Visual rehabilitation 29/09/2014

What is low vision?

The latest advances in ophthalmology and the frequency of preventative eye check-ups mean that a large number of pathologies affecting the eyes do not result in total sight loss.

However, some illnesses cause a loss of vision that cannot be restored by means of surgery, other pharmacological treatments or even conventional glasses. Such vision, which can be useful but insufficient, is called low vision.

The most frequent symptoms are a loss of vision of detailed objects, a reduction in the visual field (peripheral sight, steps, etc.) or both at the same time.

The most frequent illnesses causing low vision are age-related macular degeneration (AMD), retinitis pigmentosa, cataracts, diabetic retinopathy (DR) and glaucoma.

What are the symptoms?

— Loss of central vision: patients may suffer from a loss of vision that prevents them from reading, watching television or recognising people's faces but does not make movement impossible. This happens to those suffering from age-related macular degeneration.
— Loss of visual field: patients suffer from limited peripheral vision (lateral, superior, inferior or tunnel vision). They have mobility problems because, for example, they can't see obstacles or steps. This is a classic symptom of glaucoma and retinitis pigmentosa.
— Glare, loss of contrast and colour confusion.
— Image distortion.
— Blurred vision.

The team specialising in low vision carries out a study to assess each patient's vision, used to determine visual acuity, contrast sensitivity, the visual field and colour vision.

When should you see a low vision specialist?

When the ophthalmologist has diagnosed an ocular illness (AMD, glaucoma, non-operable cataracts, etc. ) that stops you from carrying out everyday tasks involving near or far sight and which conventional optical solutions (glasses, contact lenses, etc.) can't improve. In many cases the ophthalmologist will recommend visual rehabilitation.

What is a visual rehabilitation programme?

Visual rehabilitation aims to provide those with a visual disability with strategies to carry out their everyday tasks at in terms of work, education, culture and leisure, enhancing their social integration and personal autonomy.

A visual rehabilitation programme consists of a series of visual exercises aimed at teaching patients how to effectively use the aids and improve their visual skills.

These instruments allow patients to take advantage of their residual sight, improving their everyday skills and therefore enhancing their quality of life.

Patients need to learn different skills to master their visual aid: placement, focus, detection, skimming and scanning. We place most emphasis on the aspects of skimming and scanning or tracking.

A good training programme lays the foundations for the satisfactory use of residual sight with the help of optical aids, ensuring that patients do not give up using their devices should they encounter any difficulty.

Training must be based on the specific requirements of each person and not only on those expressed by the family or those assumed by the optometrist, and training must therefore be individualised.

The aims of specific low vision training must be established taking into account each patient's characteristics: age, cause and degree of disability, intelligence, motivation, profession.

The starting point for training or rehabilitation consists of the patient realising the potential of their residual sight, the functional repercussions of their pathology and how to optimise their sight with the help of optical aids.