Transcript Overview of Low Vision Examinations

Overview of Low Vision
Examinations
400 Freedom Drive
Newtown, PA 18940
(215) 968-1035
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What is a low vision examination?
• Not the same as annual eye examination
• Performed in a doctor’s office by an
ophthalmologist or optometrist who specializes
in low vision (corrected vision no better than
20/70 or a visual field less than 20 degrees)
• Focuses on functional vision - how does the
patient’s visual impairment affect their day to
day living
• Does not treat the cause of vision loss – instead
helps the patient learn to maximize remaining
vision
What does the doctor do during
a low vision examination?
Step 1: A review of your health and
medication history
You will be asked questions about
• Your overall health
• Your family’s medical history
• Any medications you are taking
• Any medical conditions you may have
including a history of smoking, high blood
pressure, diabetes etc.
Step 2: Your Vision History
You will be asked for
• The name and contact information for your
referring optometrist or ophthalmologist
• The date of your last eye examination
• A diagnosis of your eye disease or disorder
• Family history of eye diseases
• Any previous eye treatments, surgeries or
injuries
• Any recent changes you have noticed in your
vision
Step 3: Low Vision History
The doctor will want to know
• When did your vision problems begin?
• What daily living tasks are you having
difficulty completing because of your vision?
(ie. cooking, watching TV, walking outside)
• Are there things you would like to do that are
challenging because of your vision?
• Have you received any vision rehabilitation
services in the past?
Step 4: Determination of Eyeglass
Prescription
You should bring any prescription eyeglasses
with you to your low vision examination.
The doctor can use a lensometer during the
examination to determine your current
eyeglass prescription.
Remember – the doctor is trying to help
maximize your functional vision and proper
glasses play a large part in your ability to see.
Step 5: Visual Acuity Testing
Your near and distance vision will be tested both
with and without using your glasses.
• The doctor uses a special low vision eye chart
that is different than an eye chart used in a
regular eye examination.
• This low vision eye chart contains different
sized letters and numbers that helps
determine the clarity and sharpness of your
near and distance vision.
Sample of a Low Vision Eye Chart
For Distance Vision
For Near Vision
Step 6: Visual Fields Testing
The doctor will use a Tangent Screen (a noncomputerized visual field test) to determine
how much side vision you have and how much
of the surrounding area you can see.
This test involves the patient looking at a black
chart with a series of circles (like a bullseye)
and identifying where they can see the dots
on the chart.
From this test the doctor can identify the extent
of your visual field (measured in degrees)
Step 7: Color Vision Screening
The doctor may screen for color blindness if
appropriate.
• The Ishihara Color Vision Test consists of a booklet,
each page containing a circular pattern (or "plate")
comprising many dots of various colors, brightness
and sizes.
• The seemingly random colored dots are arranged in
such a fashion that a person with normal color vision
will see a single-digit or two-digit number within the
array of dots.
• A person with a color vision deficit will either be
unable to see a number or will see a different number
than the one seen by a person with normal vision.
Step 8: Eye Examination
The doctor will examine both the external and internal
parts of your eyes to identify any concerns.
The exam includes use of:
• An opthalmoscope to view the retina and optic nerve
(can be used to identify retinal problems such as
diabetic retinopathy )
• A slit lamp to view the front and back sections of the
eye (to evaluate overall eye health)
• A tonometer to measure pressure within the eye (for
example increased pressure is a common symptom
of glaucoma)
Step 9: Refraction
• During the low vision examination, if the doctor
determines a different eyeglass prescription
would maximize your vision she may complete a
refraction to identify the appropriate
prescription.
• She uses a phoropter - equipment that contains a
series of different strength prescription lenses
that can be adjusted to determine the optimal
prescription to use.
• You would then receive a prescription for new
eyeglasses that can be filled by a local optician.
Step 10: Low Vision Aids
Based on the information gathered during
your eye examination, the doctor may
recommend prescription low vision aids to
assist you in maximizing your vision.
Recommendations are based on your vision,
the tasks you are interested in doing and
what level of technology you are
comfortable with.
Low Vision Aids continued
• It is important to realize that low vision aids
prescribed by the doctor after a low vision
evaluation are very different than the types
of magnifiers or glasses you can buy in a
drug store.
• Most hand held magnifiers or glasses sold in
stores can only increase magnification by up
to three times (3x). The doctor can prescribe
aids with fourteen times (14x) magnification.
Samples of Prescription Low Vision Aids
• handheld magnifiers
• monocular
• portable electronic readers
• Max Detail Binocular glasses
Non- Prescription Low Vision Aids
The doctor may also recommend some
non- prescription aids that can be found
in stores to help with daily living tasks.
• Talking Watches
• Large Button Telephones
• Talking Scales
Step 11: Low Vision Aid Training
• Low Vision Aids can be very helpful in
increasing independence for patients, but can
take some practice to use them effectively.
• If the patient selects a low vision aid, it is
recommended that they receive training to
use the aid properly.
• The doctor or her assistant provides some
initial training on how to use a low vision aid,
but many times more training is needed for a
patient to be comfortable.
Low Vision Aid Training continued
• In these cases, the doctor can make a referral
to an Occupational Therapist (OT) certified in
low vision to help teach patients to use aids.
• Training can be provided either at the Low
Vision Clinic or in the patient’s home setting.
• If a patients does not find their low vision aids
helpful even after training, they can return to
the clinic for a follow up appointment to
explore other options.
Step 12: Other Services
The Low Vision Clinic is one of many services
offered by the Bucks County Association for
the Blind and Visually Impaired (BCABVI).
As a final piece of the low vision examination,
we will give you information about other
services we can provide that may be helpful
either now or in the future.
There is no pressure to use any additional
services, but they are there if you need them.
Meet our optometrist
Dr. Denise T. Wilcox, O.D., Ph.D
• Has specialized in low vision for
over 25 years
• Provides low vision services for
Veterans Administration
Hospital in Philadelphia
• Is an adjunct professor at
Gwynned Mercy College
• Was featured in “Women of
Optometry” for her work in
low vision
How do I schedule a Low Vision
Evaluation with Dr. Wilcox?
To schedule a low vision evaluation you
can:
• call (215) 968-1035 to speak with our
scheduler
• send an email to
[email protected]
Things to know when scheduling
• The low vision evaluation lasts for
approximately 90 minutes
• A follow up visit (30 minutes) may be
needed
• Dr. Wilcox is only available for
appointments Mondays and Thursdays
9:00 am – 3:00 pm
• Transportation may be available
What should I bring to my appointment?
The day of your appointment you should bring
• Your prescription glasses
• Any visual aids you are currently using
• A list of current medications
• Your insurance card and copay (if applicable)
When possible, it is helpful to have a family
member or friend come with you to your
appointment. They can take notes, help ask
questions and listen to the doctor’s
recommendations.
Costs for Low Vision Services
• Most insurances cover the cost of low
vision examinations and occupational
therapy
• Patient is responsible for any
copayments
• No one is refused services based on an
inability to pay
Resources for financial support
Pennsylvania Bureau of Blindness and Visual
Services (BBVS) or the Office of Vocational
Rehabilitation (OVR)
• Patients who are eligible for services through
BBVS or OVR can have their low vision services
and equipment paid for with no copayment
(with prior approval)
• If you are not currently connected with BBVS
or OVR but meet the eligibility requirements,
we can make a referral for services on your
behalf
Other Financial Resources
Many local community organizations such
as Lions Clubs, Rotaries, Exchange Clubs
and church groups are willing to provide
financial assistance for people without
resources.
We have established relationships with
these groups and can often work with
them to purchase low vision aids for
members of their communities.