Your priorities and needs (replace with activities inventory)
Note: this list is to be replaced with the activities inventory
Asking yourself what you need: the functional history
In order for vision enhancement training to be as helpful and as effective as possible, it needs to address your needs and your wishes. Asking yourself the questions that will clarify what activities in your life are difficult or are becoming difficult due to vision loss allows you to prioritize where attention should be focused when you work with a professional low vision therapist.
You want to ask yourself not only what is hard to do but what you most want to be able to continue to do.
Low Vision Related Health Requirements: Do you have health problems or treatment requirements that will impact low vision recovery? Are you a diabetic, and if so can you see to fill insulin syringes, read nutritional labels on food containers and see to monitor your foot care? Are you taking medications that may impact your vision?
Reading and Near Vision: What are your reading requirements and desires? Do you need or wish to read specific materials– the newspaper, your mail, newsletters? What happens when you try to read? Can you read newspaper print, large print, or large headlines? Is eyestrain or ocular fatigue present? Are you an avid reader? What low vision devices have you tried?
Intermediate Activities: Can you see to perform other near point and intermediate visual activities like writing, sewing, cooking, and viewing the computer? Can you see to write checks and balance their checkbook? Do they use large print (deluxe guide) checks? Can they see to use a calculator or a watch?
Activities of Daily Living: Have you marked your appliances to improve visibility? Can you see to do other routine housekeeping duties like cleaning, paying bills, and laundry?
Computers: Are computers used? How large is the monitor? What type of work is being done? How close must you sit to the computer screen? Are you using Is computer enlargement or voice software? Do you have dedicated eyewear for the computer? Can you access the Internet?
Recreation: What do you do for recreation? Doe you have a hobby? Can you watch television? How close do you sit? How large is the television? How well do you see the colors on the screen?
Mobility: Do you have any mobility issues? Can you travel independently? Do you run into objects or trip on curbs? Have you had mobility and orientation training? Do you take trips? How do you travel? Are their any difficulties?
Driving: Are you still driving?, If so, with or without a valid license? Have you had accidents or traffic violations? When will the license expire? Does your family support continued driving? Have you limited your driving? Is someone else available to drive? Is public transportation available?
Light & Glare: How well do you function in bright sunlight, inside lighting and at night? Do you wear sunglasses? If so, what color and type? Does light and glare affect your mobility? Do you have difficulty changing from different light levels? Is there a residual decrease in vision after coming inside from bright light? Do you have trouble functioning at night?
Vocational: Are you employed or doing volunteer work? What type of work was done in the past and did you leave your job because of vision problems? Are you now seeking employment? What are the visual requirements for your job? Has the lighting, visual environment of the job and position of equipment been adapted to fit you? Are their safety issues? Is appropriate eye protection worn?
Educational: Do you have specific educational needs? Are you using educational programs that are adapted to the your visual abilities? What educational services are available? Do you use large print books? Can you see the chalkboard? Are there computer requirements? Will you be able to handle the increased reading required in college? Will there be mobility or transportation issues in attending school? Is there access to computer technology adapted for visual impairment, closed circuit magnification, audio textbooks or a personal reader/note taker?
Emotional: How motivated are you? What support is available to you? Do you have family or friends to provide support, help with housework or transportation? How would you say you are adapting emotionally? Have you experience anycvisual hallucinations?