some basic principles and pointers for the practicing Ophthalmologist?
To give your patient with acquired low vision the best chance of remaining functional and relatively happy, namely:
• Recognize that vision impairment begins early for some patients, especially if there is central scotoma, field loss or contrast sensitivity loss. This is particularly true if the person reads a lot, has hobbies involving fine vision, is working or uses the computer.
• Provide low vision rehabilitation or refer to low vision services in your area. Do this early, before patients lose hobbies or job and become depressed or seek alternative care.
• If the condition is unlikely to cause total blindness (as, AMD), tell this to the patient. This may prevent much unnecessary worry and depression.
• Do not tell a low vision patient "There is nothing else that can be done". Say, "There is nothing else we should do at this time. Let us keep following you. Meanwhile, go to the low vision clinic and they will help you do things such as reading or whatever you need or want to do".
• May give patient material provided by the AAO. PDF 6653, Smart Sight Patient Materials, has much information for low vision patients. Go to AAO web site, log in, enter "Smart Sight" or PDF 6653 in search box.