As it now stands, too few general optometrists understand how low vision specialists define the condition, and this limits referrals to specialists, according to a poster presented at the 2014 Academy meeting by students from the New England College of Optometry.
You may have been taught that BCVA of 20/70 or worse signified low vision. “The problem with this numeric definition is that it did not take into account the functional problems many individuals with better than 20/70 vision have with conditions that cause glare and/or contrast loss that are not evident during high contrast visual acuity testing routinely performed by eye care providers,” says Mark Wilkinson, OD, clinical professor of ophthalmology at the University of Iowa Carver College of Medicine.
To be more inclusive, the NEI defines low vision in functional terms. Its definition encompasses individuals of all ages who have a congenital or acquired impairment of visual acuity or visual field, or other functionally disabling factors, in the better-seeing eye. This loss of vision interferes with the process of learning, vocational or avocational pursuits, social interaction or activities of daily living and is not correctable by standard corrective lenses, medications or surgery.
“Low vision rehabilitation should be part of the continuum of eye care that includes refractive, medical and surgical eye care, which begins at birth and carries forward throughout life,” says Dr. Wilkinson, who shares the following patient screening questions developed by Roy Cole, OD, director of the Vision Program Development at Lighthouse Guild in New York:
• Do you have trouble doing what you want to do because of your vision? For example, reading your mail, watching television, recognizing people, paying your bills, signing your name, climbing stairs, crossing the street or driving?
• During the past month, have you often been bothered by feeling down, depressed or hopeless? Do you notice yourself having little interest or pleasure in doing things?
Refer any patients who answer yes if their difficulties cannot be ameliorated by standard means.
The demographic trends that fuel age-related eye disease are adding to the ranks of the vision impaired every month, not just this one. But try to find a little time in February to raise the awareness level of low vision among patients, caregivers, staff—and yourself.