2020–2021 BCSC Basic and Clinical Science Course™
3 Clinical Optics
Chapter 9: Vision Rehabilitation
Patients with visual acuities less than 20/40 or scotomas, field loss, or contrast sensitivity loss will benefit from low vision evaluation and multidisciplinary vision rehabilitation to assist them to achieve their goals and maintain quality of life despite vision loss.
An evaluation of visual acuity, contrast sensitivity, location and size of scotomas relative to fixation, and extent of midperipheral and peripheral field loss allows clinicians to appreciate the impact of vision loss on patients’ function and informs effective rehabilitation interventions
Multidisciplinary vision rehabilitation addresses reading (eg, magnification requirements), daily activities (eg, computer accessibility or doing kitchen tasks), safety (eg, fall prevention or ability to take medications), participation (eg, driving) and psychosocial well-being (eg, adjustment to vision loss or depression).
The range of devices that patients can benefit from includes optical devices, such as reading adds and illuminated magnifiers; electronic devices, such as smartphones, e-readers, video magnifiers, or audio books; and nonoptical devices, such as large-format telephones or television remote controls.
Medicare and some insurance companies fund training by occupational therapists for patients with vision loss, just as rehabilitation is funded for patients who have had strokes or hip fractures.
Patients with any level of vision loss may experience vivid, recurrent visual hallucinations, such as seeing patterns, faces, flowers, or people. When patients have full insight that these images are not real and no other neurologic symptoms or diagnosis to explain the hallucinations, it is attributed to the Charles Bonnet syndrome.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.