FOCUS ON LOW VISION
Senior Class: Training Tips
by Karlen McLean, ABOC, NCLC

Low vision devices help seniors see the world more clearly. Photo courtesy of Eschenbach Optik

During low vision office visits and device dispensing, efficiency counts not only in the practice, but also with senior patients. The number of visits, cohesiveness of education, and additional services available can make or break a low vision practice.

Taking tips from veterans, EB has put together this primer to help you and your patients get the most for the investment.

CONVENIENCE

Convenience is a challenge for seniors with low vision who may be dependent on others for everyday tasks like driving and shopping. Getting from one place to another is often the biggest problem.

"The more transportation seniors have to do, the less successful their low vision training might be, simply because transportation can be so
difficult for this age group when combined with the challenge of low vision. We try to minimize travel," says Judith E. Goldstein, OD, a practitioner with 11 locations in Maryland.

Successful training and use of a low vision device on the first or second visit is crucial. Seniors must understand that working to use these devices can help them gain independence and make their lives easier.

Low vision devices can make reading possible again. Image courtesy of Enhanced Vision

"Seniors with low vision tend to get discouraged easily and are reluctant to pursue further service if they don't see some tangible result from their visit," mentions Paul Homer, MD, of Low Vision Solutions in Boca Raton, Fla. "Those who are looking for a magic pair of glasses are a setup for failure. Once they accept the principle that they were referred to us because their regular glasses don't work due to impaired vision, they do much better."

Adds Goldstein, "I try to prescribe only one device at the first visit to cut down on confusion. This helps them have to master only one thing at a time. I don't want to overwhelm them with technology."

COGNIZANCE

While making sure there are clear goals for the patient is key, pulling caregivers into the process is critical as well. "It's important to educate family members on eye health and why the patient's vision can't be restored, but it can be enhanced. This is an educational process for family members who may also be at risk as they age," says Beverly Heishman, ABOM, NCLC-AC, optical manager at Fava & Maria Eye Associates, a practice based in Lebanon, Pa. 

GETTING THERE

Office visit frequency is dependent on the patient's ability and the type of vision device. "Office visits are often covered by insurance, but devices are not. There are agencies available to help with the purchase of low vision devices," Goldstein notes.

"You have to be upfront with this. Above all, you must show these patients value within the first and second visits," she adds. "Value isn't only a product, it could be an occupational therapist being able to work with them at home."

COMPETENCE

While the doctor's initial evaluation and device Rx sets low vision patients in motion, it's often the follow-up care that drives success.

"During home visits, occupational therapists can address low vision health-related care, such as talking glucometers for diabetics, talking or large-size dispensers for medicine, and large timers for kitchen use," Homer says.

Heishman advises to never lose sight of the basics. "Be patient. Be positive. Relate to the patient on their level about using devices. Re-education is likely. For example, with high-add Rxs, patients often revert to trying to hold their reading material at regular reading distance while the focal length is much closer."