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LOW VISION AIDS

Dr. Divyesh P. Shah
Sight First Technical Advisor, MD 322
Lions Clubs International Foundation
LOW VISION DEFINITION
“A PERSON WITH LOW VISION IS ONE WHO HAS
IMPAIRMENT AND /OR STANDARD REFRACTIVE
CORRECTION AND HAS A...
What is Low Vision?
• Low vision can be described as reduced vision which
cannot be corrected by optical or surgical means...
Low Vision and Low Vision Rehabilitation:
• A person with a significant reduction in visual acuity
due to ocular disease t...
• The role of a low vision specialist
(optometrist or ophthalmologist) is to
maximize the functional level of a patient's
...
A Global Estimate of Low Vision Care Needs
• 148 million visually disabled (blind+ low vision, ref. ICD-10)
8 million blin...
• Worldwide, for each blind person, an
average of 3.4 people have low vision, with
country and regional variation ranging ...
95% of people with low vision have some level of
useful vision.
• Those with worsening sight and the
prognosis of eventual blindness are at
comparatively high risk of suicide
• These peo...
Lack of Services – The Impact
to Children
• For children, the lack of low vision
services means:
– Developmental delay
– L...
Lack of Services – The Impact
to Adults and Seniors
For adults, the lack of low vision
services means
• – Isolation
• – De...
Woeful lack of awareness
•
•
•
•
•

Patients
Society
Doctors
Opthalmologists
Facilities providing services

LACK OF AVAILA...
Conditions causing Low Vision
Include :
• A R M D- central loss
• Diabetes- retinopathy Laser treatment
• Retinal Disorder...
Central Loss
• Macular

Degeneration

VISUAL
EFFECTS

LOW VISION
AIDS

V a: may vary with the extent of the deg:
with dry-stage ARMD,ac...
Age-related Macular
degeneration
• The most common cause
of visual loss in Western
countries
• >50% of all registered
VI
•...
Homonymous hemianopia
Glaucoma

VISUAL
EFFECTS

LOW VISION
AIDS

CCTV or max are useful because increase
contrast & brightness along with
Photop...
End Stage Glaucoma
Albinism

VISUAL
EFFECTS

LOW VISION
AIDS

Albinism has the most severe effect
on visual acuity, ranging from 20/200
to 20...
Retinopathy

VISUAL
EFFECTS
Depending on the severity of retinopathy,
visual acuity ranges from 20/20 to total
blindness. ...
Diabetic retinopathy
Retinitis Pigmentosa

VISUAL
EFFECTS

LOW VISION
AIDS

Central vision ranges from 20/20 to no
light perception. In early s...
Purpose of Low Vision Assessment
• Low vision rehabilitation allows people to
resume or continue to perform daily living
t...
Assessment
• Establish patient’s understanding of eye
condition
• Explanation given if necessary, backed up
with written o...
REFRACTION
• Encouraged to have up-to-date refraction
• Many patients with low vision benefit from
having separate readers...
Low Vision Examination
Vision Test
Prescription of
Visual Devices
Counseling and Emotional
Support
• Counselling and Emotional SupportPatients may experience similar feelings to
the variou...
Establish visual needs and
requirements
• Near / Distance
• Hobbies / Leisure
• ‘Survival’ reading such as :
correspondenc...
Optical Aids
• Magnification: aim to
use lowest possible
• Higher magnification
=smaller magnifier
lens, therefore smaller...
Optical Aids
• Choices:
hand/stand/lighted/
dome depends on:
• Patient choice
• General health
issues
• Task
Stand Magnifiers
• May be non-illuminated or
illuminated with an LED
• Location of image inside of
the focal point of the ...
Distance and Near Magnification Systems
Distance Telescopes
• Used to magnify the
apparent size of a distant
object when the patient
cannot move closer to the
obj...
Tints/Filters/Glare Control
 Wrap around filters
available to control both
indoor and outdoor
glare.
 Optical coatings s...
Binoculars and Monoculars
TV glasses and Clip ons
Macular Degeneration
• UVShields with UV protection.
Field expanding spectacle
•Touch screens -are devices placed on the
computer monitor(or built into it) that
allow direct selection or activation of ...
Magnification with CCTV
• If the CCTV is viewed
from a distance closer
to the screen than 40cm,
the total magnification.
A...
Recent Advances in Low Vision
• Bioptic & Auto focus
Telescope
• Computer soft wares
• Speech recognition softwares
• Mult...
• Large /bold print bank
statements and Utility
bills
• Clipboards and reading
stands
• Shades and Visors
• Large button p...
1.
2.
3.
4.
5.

Listen, Listen and Listen..
Detail explanation low vision rehab programme.
Psychological management.
Frien...
• The sooner the patient
receives support, the
better
• NSF for older people
states that patients
should be enabled to
ret...
•

Low vision care AND Vision rehabilitation is the crying need of the day

•

Low vision rehabilitation offers the practi...
THANK YOU
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  • {"41":"If cctv enlarges and you bring yourself closer then it is the mutiplication of enlargement times distance \n","4":"I am more a golf instructor than any new information you know you hit the ball in the hole the question is how do you hit it into the hole?\n"}
  • Transcript of "Low vision aids dr. d p shah"

    1. 1. LOW VISION AIDS Dr. Divyesh P. Shah Sight First Technical Advisor, MD 322 Lions Clubs International Foundation
    2. 2. LOW VISION DEFINITION “A PERSON WITH LOW VISION IS ONE WHO HAS IMPAIRMENT AND /OR STANDARD REFRACTIVE CORRECTION AND HAS A VISUAL ACUITY OF LESS THAN 6/18 TO LIGHT PERCEPTION IN THE BETTER EYE OR A VISUAL FIELD OF LESS THAN 10 DEGREES FROM THE POINT OF FIXATION, BUT WHO USES OR IS POTENTIALLY ABLE TO USE , VISION FOR THE PLANNING AND / OR EXECTUION OF A TASK” (WHO/PBL/93.27)
    3. 3. What is Low Vision? • Low vision can be described as reduced vision which cannot be corrected by optical or surgical means World Health Organisation definition: Best corrected VA less than 6/18 to PL or a Visual field of less than 10 degrees in better eye
    4. 4. Low Vision and Low Vision Rehabilitation: • A person with a significant reduction in visual acuity due to ocular disease that is not correctable by surgery, conventional eyeglasses or contact lenses has Low Vision • The process of helping a person with low vision achieve the highest level of visual function, independence, and quality of life possible is Low Vision Rehabilitation
    5. 5. • The role of a low vision specialist (optometrist or ophthalmologist) is to maximize the functional level of a patient's vision by optical or non-optical means called LOW VISION AIDS
    6. 6. A Global Estimate of Low Vision Care Needs • 148 million visually disabled (blind+ low vision, ref. ICD-10) 8 million blind, without any perception of light 140 million partially sighted (of whom 30 million blind, but having some residual vision) 25% 35 million in need of low vision care 75% 105 million in need of cataract surgery and/or routine refraction
    7. 7. • Worldwide, for each blind person, an average of 3.4 people have low vision, with country and regional variation ranging from 2.4 to 5.5.
    8. 8. 95% of people with low vision have some level of useful vision.
    9. 9. • Those with worsening sight and the prognosis of eventual blindness are at comparatively high risk of suicide • These people can be helped with Low Vision Aids
    10. 10. Lack of Services – The Impact to Children • For children, the lack of low vision services means: – Developmental delay – Loss of educational opportunity – Isolation – Dependency – Inability to participate in family and society – Put into the category of blind and they are provided with braille instead of general stream.
    11. 11. Lack of Services – The Impact to Adults and Seniors For adults, the lack of low vision services means • – Isolation • – Dependency • – Inability to participate in family and society • – Unemployment/underemployment • – For the elderly it may mean increased risk • for psychological and health effects; even
    12. 12. Woeful lack of awareness • • • • • Patients Society Doctors Opthalmologists Facilities providing services LACK OF AVAILABILITY OF SERVICES AND TRAINED MANPOWER
    13. 13. Conditions causing Low Vision Include : • A R M D- central loss • Diabetes- retinopathy Laser treatment • Retinal Disorders • Stroke +/- Field Loss • Nystagmus • Congenital Conditions • Multiple Sclerosis • Glaucoma
    14. 14. Central Loss
    15. 15. • Macular Degeneration VISUAL EFFECTS LOW VISION AIDS V a: may vary with the extent of the deg: with dry-stage ARMD,acuity can range from 20/20 to 20/400.With wet-stage (exudative) ARMD,the acuity can show loss worse than 20/400. Main problem is very difficulty to reading or writing. Should be prescribe optical glass & direct illumination should be recommended for all near tasks. Most of the patients respond well to magnification at distance & near. Non-optical aids . CPF lens improved contrast & control glare.
    16. 16. Age-related Macular degeneration • The most common cause of visual loss in Western countries • >50% of all registered VI • >70% of all visually impaired over 75 years of age
    17. 17. Homonymous hemianopia
    18. 18. Glaucoma VISUAL EFFECTS LOW VISION AIDS CCTV or max are useful because increase contrast & brightness along with Photophobia ,seeing halos around light, opacity or haze on lens, central visual acuity magnification,CPF are beneficial in is generally unaffected until the end stage of reducing glare, reverse telescopes can be used to enhance visual field, flashlight can this disease. be helpful for night travel, long cane also Visual loss in end –stage glaucoma pt: creates problem with orientation & mobility. helpful for travel (end-stage). Blurred vision which is gradual.
    19. 19. End Stage Glaucoma
    20. 20. Albinism VISUAL EFFECTS LOW VISION AIDS Albinism has the most severe effect on visual acuity, ranging from 20/200 to 20/400. Photophobia, may high refractive error, nystagmus, color vision is normal. Correct refractive errors. Controlling illumination sun lenses, CPF & color contact lenses or pin hole cl, visors & hat can often reduce photophobia. Telescope for distance.
    21. 21. Retinopathy VISUAL EFFECTS Depending on the severity of retinopathy, visual acuity ranges from 20/20 to total blindness. Loss of color vision. Most commonly , decreased vision is a result of lens changes (due to fluctuation in blood sugar level) or macular edema. LOW VISION AIDS Correct refractive error.CPF & sun lenses that block blue wavelenths may inprove contrast & eliminate glare & photophobia. Direct illumination for near tasks is generally helpful. Prismetic glass ,hand mag & CCTV may helpful for near task.
    22. 22. Diabetic retinopathy
    23. 23. Retinitis Pigmentosa VISUAL EFFECTS LOW VISION AIDS Central vision ranges from 20/20 to no light perception. In early stages of the disease, acuity usually remains normal. In later stages, acuity may become moderately to severely decreased secondary to lens or macular changes. Photophobia, night blindness, color vision problem. Slow reading & mobility problem. Refractive error should be evaluated carefully. CCTV or Max are useful (increasing contrast & brightness along with magnification ). Prismatic lens & good illumination helpful for near task.CPF lenses are helpful for improving contrast & reducing glare. Reverse telescope for distance. Vision rehabilitation is also needed.
    24. 24. Purpose of Low Vision Assessment • Low vision rehabilitation allows people to resume or continue to perform daily living tasks, reading being one of the most important • This can be achieved by providing non optical and optical devices as well as training in the use of residual vision
    25. 25. Assessment • Establish patient’s understanding of eye condition • Explanation given if necessary, backed up with written or taped information if required • Aim to dispel myths: -Tend to retain peripheral vision in ARMD -Can’t ‘use up’ remaining vision -Don’t feel guilty about using sight
    26. 26. REFRACTION • Encouraged to have up-to-date refraction • Many patients with low vision benefit from having separate readers, rather than using bifocals or varifocals, especially if a magnifier is to be used, or eccentric viewing taught
    27. 27. Low Vision Examination Vision Test Prescription of Visual Devices
    28. 28. Counseling and Emotional Support • Counselling and Emotional SupportPatients may experience similar feelings to the various stages of bereavement • Charles Bonnet syndrome- patients need reassurance that their visual hallucinations are a common symptom of visual loss
    29. 29. Establish visual needs and requirements • Near / Distance • Hobbies / Leisure • ‘Survival’ reading such as : correspondence labels / prices food packets & use-by dates medication instructions/syringe markings
    30. 30. Optical Aids • Magnification: aim to use lowest possible • Higher magnification =smaller magnifier lens, therefore smaller field of view
    31. 31. Optical Aids • Choices: hand/stand/lighted/ dome depends on: • Patient choice • General health issues • Task
    32. 32. Stand Magnifiers • May be non-illuminated or illuminated with an LED • Location of image inside of the focal point of the F1 requires accommodation or an add to resolve the image.
    33. 33. Distance and Near Magnification Systems
    34. 34. Distance Telescopes • Used to magnify the apparent size of a distant object when the patient cannot move closer to the object • Tasks: viewing faces across a room, grocery store isle markers, bird watching, sporting events, tv
    35. 35. Tints/Filters/Glare Control  Wrap around filters available to control both indoor and outdoor glare.  Optical coatings such as AR, and Polaroid lenses may reduce glare
    36. 36. Binoculars and Monoculars TV glasses and Clip ons
    37. 37. Macular Degeneration • UVShields with UV protection.
    38. 38. Field expanding spectacle
    39. 39. •Touch screens -are devices placed on the computer monitor(or built into it) that allow direct selection or activation of the computer by touching the screen. 10/30/13 40
    40. 40. Magnification with CCTV • If the CCTV is viewed from a distance closer to the screen than 40cm, the total magnification. Achieved is the product of RDM x RSM.
    41. 41. Recent Advances in Low Vision • Bioptic & Auto focus Telescope • Computer soft wares • Speech recognition softwares • Multilingual. • Braille output printers. • CCTV / LCD display/portable
    42. 42. • Large /bold print bank statements and Utility bills • Clipboards and reading stands • Shades and Visors • Large button phone • Aids:Talking clocks, watches, tins. • Talking microwave, measuring jug and scales, spirit level and rulers • Electronic colour detectors
    43. 43. 1. 2. 3. 4. 5. Listen, Listen and Listen.. Detail explanation low vision rehab programme. Psychological management. Friendly advise & counseling. Important of follow up. 10/30/13 44
    44. 44. • The sooner the patient receives support, the better • NSF for older people states that patients should be enabled to retain their independence
    45. 45. • Low vision care AND Vision rehabilitation is the crying need of the day • Low vision rehabilitation offers the practitioners a feel good niche and the patient a real choice to regain visual independence. • A large section of totally underserved partially blind population is waiting to be served WE HAVE TO MAKE SURE THAT WE ARE READY TO SERVE 10/30/13 46
    46. 46. THANK YOU
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