FOCUS ON LOW VISION

Understanding VIPs…

What you need to know about working with visually impaired patients

Photo courtesy of Eschenbach

there are two things your visually impaired patients (VIPs) need from you. First, they need to have confidence, even after being told, “There is nothing more I can do to help your vision.” And, second, they need direction toward—and education about—the array of services, technology, and techniques that can help them adjust and maintain an active lifestyle.

IT’S NOT JUST EYES

I know, partly because I am a retired low vision specialist, but also because I am someone who has been legally blind for the past 30 years (20/400 OU VA) from Stargardt Disease.

I know first-hand how important it is for doctors to remember that their visually impaired patients aren’t just “eyes.”

VIPs are people who populate your community, business, and professional world, and they need direction for retaining their place in society. These patients and their families need to:

• Feel their doctor still cares about them as they begin to cope with new realities

• Understand their diagnosis and prognosis, as early as possible, in order to preclude unnecessary anxiety or premature lifestyle changes

• Realize that regular eye exams are still important, because often their response is: “If they can’t help me, they must only want my money!”

• Receive information and direction. That means you, their ECP, needs to take that extra minute to say, “Let me refer you to… or let me give you some resources…that can assist you in adjusting to the practical issues.”

Neither diagnosis nor visual acuity indicates actual ability or potential. Personality, motivation, information, and encouragement dictate how successful a person will be in adjusting to vision loss. The usual steps in the adjustment process—shock, denial, depression, fear, etc.—will be present, but adequate information will help patients through the adjustment and to make informed decisions.

Even today, in my Arizona retirement community, I still meet too many individuals, newly diagnosed with AMD or other sight-loss conditions, whose doctors are too busy (surely not uncaring) to incorporate a simple process for directing patients to the many resources available for them—services, techniques, technology, and support to help them maintain much of their independence.

WHAT YOU CAN DO

I’ve known doctors who started to understand the need to offer help only after they or their parents developed AMD. Here are just a few of the many things you can do right here and now for patients:

1. Provide printed information at the time of diagnosis! When a patient is told “the bad news,” they may not hear all they are told. Hand them information they can take home and digest later, when they are able to focus on it.

2. If your practice does not offer low vision services, refer patients to low vision specialists or clinics. Knowing the options before needing them can relieve much anxiety.

3. Develop low vision services—on a full- or part-time basis—with a trained tech or other personnel (a visually impaired person, as I was, has special insight). Services can include a basic or more extensive visual-aid inventory for evaluation and ordering, verbal and printed instructions, resource lists. and referrals.

4. At the very least, compile “Facts” and “Resource Lists” to give the patient or family some direction for their new or future needs.

If you don’t already provide some level of low vision services, consider the changing needs of patients as baby boomers swell the ranks of seniors with age-related eye conditions. Your response to those needs will ensure patient confidence and is also good PR, as they will often relate their eyecare experiences to others.

— Sondra Williams

Sondra Williams is a retired low vision specialist from Green Valley, AZ, and legally blind herself. She is also an author and is happy to help provide forms, handouts, and other resources for conducting low vision services.