PPLVR Publications

  • The Provision of Low Vision Rehabilitation Services for Children, Youths, and Adolescents: An Initial Discussion

    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?

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  • Medicare Coverage of Vision Assistive Equipment for Low Vision Patients

    In 2002 Medicare approved coverage of rehabilitation services provided to beneficiaries who have low vision.  However, Medicare has consistently refused to cover magnifiers and other vision assistive equipment because they interpret the spectacle exclusion clause in the Medicare law to apply to such equipment.  Dr. Alan Morse has long been a strong advocate for Medicare coverage of low vision rehabilitation and is the primary person  responsible for educating Medicare on the issue and helping them craft their 2002 Program Memorandum.  Dr. Morse and his colleagues published a special article in the October, 2010  issue of Archives of Ophthalmology that presents a case for Medicare coverage of vision assistive equipment.  A summary of that article is presented here along with a PDF, which contains the supporting case studies described in the Archives article as being "available in an appendix on request from the author."

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  • The Assistive Devices Program (ADP)

    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.

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  • Medicare Low Vision Demonstration Project

    Final Reports - September 2010

    Three major reports on the Medicare Low Vision Rehabilitation Demonstration Project have just been released. These reports describe the results of studies by Brandeis University of low vision service providers, beneficiaries, and claims in the Medicare Low Vision Rehabilitation Demonstration Project.

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  • Orientation & Mobility (O&M) Services for People with Moderate Low Vision

    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 falls2-4 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

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  • Rehabilitation or Referral of Depressed Low Vision Patients

    Demographic aging will lead to an increased demand for medical care, including low vision rehabilitation. Therefore, in the near future, low vision rehabilitation centers need to make efficient decisions and choose the rehabilitation program that has the greatest likelihood of benefiting each individual. The growing demand for service by our aging population probably means that low vision centers will no longer be able to afford spending too much time on any one patient without being sure the patient is going to benefit from the offered treatment.

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  • Low Vision Driving Instructor: A New Role for Vision Rehabilitation Specialists

    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.

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  • Medicare Policy Issues Related to Low Vision Rehabilitation

    Approximately 80% of the U.S. low vision population is over age 65.1 Consequently, Medicare coverage policies have a large impact on the types and levels of low vision rehabilitation services provided by the health care system and on the choice of health care professionals who provide those services. Medicare policies relevant to low vision rehabilitation have undergone significant revisions over the past several years and are expected to evolve with the Center for Medicare and Medicaid Services (CMS) 5-year Medicare Low Vision Rehabilitation Demonstration Project.

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