Low Vision

[Joann Raytar]

Tim Hunter mentioned doing low vision work at the hospital. Are there many Opticians and DO's supplying low vision aids and treating low vision patients in the UK? You cannot find that many professionals who deal with low vision here in the US; the field is growing but it is not the largest area of expertise, especially when it comes to finding retail outlets that offer quality low vision aides.

I have had a few patients, especially book worms, come in with new prescriptions only to break down in tears when they find out they still cannot read. I try my best to connect them with services to help out but I am not the best versed in the field. I just wish they would come in from the Ophthalmologists' offices with more realistic expectations; it can be heartbreaking at times.

What are your favorite low vision aides and techniques for dealing with these patients?

[Steve Machol]

Here's some Low Vision URLS:

Low Vision Council
The Low Vision Gateway
The Lighthouse Professional Products Division

[Tim Hunter]

Jo

Too big a subject to cover in a short e mail, but there are a variety of professionals involved in LVA provision in the UK. There is a statutory requirement to assess the needs of patients who are registered visually impaired and a basic system for supplying "free" LVAs (non-existent in parts of the UK I'm afraid).

Favourite LVAs are simple low powered hand magnifiers for minimally impaired, decent fov but limited magnification.

For more visually impaired I like the Eschenbach illuminated stand magnifiers which are available up to 12.5x.

But really it's very patient specific. The most important thing we do is essentially a form of counselling, explaining the condition they have, the effect on the vision and prognosis and giving them a realistic expectation of what optical aids can do!

Fortunately we have our ophthalmologists reasonably well trained working along side them in the hospital. Our community colleagues are not so lucky!

[Steve Machol]

Tim,

What do you think of OptiBoard's Low Vision style?

http://www.optiboard.com/forums/index.php?s=&styleid=25

[sandeepgoodbole]

Check:
Video Eye
:cheers:

[hcjilson]

I've been doing LV for 4+ years. I even changed the name of my company to Eyeglasses One-Vision Rehabilitation Center. I felt then and feel today that low vision has a negative conotation and was looking for something more positive in nature.

After giving the subject of getting into it some thought and research I came up with a plan that made sense for me.If you want to get into vision rehabilitation be prepared to spend some money and some time.Money for the products you will need to carry and time to spend learning them and then demonstrating them.

Sandeep gave us a website for an electronic magnifier.I have another one which is my company of choice for electronics magnifiers.
http://www.telesensory.com/
There are many others on the market. Most are very good and your choice will depend on what suits you or your customers needs.

Jo mentioned the expectations of a low vision patient has when they leave the doctors office.That's why I went with an electronic magnifier.Regardless of the degree of impairment
if its somewhat correctable at all the electronic magnifier almost always works.I have had many legally blind people be able to read the 20/20 line on the Varilux Card."Allow yourself 2 weeks or so of continual........" If you are going to get into low vision you must be able to provide a solution when all else fails.The fact is that electronic magnifiers always work.

Jo, like many of us in the field look at low vision like its highly specialized, and that we need to be something other than what we are in order to be in low vision.Her quote " but I am not the
best versed in the field. " I'm here to tell you that you can learn all you need to know to get started in this field in an evening.You will be able to help a low vision customer in the choice of a magnifying aid the next day.You won't learn everything there is to know, but you will learn enough to get into it.You build on it from there.

I use a system designed by Eschenbach which is straight forward and simple.Once you learn what the tools are, and how to use them, its realativly easy.It does take a lot of time with the customer and don't expect to get rich at it.I am probably just about covering my expense for inventory but the satisfaction gained from watching someone be able to read- be it a book, thermostat, or oven setting....is worth its weight in gold.The big plus is that I can offer a service to the eye doctor that my competition can't.Its rewarding in that regard as well.

back to work! hj

[Joann Raytar]

There is a statutory requirement to assess the needs of patients who are registered visually impaired and a basic system for supplying "free" LVAs

Harry,

Do we have any such program available stateside?

Tim,

What types of LVAs are covered in the program? Would the electronic magnifiers that Sandeep and Harry mention be covered in full?

[Tim Hunter]

Thanks for pointing me in the direction of the Visually impaired site of the site! The larger print format is definately helpful, although as I type this I note that it is coming up in a smaller size than the surrounding print. It's a nice idea but as with everything not all visually impaired people will like the format or the black on white print etc. etc. Thumbs up (with the usual reservations which I always have when speaking about the visually impaired and not being vi myself)

[Tim Hunter]

Jo said:
What types of LVAs are covered in the program? Would the electronic magnifiers that Sandeep and Harry mention be covered in full?

Unfortunately CCTV (closed circuit television) aids are not funded by the Hospital or other community based NHS LV schemes. They are however available through the education support service for visually impaired children (0-19) and also under the support VI people get to stay in work, which are funded from other budgets than the NHS.

We can demonstrate CCTVs here at SJUH and advise patients on where to purchase them but we cannot supply at present.

There is a major review of LV services going on in my area (and in the UK) and this may change in the future.

Interestingly in some research being done at Moorfields Eye Hospital in london, patients using conventional optical aids were given electronic aids to use and whilst most found them helpful they still wanted their optical aids as well! We tend to agree that patients need a range of aids and unfortunately one type of aid is unlikely to be sufficient for all their needs.

Although it varies for LV provider to provider we certainly supply as many optical aids as we feel the patient will benefit from and if we had the monies would be supplying the electronic ones as well.

[hcjilson]

Jo, et al,
It was interesting to see Tim mention Eschenbach because they are my major low vision vendor.I will preface the following by saying I have no interest in the Eschenbach Company other than professional.(In other words they are not paying me to say this)

I have found Eschenbach to be extremely helpful in establishing a low vision capability for my business.They offer a 3 hour seminar on how it can be done, and how to do it adequately.There are hands on Demos with many of their products, and you can get a good handle on what it takes.It really is a lot more simple than we are led to believe.

You may reach Eschenbach (USA) at
1-800-487-5389 and you will be directed from there.

Tim is correct that CCTV's are not the total solution, but thats the name of the game in LV.Problems of the visually impaired are solved on a "task oriented" basis.You have to determine what problem needs to be solved and then look for the aid that solves it.For example you wouldn't try to sell a 3 thousand dollar full color CCTV to someone who only wants to look up phone numbers.Finding the right solution for the right problem is what makes LV time consuming.But its worth all of it when the problem is solved.

best from harry

[Steve Machol]

Tim Hunter said:
The larger print format is definately helpful, although as I type this I note that it is coming up in a smaller size than the surrounding print.

Unfortunately that type size is determined by the individual's computer and browser. I can't control it from this end.

[optigoddess]

There is a really wonderful resource called: Sight Connection and they offer products for living with vision loss.

It is part of the Community Services for the Blind and Partially Sighted (CSBPS) based in Seattle.
The website is: www.sightconnection.com
phone # 1-800-458-4888

Some of the products they offer in the catalog are: calculators, clocks, cooking "helpers", games, sewing "helpers" , large print address books, check registers, dictionary and more!

Karen

[Joann Raytar]

optigoddess,

Great website!!! I found a ton of ideas there. Many of the items are readily available anywhere, like the medium and bold point pens and big numbered phones, you just don't think of them sometimes.

Thank you.

[Tim Hunter]

A website for those interested in the UK LV scene is the RNIBs (Royal National institute for the Blind)which has a fairly comprehensive list of LVAs available in the UK.

http://www.rnib.org.uk/lowvision/general/manulinks.htm

[lowvisionlabrat]

Hello,
I hope that I am not too late for a post on this subject, been out of the loop for awhile. I am the lab manager for a low vision practice in central Kentucky. You are correct in your assessment that the hopes of your patients are the first problem to overcome. Many doctors do not want to tell these folks that this is the best that they will get, and that it is likely to get worse ( in some cases, at least) In the US there is currently no federal finacial help for low vision devices that I know of, and it therefore goes state by state. Our state does some funding but it is getting tight out there. You might contact your local school for the blind to get further info about this.
Another poster also posted that you wont get rich doing this, they are correct. It is about a wash for stocking costs for lenses and so forth. They were also correct that when you can make something that can help them tell the differance between a 1 dollar bill and a 20 dollar bill, you are making a differance in their lives, and that is why I do this. It does take a higher level of expertice to do some of this stuff, and some retooling of equipment to get serious about doing it. If you are more concerned about helping people that need you, more than the next guy down the road, you will build more of a customer base, for they really do understand that if you can do these super high Rx's for the nearly blind, you can most likely handle their comparitively light Rx's with no problem at all.
I do all kinds of wicked Rx's, I stock up to a +20 add power from plano base to a 20 base lenticular in round segs. I also stock minus base lenses that I can run up to a minus 23 or so. I also drill mount telescopes that run right through the lenses so that some one may drive with them, it looks funny, but it works for some folks. I hope that you can help some of these people, and if you have any questions that you would feel free to contact me through this board, and I will help you in any way that I can. I love this job! It hurts sometimes, but I am passionate about it. The upside is really up. Thanks for being patient with my rants and raves. Daryl

[hcjilson]

Daryl,

Its amazing that the governments (state and federal) will offer assistance to the hearing impaired and physically challenged, but offer very little help for the visually impaired. They will supply wheel chairs, artificial limbs, and hearing aids, but they won't pay for magnifiers.

It is interesting to note that the Low Vision Council was taking the state of California to court under the "Americans with Disabilities Act" because they were discriminating against the visually impaired by not allowing them any similar benefits. I first heard that 2 years ago and have heard nothing since. This was test case and supposed to hold great promise if the council was victorious. Have you heard of this??

hj

[lowvisionlabrat]

No I had not heard about that, but I am not suprised by that, either. We just got a bioptic driving program for the visually impaired pushed through here in the last 18 months or so. This is for people with specific visual problems that can be corrected with a drill mounted telescope in one lens. We have even been somewhat succesful in mounting tinted covers for the scopes so that they have effective sunglass lenses for them, more fun every day! Daryl