Therapists keep hope in sight for low vision patients By CHRISTINA TISCHNER
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Tampa Bay Newspapers : Pinellas County www.tbnweekly.com/pinellas_county/content_articles/051007_pco-05.txt PINELLAS COUNTY – Imagine picking up the remote control and not being able to see the buttons to use it. Perhaps reading the paper is a chore because only half of the print is readable.
Patients with low vision face these kinds of issues every day.
Low vision is vision loss that cannot be corrected by ordinary glasses, contact lenses, medication or surgery. This impairment affects a patient’s daily life activities.
Linda Self, a licensed occupational therapist at Morton Plant Mease Health Care’s Palm Harbor Wellness Center, says a patient’s chances for low vision increase as he or she ages.
“Fifteen percent of the population (nationwide) age 45 to 64 has a visual impairment, and 26 percent of the population age 75 and up has a visual impairment,” Self said. According to the National Institutes of Health, by the year 2020, approximately 43.5 million people age 40 and older will be affected by an eye disease that puts them at risk for blindness.
The three major causes of low vision are glaucoma, macular degeneration and diabetes.
Diabetes is becoming more prevalent, with Type II diabetes (also known as adult-onset diabetes) showing up in children. According to Prevent Blindness America, diabetic retinopathy, or bleeding in the back of the eye, is the number one complication of diabetes. In addition, the longer a patient has conditions such as diabetes, the more likely the patient is to develop complications from it.
However, these complications can be prevented through management of risk factors.
“Controlling your blood sugar has a direct impact on associated risk,” Self said.
Macular degeneration is the reduction of central vision due to the natural degeneration of a specific portion of the retina. People with the disease often see black spots when looking straight ahead.
Glaucoma is an increase in fluid pressure inside the eye, causing damage to the optic nerve, which transmits images to the brain. The progression of glaucoma can be controlled by prescription eye drops. However, for patients already experiencing the effects of these diseases, occupational therapy can help.
Often, patients begin therapy through a referral from their doctor. Once there, therapists who specialize in low vision evaluate the patient’s situation, taking note of the specific vision impairment, patient strengths and weaknesses, medications, medical history and living conditions.
Even tasks that seem basic to most people become a challenge to the vision impaired. Therapists assess how well patients use the phone, read the mail, operate the remote control and maneuver about the kitchen, all in an effort to develop a therapeutic regimen.
“You don’t realize how dependent you are on your vision until you lose it. It can be very disorienting, very confusing,” she said.
Once they complete the evaluation, therapists educate patients on their options regarding available resources. The main goals for low vision patients include being safe in their environment, being as independent as possible, and being able to interact with others and enjoy leisure activities, all in an effort to have the best quality of life possible.
There are a variety of tools available for low vision patients. Special magnifiers and telescopic lenses increase print size; lighting and contrast help patients see objects more clearly; and stencils aid patients in filling out forms, signing checks and writing lists.
Each of these tools can help. However, Self cautions that visual aids may not completely fix the problem. Patients must cope not only with a loss of vision, but a loss of independence as they once knew it.
Self said it is difficult for patients to hear someone tell them there is nothing more that can be done medically. However, occupational therapists also provide counseling for patients so they may better adjust to lifestyle changes.
The Centers for Medicare and Medicaid Services (formerly the Health Care Financial Administration), the government agency responsible for administering Medicare and other government benefits classified low vision in 1991 as a physical impairment, allowing patients to utilize Medicare for treatment. Most health insurance companies cover low vision therapy as well. However, costs for low vision aids and equipment are out-of-pocket.
According to Self, patients need to know they can achieve their goals and improve their quality of life by maximizing their existing vision. Also, patients must be made aware of the available resources by their doctors. Often, patients don’t know what’s available, or they can’t access the information because of their impairment.
“The person who needs to know the most is least likely to have access to it,” she said.
Most of all, Self said hope gives patients more options. They can regain the things they have lost and be more independent.
A few resources:
• Morton Plant Mease
www.mpmhealth.com• Lighthouse International helps people with vision loss.
www.lighthouse.org• National Eye Institute
www.nei.nih.gov Article published on Thursday, May 10, 2007
