# Low Vision Rehabilitation/Case study: Thelma Scope

Your first patient at See Well Australia is Mrs Thelma Scope. Through working with Mrs Scope you will come to understand the concept of low vision and the impact of eye disease when treatment is no longer an option. You will be exposed to the roles and approaches of a range of professionals who might work with a patient with vision impairment. You will be challenged to determine your role as an Orthoptist in this multidisciplinary environment.
There is an overarching question you will need to answer, and scenarios with supporting information to help guide your understanding and formulate your answer.

## Question

How does low vision differ to legal blindness and what are the various definitions used to describe vision loss and what is the socio-economic impact of vision impairment? Use the scenario and resources below to formulate your own response to this question. You are looking for reasons as well as proposed solutions.

## Activities

Task 1
(Keywords: #low vision #vision impairment #legal blindness)
Watch the What is Low Vision? lectorial where you will find out about your new patient Mrs Thelma Scope.
Consult the resources below in addition to finding your own resources to answer the Task 1 questions. When answering the questions, think about what you know so far about Mrs Scope. Discuss and compare your answers with the students in your group.
* Terminology in Eye Health
* WHO | Visual Impairment and Blindness factsheet
* Oxford Dictionary
Questions - Task 1
* Why is it important to a patient that we define disability or vision impairment?
* How does the World Health Organization (WHO) define ‘low vision’
* According to the WHO definition, can you classify Mrs Scope as having ‘low vision’?
* What is the definition of ‘impairment’? How does this definition specifically relate to vision?
* Do you think Mrs Scope has an ‘impairment’? Discuss.
* Define ‘disability’ and explain how this relates to the sense of vision.
* Do you think Mrs Scope is disabled? Explain why/why not.
* Define ‘handicap’ and explain whether this definition can be applied to Mrs Scope.
* Do you think you have enough information about her case history in order to classify Mrs Scope as either having impairment, disability or handicap? What other information would you need?
Task 2
(Keywords: #economic cost #financial impact #direct & indirect costs)
Referring to the Eye Research Australia (Clear Insight) Economic Impact and Cost of Low Vision in Australia publication, answer Task 2 questions. Don't forget to consider your patient Thelma when answering the questions.
Questions - Task 2
* Of a composition of the total cost of vision disorders in 2004, what is the total cost of suffering? What do you think “cost of suffering” means? Explain your answer in the context of Mrs Scope.
* On page 4 of the report it states: “the share of pharmaceutical costs has increased to 11.4% of the total and of ‘other health practitioners’ to 10.6%. Why would this be so? What would contribute to this?
* There are significant indirect costs associated with vision impairment. In the context of Mrs Scope, explain how each indirect cost could impact on her life.
* Mrs Scope is 73 years old and she is expected to live quite a few more years, especially as she is generally healthy. What are the most likely reasons that her vision impairment would prevent healthy and independent ageing in her case?
* What are the top 3 causes of blindness in people aged over 40 in Australia?
* What age groups are most pre-disposed to each of the 3 causes you selected?
* What are the projected forecasts for visual impairment and blindness in Australia for the future?
* Why is addressing vision impairment a serious issue in this country?

## Resources and help

* Focus on Low Vision is an excellent publication by the Centre for Eye Research which will be useful to complete all the topics in this enquiry. You should refer to it often.