focus on low vision

What Patients Say

by Grace Hewlett

This is the third time Eyecare Business has followed a group of low vision patients. In 2007, we interviewed a total of 60 patients in the western U.S. At that time, their average age was 68, and one common denominator was that all respondents had previously communicated to their ECP/low vision service provider that they had a hard time finding someone to offer help for their vision problems.

Another common denominator: We actually met most of these folks in person at a series of events conducted for low vision patients and their caregivers in Southern California.

FOLLOWING UP

We made contact with the same set of patients three years later, in 2010. At that point, of the 34 members of the original group we were able to reach, most reported that they were still seeing the same practice or professional group.

It has now been five years since we first contacted the group, meaning the average age is now 73. Over the past couple of months, we communicated with 25 of the original 60 patients, or in some cases their caregivers, who gave us permission to include their responses.

This group is not intended to represent the low vision market as a whole, but rather provide a snapshot of a number of individuals who have shared their experiences over time.

Three years ago, approximately one-third of them reported their vision was stable, and another third reported changes due mostly to age-related macular degeneration. This time, nearly half said their vision was more challenged.

Asked how their treatment had changed as their vision problems increased, several have been referred “out” by their doctor for additional care. Also, more respondents now participate in at-home and other training programs. And, they report that both support groups and online resources are more popular.

The biggest change, however, has been the increase over time of the number of devices used by patients. In 2007, half said they used only one. That was down to 23 percent in 2010, with 33 percent of respondents reporting they used two devices, and another 15 percent saying they used three or more.

In our latest survey, usage has increased even more, with only 12 percent using just one, 40 percent using two, and 20 percent reporting they now use three or more devices.

LOW VISION SERVICES

PRIMARY DEVICES

CURRENT QUESTIONS

In addition to surveying patients about their low vision needs, we also gave them the opportunity to ask questions. Following are a few of them, as well as our responses (from outside experts).

IMPLANTABLE TELESCOPE

Q I've heard about a small telescope that is put into your eye and you don't need all the hand [held] devices we have to use today. Is it available in this country?

— Mr. L, 74, diagnosed with age-related
macular degeneration (ARMD)

EB: Yes, there is an implantable telescope available in the U.S. It is meant for patients with ARMD and cataracts. Doctors tell us that it is suitable for a small percentage of low vision patients. You still have to use devices in addition to the telescope. There is also at least one system available in Europe that has proven to be efficacious, but it has not received FDA approval for use in the U.S.

MAGNIFIERS

Q My son recently bought a very expensive magnifier for me, and the results were outstanding in terms of clarity. I was told the magnifier had a special coating that would cause the object I was looking at to be brighter. It did.

— Mr. J, 82, diagnosed with
diabetic retinopathy

EB: Some manufacturers report they put an anti-reflective coating on their magnifiers that will increase the amount of light that can pass through the lens. Industry experts tell us some eyecare professionals believe devices with the highest optical performance characteristics should be prescribed while others opt for a lower-cost solution. Your eyecare professional will be able to show you the options and differences.

PRODUCT IMPROVEMENTS

Q Are there any product [device] improvements that can help those of us with macular degeneration?

— Miss T, 80, diagnosed with ARMD

EB: Many products have improved in terms of ergonomics, including illumination. In particular, electronic magnifiers have become smaller, more portable, and lower in cost.

FIELD OF VIEW

Q My RP is causing worsening tunnel vision. Is there anything available that could help me? My ophthalmologist didn't offer any information in this area.

— Mr. A, Age 76, diagnosed with retinitis
pigmentosa (RP)

EB: There are least two types of minifiers available in U.S. that are used to expand the field of view. Think of them as similar to the peephole in a hotel room door. They would be either spectacle mounted or used as a handheld device. A low vision specialist, usually an optometrist, can help determine if this type of device would be appropriate for you.