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Low Vision Eye Care and Exams

Low vision is vision loss that cannot improve with medical or surgical treatments or conventional glasses. However, there are many ways to help people who have low vision. In addition, there are many tools and resources in the MHS and VHA available to help you learn to adjust. Get an eye exam right away if you experience signs of low vision.

Primary Eye Care and Low Vision

Routine comprehensive eye exams are essential for all patients. Patients with vision loss can benefit from an advanced eye exam by an optometrist or ophthalmologist who specializes in low vision rehabilitation. Primary care or eye care specialists can help identify, refer, and guide patients to medical professionals who can help support their low vision needs. Eye care providers who specialize in low vision educate people with vision loss about the nature of their disease/pathology. Low vision eye care providers help patients adapt when conventional glasses or surgery will not improve their vision.

What is a Low Vision Exam

Low vision exams are different from routine eye exams. Both exams review the patient’s eye and medical history. A regular eye exam focuses on eye health, treatment of eye diseases, and basic refraction with glasses or contacts.

Many providers define low vision as reduced visual acuity or visual field deficit that will not improve with conventional glasses, contact lenses, or surgery. Visual acuity measures the eye’s ability to recognize the shape and details of an object at a given distance. Visual field deficit is when the eyes have difficulty seeing in a particular direction. An optometrist or ophthalmologist specializing in low vision can conduct a low vision exam. This specialized exam helps determine how vision challenges affect daily life. In addition, providers who specialize in low vision can prescribe tools to enhance the remaining vision and assist with everyday life.

Low Vision Services Include

  • Capturing patient details
    • Functional history (ex: feeding, dressing, grooming, ambulation, bathing)
    • Social history (ex: smoking, alcohol, recreational drugs, accommodation and living arrangements, marital status, baseline functioning, occupation, pets and hobbies)
    • Screening for depression and behavioral changes associated with loss of activity and independence due to vision loss
  • Assessment of visual status including
    • Visual acuity assessment
    • Visual field assessment
    • Determination of a preferred retinal locus
    • Contrast sensitivity assessment
    • Determination of refractive status
  • Patient education on
    • The nature of their eye disease
    • Why conventional glasses or surgery will not improve their vision
    • Availability and benefits of low vision therapy/training
  • Exploration and education of low vision strategies, aids, and adaptations including
    • Prescription of refractive lenses, contacts, optical devices, or adaptive devices
    • Determination of appropriate environmental modifications and visual interventions to optimize optical functioning
    • Determination of visual interventions to optimize optical functioning (e.g., using visual field information to teach methods of eccentric viewing)
  • Referral to vision rehabilitation professionals as appropriate for rehabilitation training options that may include training in the office, in the home, or the community.

What to Expect During a Low Vision Exam

An optometrist specializing in low vision rehabilitation will ask the patient for a complete personal and general familial health and eye history. Additionally, the doctor will concentrate on the patient's visual difficulties. The conversation might include: discussing the visual impairment and how the impairment affects the patient's daily activities like using the computer, reading, traveling, recognizing faces, functioning in the kitchen, driving, working, watching TV, and participating in hobbies. The doctor will also screen for depression, which is more common with vision loss.

  • Specialized refraction and examination of each eye
  • Visual acuity measurement  using low vision test charts
  • Evaluation of visual fields
  • Investigation of glare, contrast sensitivity, and reading ability
  • Creation of a comprehensive, individual plan based on the patient's visual abilities and goals

Providers should look for signs that their patient's vision impairment may be causing difficulties in performing routine activities.
Patients should speak with their provider about their vision concerns. Especially if basic eye exams indicate normal vision but they are having trouble recognizing shapes and details of objects, or have difficulty seeing in a particular direction. This could indicate a need for specialized examination like a low vision exam.

Schedule an appointment today with your eye care provider.


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