What is vision rehabilitation?
Like physical therapy for someone who has injured their back, low vision rehabilitation can help you develop strategies to maximize the vision you have and to substitute for lost vision.
Low vision services work with you to utilize your remaining vision to its fullest potential. Low vision doctors can prescribe specialized eyewear, filters, magnifiers, and adaptive equipment, recommend independent living aids, and train and counsel people with low vision.
Low Vision services are not focused on the cause of your vision problem and are not meant to replace the need for concurrent treatments such as laser, medication and surgery you may be undergoing, which are the focus of your eye doctor or ophthalmologist.
The goal of low vision rehabilitation is for you to be able to live your life as independently as possible.
How this is done varies with each person: their eye conditions, their current functional abilities, their needs and their aspirations. While your doctor tries to reinforce your eyes, vision rehabilitation helps you reinforce your visual foundation. The process includes assessment, defining goals and training. It may also include selecting and training in assistive devices. Most rehabilitation programs also offers support groups, counseling and education.
“I don’t think I’m bad off enough to need rehabilitation.”
Do you need low vision rehabilitation? There is no red line which you cross over into the need for vision therapy. Research has shown that those people who take advantage of rehabilitation report significant improvements in their functional abilities, improvement in reading and distance vision, and greater satisfaction with the quality of life. And if you are considering an assistive device like a magnifier, those who select devices and are trained in them in rehabilitation continue using them for a longer period of time and use them more successfully.
The low vision rehabilitation process
The first step in low vision rehabilitation is a functional vision assessment to evaluate the extent of your useful vision. This assessment is very different than the testing you receive from you eye doctor, who is concerned not with your functional vision but with how your eyes are functioning.
Although assessment may include testing of ocular functions such as acuity, visual field, contrast sensitivity, depth perception, and color vision, special emphasis is placed on the functional problems you are experiencing such as reading, working in the kitchen, glare problems, travel vision, functioning in the workplace, using a computer, etc
We’re so used to the “eye exams” we have had with eye doctors that we assume the low vision assessment will be more of the same, but the low vision exam begins not with the tests we’re accustomed to but with questions and tests focused on your functional needs and your visual capabilities and limitations.
Together, you develop a case history which helps you determine how you are functioning and what your needs are and includes your visual goals–what you want to be able to do in your daily life. Do you read a lot, work at a computer, sew, enjoy bird watching, watch TV…?
Developing a plan
The assessment allows the low vision doctor to develop a plan for low vision rehabilitation that identifies your goals and which services and device are best suited to maximizing your remaining vision and your quality of life. recommendations may include:
- Specialized eyewear for low vision, including specialized materials, lens styles, filters, and antireflection and ultraviolet coatings.
- Light and glare control, adjusting and supplementing lighting, including specialized task lighting or modification of work, home or office lighting
- Optical devices to help you adapt include magnifiers or dedicated microscopic reading eyewear for reading or other close or intermediate tasks. Bioptic systems, hand held telescopes or head worn binocular aids for distance vision.
- Visual field rehabilitation such as scanning therapy and/or adaptive strategies, as well as technology such as visual field awareness prisms and reverse telescopes.
- Computer enhancements such as a larger monitor, screen enlargement software or screen readers.
- Low vision training, including training for eccentric fixation or scanning, for both home and office
- Occupational therapy for activities of daily living, scanning therapy or home modification.
- Mobility and orientation training
- Independent living and personal management skills training
- Independent movement and travel skills training
- Driving concerns, including evaluating your ability to continue to drive
- Occupational therapy
- Counseling to help you adjust to your vision loss
This list is but a sampling of the strategies you can learn to adapt in low vision rehabilitation.
People with a constricted visual field might expect to be introduced to scanning therapy and devices such as visual field awareness prisms and reverse telescopes. People with severe vision loss should expect to receive orientation and mobility training, occupational therapy, and information about animal guides and occupational therapy.
In addition to these skills, vision rehabilitation specialists teach how to manage daily activities such as:
- Adapting the home for safety and navigation;
- Improving lighting conditions
- Preparing meals
- Labeling medications, clothing, and appliances;
- Keeping financial records
- Personal grooming
- Using magnifiers for easier reading
- Systematizing shopping and payment at the register.
Who and where
When dealing with vision loss, your eye doctor is likely to be the professional you turn to first.
Your eye doctor’s concern and treatment will be focused on the physiology and functioning of your eyes. Their office, equipment and procedures are designed to treat diseases and conditions of the eyes.
For vision rehabilitation services you will want to find a vision rehabilitation practice trained and equipped to provide vision assessment and rehabilitation.
These resources can help you locate a vision rehabilitation service provider: Resourcers
Why is it hard to get yourself to a low vision assessment?
You may be feeling helpless and want to withdraw. You may want to deny that there is a problem that needs addressing! Perhaps you are dealing with multiple serious medical issues.
But many people never get the help that is available because they:
- think they are too far gone. (“You told me there is nothing more to be done….”)
- don’t understand what vision rehabilitation is.
- live a distance from services that feels too daunting.
- don’t have the financial resources, health insurance, etc. In fact, most insurance plans cover assessment, including Medicare. Although coverage for low vision devices varies, do check with your insurance carrier. (And keep checking, as their coverage policies evolve over time.)