Basic Primer for Low Vision

[Lee Prewitt]

I am looking for a basic primer on low vision such as concepts, eye exams, procedures, etc. I am notlooking to begin this area of practice but am seriously lacking knowledge in this area.

Thanks

[optigoddess]

Lee -

if your office still has the September 2002 Eyecare Business magazine, there is a supplement called: Focus on Low vision - a resource guide to low vision services and products.

If you are interested in receiving a copy, call Boucher Communications at: 215-643-8146.

I went to eye care biz to see if the supplement was on the site - I didn't come across it in the archives but if you search the archives for the subject LOW VISION, it looks like they have an amazing list of articles to reference.

I see you are up in Washington; have you ever visited Community Services for the Blind and Partially Sighted?
csbps

(it is near Northgate mall (9709 Third Ave NE #100).

They have some amazing resources!

Check out the "Vision Resources" page at:

Lighthouse

I think it has further information on disorders and treatments.

HTH -

Karen

[Jeff Trail]

Lee,

This is one part of our field that seems to be the forgotten step child.. I do a lot of low vision work and even among my OD and MD friends they tell me some of the things I do does "not work" and still I get it to time after time.. One I do NOT use Fresnal prism (garbage) Two I go in each time starting with a clean "slate" Three.. low vision is NOT a stinking set of magnifyers sitting on a display!!
You usually get far better results if they have visual accuity problems OU, be it MD or retinal pig. or whatever, since I use lens power magnification in the adds and prism in the distance.. one thing about it when plotting the prism using a trial frame (and a lot of patience) you may end up with prism in the same direction in the vertical merridian , which all my OD and MD friends tell me "won't" do anything, but what you are looking for is active macula and if the fovea centralis or nerve has not been damaged than you can work around it..
I also found that as you increase prism you can enhance the "brightness" but at a certian point you stop doing anything for accuity..
Most of what I learned I kind of did it through physiology and anatomy books and by working with an "old time" refractionist who had been out of it long enough that what they are teaching in school did not apply.. the books tell you it could and would not work, I'm saying I seen this guy do some amazing things, getting people who came in that couldn't see the wall..let a lone the "E" on the snellen chart
Seen him get them down to 20/60 distance and 20/40 even 20/30 reading.. sounds like not a lot.. but you consider the option they had before..than this is amazing
It usually takes a good 1 1/2 to 2 hours to do the exam and a lot of tinkering with the trial frame but it sure seems to work..oh not all the time but probably 75% of the time I can get a markable difference
I get tired of going into an OD's office and they say "low vision" on the window or whatever and they got a set of magnifyers.. or worse some of those systems you hook up to a TV and it blows up the letters about 1 zillion X and it costs $2,000 for the system...
If you are in an OD/MD practice and they will let you have access to a trial frame set and you can find some willing participants than tinker away..you can't hurt a thing...and once you get down how the eye works and the visual pathways and in relation to medical conditions it starts to make a lot more sense..
Just an option to consider...

some good books: Primary Care Optometry
Ocular Anatomy and Physiology (Saude)

Jeff "40 add..I could burn ants with that sucker" Trail

[Traci]

Lee,

If you are able to - JCAHPO has a list of Low Vision Specialist you can train with for a 1 week period of time. This is a great way to learn about low vision and patients working with low vision devices for the first time or even repeat patients expanding on what they have done on previous visits to the low vision specialist.

Jeff, first I have to say how impressed I am for the accomplishments you and "the old time refractionist" have done! Congratulations, and keep up the good work. Maybe you could teach a course on it in the lecture circuit ? ? ?

I do believe there are very poor models of CCTV's out there, and they usually are the ones who advertise in geriatric magazines, however, there are good CCTV's that are just fantastic. And as for magnifiers, the Eschenbach handheld magnifier with LED's that were introduced last year are great!

If one can accomplish better vision through glasses - that is by far the best choice, but if magnifiers, lamps, or CCTV's can make a person achieve good or better vision, then go for it!

It has been my experience that not one device is perfect for everyone. And more so, each person likes to have more than one device.

[sarahr]

In my opinion one of the best books on Low Vision is 'Low Vision Principles and Practice' - C Dickinson.

It is written in plain speech and is very readable. I found that rather than using this book for reference, I happily read it from cover to cover. It draws the reader into the real world of Low Vision in practice as well as giving all the 'text book' facts neccessary for theory exams etc. I think this book takes you into the mind of the patient and recognises the emotions, and draws attention to the stages of visual deterioration which may have the potential to cause further distress. It also gives an account of different aids available as well as other methods of assistance. Obviously no single book can totally prepare a practitioner for what they will be presented with, I fully expect to be learning from my wonderful and inspirational patients in twenty years time, but if you only purchase one book on this subject, this is the one! Available from abdo.org.uk online bookshop.:cheers: