What is a low vision assessment?

Your role in a low vision assessment is not passive.To get the most out of the examination, spend some time assessing your current abilities and disabilities. And equally important, make a list of the activities and functions that you feel are most needed and desirable for you to live an independent life with the vision loss you have. See Helping yourself for ideas on how to assess your current functional vision.

A low vision assessment usually includes:

Medical and vision history

An assessment begins with a survey of your overall health: any diseases or conditions you are being treated for and the medications you are taking for them.If you are being treated for an eye disorder, bring whatever information you have on your diagnosis and treatment.

Functional vision assessment

A low vision examination is intended to assess how your vision is working in the real world – how it functions in day-to-day living. Beyond how well you can see the letters on an eye chart, it assesses  how well you can read printed matter, see curbs, stairs, signs, faces, light switches and all the many visual clues that make it possible to live your daily life.

Low vision care focuses on rehabilitation, not cure. Since it it seeks to help you find new ways to accomplish the tasks of daily life –  cooking, reading a book, driving, shopping… – an important component of the low vision exam is creating a profile of your activities, to identify which activities are of the highest priority in your life and which activities are most likely to be affected by vision loss  .

This assessment of your functional abilities and functional needs includes examining your vision in relation to areas of your life such as:

  • Communication – handwriting, typing, word processing, telephone…
  • Financial managemen – handling cash, checks bill paying, banking…
  • Consumer interactions – retail services, public services…
  • Orientation and mobility – navigating rooms, walking streets, crossing roads…
  • Leisure – orientation, walking, driving…
  • Education / Vocational –  blackboard, notes, tests, reading assignments, or: specified vocational tasks…
  • Leisure – active, passive, social interactions Self care  personal care, clothing, health care…
  • Meals – preparation, cooking, appliances, eating…
  • Home – management housework, gardening, small repairs …
  • Reading – personal, informational, recreational…

The assessment includes asking you to answer many questions about your vision. Some questions probe the state of  your vision.

  • Are you affected by glare – outdoors, indoors or both?
  • Do you have difficulty seeing under different lighting conditions?
  • Do you see better on sunny days or cloudy days?
  • How do you describe your ability to see contrast, such as a light gray sweater lying on a white bedspread?
  • Are there any blurred or distorted areas in your vision?
  • Where are they? Do you see better when you look slightly away from the object?

Other questions explore how well you manage activities and tasks of daily living. The goal is to assess how your vision impairment is impacting your life.

  • Do you travel independently?
  • Can you safely prepare your own meals?
  • What about grocery shopping, making phone calls or taking medications?
  • Can you write checks and manage other financial tasks?
  • How does your vision loss affect your participation in leisure pursuits or in employment-related activities?
  • Do you have any special or unusual hobbies that will need some creative solutions?
[popup url="http://www.meyesight.net/functional-history" height="700" width="700" scrollbars="0"]Self-assessment of activities: problems and wishes[/popup]

Eye health assessment

Vision tests are certainly a part of a low vision exam, but not onlt the ones you are used to from the doctor’s office.

Specialized low vision eye charts assess your near and far distance

Other tests measure:

  • contrast sensitivity
  • depth perception
  • color vision
  • visual field

Several different kinds of visual field tests may be used to locate scotomas–distorted, blurry or blind spots in your field of vision.

The assessment clarifies both the capabilities and limitations of your visual system, assessing ocular and systemic diseases and their impact on functional vision.

As well, the low vision exam includes a dilated internal examination, intraocular pressures and external eye health evaluation to assess whether there are ocular diseases or complications that require medical treatment or referral to a clinical specialist..

Evaluating for appropriate assistive devices

The tests and questioning result in  a plan that may include assistive devices and training in strategies for optimizing vision.

What devices are recommended depend on a variety of considerations:

  • How strong of a lens do you actually need?
  • Can you use a weaker lens for some tasks? A strong magnifier can be difficult to use. It must be held very close to the object it’s magnifying, and even the slightest motion can cause it to lose focus. The size of the area that can be viewed is also reduced as the magnifier gets stronger. In fact, the “best” magnifier is usually the weakest one that still allows you to accomplish a specific task. Sometimes it’s even necessary to practice with a weaker magnifier in order to develop the skill to use a stronger one.
  • How and where will you use the device? Do you plan to carry it with you, or will it sit on your desk?
  • With what kind of activity will the device assist, and how close can you get to the task at hand? Very close (reading a newspaper), not too close (cooking an omelet) or not close at all (watching a theater performance)?
  • Do you need your hands to be free while doing the task, or can you hold a magnifier? Are safety issues involved?
  • How big are the items you wish to see? Can the activity be made easier with better use of lighting, controlling glare or increasing contrast?

Regardless of the recommendation, in the end you decide which devices you feel will best improve your life and which one you think you are likely to embrace.

Training and practice are a critical component of the process of selecting devices. Learning to use a device properly can make the difference between a device that becomes a valuable tool and one that sits unused.

Beyond devices–strategies, techniques and tricks

Not all vision disabilities are improved by devices. If the assessment of your needs and goals identifies activities that you are no longer able to do with your current vision, the specialists working with you may be able to teach you alternative techniques for accomplishing these.When vision goes it’s easy to give up tasks that you can no longer do in the way you have been doing them for your whole life. But with training – and encouragement – you can learn new ways to take part in the activities that are important to you.