# Low Vision Rehabilitation/Optical management of low vision

This topic looks at the concept of low vision and the impact of eye disease when treatment is no longer an option. There is an overall enquiry question you will need to answer, and scenarios with supporting information to help guide your understanding and formulate your answer. You should spend around 6-8 hours with this topic.

## Enquiry

What is the appropriate method for prescribing a low vision aid for my patient? Use the scenario and resources below to formulate your own response to this question. You are looking for reasons as well as proposed solutions.
In this section, you will consider optical management of different types of patients, from school aged children to adults and the elderly. Consideration of appropriate low vision intervention in the ophthalmic clinic is also included.
The estimated time commitment for this enquiry is 4-6 hours.

## Scenario

Percy Fredericks - needs an optical low vision aid
Case study
Your new patient at See Well Australia is Percy Fredericks who is 92 years old. He has been referred to you by his ophthalmologist for a low vision assessment. As part of your new job at See Well Australia, you are asked to see Mr Fredericks at his home. Details about your initial consultation (home visit) are as follows:
GH: Generally fit, hypertension, arthritic hands and feet POH: diagnosed with atrophic AMD SH: lives in a retirement village with his wife (she has early dementia). Has Department of Veterans’ Affairs gold card Existing LV aids: fluorescent desk light, no magnifiers
C/o difficulty reading newsprint and occasionally the mail.
Near vision c SVN = n12
Near vision @ 10% contrast = n40 (indicates moderate to severe contrast loss)
Task 1
Watch the playlist Optical Low Vision Aids.
Task 2
Use the following resources to help you to answer the questions related to Mr Fredericks.
* Woo GC and Mah-Leung A. The term magnification. Clin Exp Optom: 2001; 84(3).
* Johnston A. Understanding how simple magnifiers provide image enlargement. Clin Exp Optom: 2003; 86(6).
* Cheong AMY, Lovie-Kitchin JE & Bowers AR. Determining magnification for reading with low vision. Clin Exp Optom: 2002; 85(4)
* Department of Veterans' Affairs Appliances and Aids
Task 3
During your Advanced Optical Aids interactive (face-to-face) class your goal is to consider Mr Fredericks' needs/requirements (i.e. he wants to read his mail and the newspaper) and find 3 options you could recommend for him. Justify your choice for each option.
Task 4
12 months has passed since you saw Mr Fredericks in your clinic. He returns for a review appointment. His wife, who has dementia, has moved into supported care and he is now living alone. George, his son, visits weekly but Mr Fredericks needs to be able to read his mail, bills, write a cheque, manage his banking etc.
Your clinical findings are as follows:
Visual Acuity: R) 6/120 L) 6/60
Near vision: N32 slowly - N40
* What strength optical magnifier would now be most suitable for Mr Fredericks?
* Are there any other options, for example electronic magnification (i.e. CCTV)?
* What disadvantages of optical magnifiers are overcome with the use of a CCTV.
* Describe how a CCTV enables magnification.
* Think about how you would explain to Mr Fredericks the change in his vision and the impact this is going to have on his ability to use both optical and electronic magnification.
Discuss in your group all the possible activities Mr Fredericks could undertake with the use of a CCTV.

## Resources and help

What is a CCTV? Orabis talking CCTV Paying bills using a CCTV