Fortunately, we have come a long way from those days. And now, the terminology�in keeping with the treatment�has evolved into �vision rehabilitation� or more specifically, �low vision rehabilitation.�

That fundamental change makes this the most exciting time for the optometrist, ophthalmologist, or other health care and rehabilitation/ education professional to become involved in the care of this underserved patient population.

As this new science has developed, we have seen more and more professionals from a broad range of differing disciplines becoming involved in the rehabilitative care of the visually impaired.

And, they all seem to refer to themselves using the term �low vision specialist� in one form or another.

A New Challenge

The result is growing confusion in determining just what is a low vision specialist. As professionals from so many diverse backgrounds are becoming specialized or certified in low vision, it is also increasingly difficult to develop programs of care, standards for rehabilitative care, and even appropriate funding for professional services.

In the face of such challenges, now is the time for some of these groups to redirect their energies from developing specialists to developing professionals who, first and foremost, are at the top of their field, and to then encourage them to apply their own specific skills toward the common goal of enhancing independence for the visually impaired.

Simply put, instead of fighting for pieces of the low vision specialist pie, it is time to focus on what�s best

for the patient�and that is providing a true continuum of care. In a

continuum-of-care scenario, here�s just one example of how multiple caregivers might interact.

� Optometrists. When looked at from this perspective, the optometrist is a competent OD first and one who has a special interest in applying optometric skills to reduce the handicapping effects of a visual impairment, including the skillful design and fitting of low vision prescriptions and low vision training.

� Opticians. Likewise, the optician will provide input into the manufacture and fitting of some of these

complex optical systems to enhance the effectiveness of the doctor�s

prescription.

� Teachers. Then the teacher for the visually impaired must understand the applications and limitations of a prescribed device so the student can use it to improve the learning environment in a typical classroom. This teacher will work with the

student in using the device to access information�that is, improve learning abilities.

� Counselors. The rehabilitation counselor and teacher will help the patient learn to use the new prescriptions in the work setting. This usually includes making modifications to the work place and working with supervisors in accommodating the visually impaired worker and his or her new prescriptive devices. 

� Therapists. In the case of the older patient, unless services are made available through occupational therapy, the prescribed lenses or magnifier may well end up on the living room bookshelf, never being utilized.

An occupational therapist (OT) can provide care in the home to reduce safety hazards, improve medical regimens for taking needed drugs, and help the patient use the prescribed device. Without home intervention following up the clinical assessment, older patients may not take the time to deal with the frustrations of using optical systems.

Continuum of Care

Part of what we�re talking about here is a continuum of care. This type of care might include:

� Return visits to the ophthalmologist and/or optometrist.

� Social worker intervention for both housing and financial needs.

� Psychologist for dealing with the common depression and frustrations of being visually impaired.

� If needed, an occupational therapist driving instructor to work with the optometric clinician in providing behind-the-wheel training to use a bioptic for driving.

� And, for post-stroke hemianopic field loss, a peripheral awareness prism system can be used with the aid of an

orientation and mobility instructor to work with the patient in a real-world setting.

The goal then is to use professional skills to work within a continuum of care by sharing resources with other professionals and coordinating care to meet all a patient�s needs.

What about you? If you don�t currently provide care for low vision patients, should you become involved in this type of patient care in your office? Should you become a low vision specialist?

If you�re proficient in your own discipline and you�re willing to work collaboratively with other professionals, then the answer is clear. It�s a resounding �Yes.�  EB

For more information on a wide variety of low vision topics, visit Eyecare Business� website�www.eyecarebusiness.com�and explore our archives.

Doctors must be able to work with other professionals. Why? Because no one profession can meet all the needs�rehabilitative, social, psychological, and eyecare�required to ensure that the patient will attain maximum independence.