Welcome to the Principles and Practice of Low Vision Rehabilitation (PPLVR) Learning Community

Emerald Education Systems has released the newest online course, Cerebral Visual Impairment in Children, A Practical Approach by Gordon Dutton, M.D. Please click here to view the official announcment and get more information.

Only 86 years have passed since Anne Sullivan Macy was shown a pair of telescopic lenses and stated, “I never knew there was so much in the world to see” (Koestler, 1976).¹ Only 57 years have passed since the first low vision clinics were established in New York City.² And, it has been only 53 years since the Veterans Administration included low vision devices as an appropriate part of rehabilitation services for veterans.² And, nearly 50 years have passed since Barraga’s dissertation study was published on increasing a child’s visual efficiency through specific activities; because of her work children who had been treated as if they were blind were beginning to be taught how to use their functional vision.³ So, why in 2010 are we still struggling to ensure that children and youths receive comprehensive low vision services?

A novel program to support device-assisted vision rehabilitation in Ontario Canada

The Ontario Assistive Device Program (ADP) coverage for visual aids was introduced in the early eighties with coverage limited to Ontario youngsters and adolescents aged 16 years or younger. Over a relatively brief period, this coverage was extended to people of all ages. The breadth and range of ADP visual aids coverage is extensive, although the program has fallen far behind with respect to coverage of new device technologies (especially newer video-based devices such as portable CCTV systems, head or face worn video devices, GPS-based mobility devices, and print access devices). The program has also been criticized for failing to keep abreast of real market pricing of eligible devices (overpaying for computers and adaptations and underfunding for customized optical devices). ADP funding guidelines preclude the purchase of duplicate devices or for two different devices having the same essential function. Accordingly, ADP will fund only one device per function, in each of the aids categories: optical, reading, writing, and orientation and mobility.

Dr. Robert Massof interviewed Ms. Karen Keeney, co-founder and president of Chadwick Optical, a custom optics laboratory in White River Junction, Vermont that specializes in fabricating microscopes, telescopes, prisms, and medical filters for low vision patients.

Background

In North America vision loss (low vision) is strongly associated with aging. Over the age of 80, 1 in 5 have some significant reduction of vision, primarily from age related macular degeneration (AMD).¹ The elderly have a variety of co-morbidities related to the aging process including but not limited to arthritis, or other joint pain, and poor stamina due to heart disease. From the perspective of safety, visually impaired seniors describe a high number of falls^2-4 and a fear of falling.^5-7 Falls amongst the elderly has been identified by the Center for Disease Control (CDC) as a major health issue with a national public relations campaign going on right now to educate Americans about falls, the importance of fall prevention, and methods by which to reduce the risk of falls in homes and elsewhere.⁸

The loss of the privilege of driving is perhaps the number one issue of concern to the low vision population. In a world of instant gratification where people can just hop in the car and everything is at their fingertips, the loss of America’s primary mobility tool can be devastating. Many people are unable to drive to work or continue living in an area without public transportation. People who have been independent for a lifetime suddenly must rely on relatives or friends to drive them to where they want to go. Since the driver’s license is such a symbol of independence, the loss can result in psychological and emotional trauma.^1-2 However, with proper instruction, and in some cases the right tools, many people with low vision can remain safely on the road.