Whether a person was born with a visual impairment or developed vision loss later in life, not seeing well in our very ‘visually oriented world’ can impact one’s life in many ways.
For seniors, who likely knew normal vision most of their lives, reading small print may be the first challenge they notice and they expect that stronger reading glasses will do the trick. Sometimes though, as a result of disorders such as macular degeneration, diabetes or glaucoma, vision issues become more complicated, and usually conventional eyeglasses, contact lenses, medication or surgery don’t offer effective solutions.
For children who were born with a visual impairment from disorders such as albinism, nystagmus, achromatopsia, or developmental issues, ‘seeing’ was never ‘normal’ to begin with. Young adults may have had normal vision in their early years and then may develop changes in their vision from Stargardt’s Disease.
It is reasonable to assume that the major challenge that individuals with reduced vision have relates to reading. With our wonderful new technologies, there are many excellent ways to magnify print to make it easier to see.
However, not only do we use our vision to read and see things, our distance vision is an important social sense. We use it to make eye contact, read body language and feel connected to the world around us. There is a growing body of research that shows that loss of distance vision can create feelings of isolation and can lead to depression. Other studies show that the lack of visual engagement in social settings and in visually-guided activities can even contribute to cognitive decline.
How Can We Help Patients Who Have Low Vision?
To address the distance-seeing needs of individuals with low vision, there are only three options:
- A better eyeglass prescription
- Move closer
- Make the image larger
In most cases, if a new refraction would have been useful, it would have already been prescribed by the time the patient saw a low vision practitioner. Remember, small changes don’t make big differences! If a patient sees 20/400 a half diopter or 10-degree axis change will be of little value. Changes in refraction will have more potential impact when acuity is 20/70 or better as a modest change might yield 20/50 and that can be helpful. Improving acuity from 20/400 to 20/300 is unlikely to impact the patient’s functional life.
While moving closer is an effective way to see objects and faces more clearly, it isn’t always practical. For example, getting very close to an individual to recognize their face is considered socially aggressive behavior. They don’t like having someone invade their personal space, and low vision individuals aren’t comfortable doing it. And, one can’t climb over the counter at a fast food restaurant to read the menu on the back wall.
Make the image larger
If we can’t get close enough to see something or someone easily, we can make it appear closer with miniature telescopes, similar to binoculars, that make the image larger and hence help us to see further away. If we can only recognize an individual’s face to about 4 feet away, a 4 power telescope will allow us to see the face at 16 feet away. The user may say that the face looks so much closer, but the benefit is that it allows them to see that much further away.
The user’s initial experience: “The field of view is so narrow!” We’ve likely all experienced the narrow field of view that binoculars and telescopes provide, and at first, it can be a challenge for an individual to find what they are looking for when looking through a telescope designed for use by the visually impaired. Just like learning to ride a bicycle, things get better with practice. But, when using a handheld telescope one must stop what they’re doing and pick up, aim, and focus the telescope. This disrupts the integration of the enlarged image into the natural seeing experience and exaggerates the impact of the telescope’s narrower field of view.
The bioptic experience:
By incorporating the telescope into eyeglasses, and positioned at the top of the eyeglass frame, the user can easily dip their head to look into the telescope without the interruption of using a handheld device. The easier and more convenient something is to use the more likely it will be used. And the easier it can be to integrate the magnified image into the general field of view. This integration can be called a ‘Fused Perception.” While one does not actually see the enlarged and normal image simultaneously the quick change in looking in and out of the telescope (called translation), can make the perception seem simultaneous, which is a major goal and benefit of an eyeglass-mounted telescope (called a bioptic).
For more information and to schedule a low vision consultation, call Ocutech today.