Low Vision Text Only
What Is Low Vision?
Scheduling an Appointment
Low Vision Services of Kentucky is located at 120 North Eagle Creek Dr.
Suite #500 Lexington, KY 40509.
Click the link on the right side of this page for a map to our location.
Next to St. Joe East Hospital
(the old Humana hospital)
120 N. Eagle Creek Dr, Suite 500
Lexington, KY 40509
Fax (859) 263-3757
Scheduling An Appointment
Typically, your optometrist or ophthalmologist will make a referral for low vision rehabilitation and our office will make an appointment for you. It is possible, however, to be seen without a referral as long as you have been diagnosed with low vision and have been seen by an optometrist or ophthalmologist within the past year.
What to bring
Please bring all eyewear or low vision devices that you currently use.
Patients who wear contact lenses should wear them in a routine manner on their appointment day.
Please bring a list of all prescription and over-the-counter medications that are currently used for general or eye health.
What Is Low Vision?
Low vision is defined as vision that is not correctable with spectacles, contact lenses, surgery, or medication.
Low vision can be due to:
- congenital problems or disorders
- traumatic injury to the eye or brain
- systemic diseases
- adult onset diseases
- aging related diseases
The eye diseases may cause:
- a loss of acuity (ability to see detail)
- loss of peripheral vision or parts of the field of vision
- constant double vision (diplopia)
- loss of contrast sensitivity
- reduced or loss of color vision
- reduced or loss of depth perception
These disorders can prevent a person from completing their daily routines. Specialized microscopic and telescopic lenses, along with other types of prescriptive magnifiers are used to perform simple visual tasks like reading, writing, watching TV, hobbies, performing an occupation, traveling more independently, and in some cases even driving a car. In addition to prescribed optical devices, the loss of vision can be compensated for through the use of electro-optical devices such as closed circuit television, reading machines, or heads-up display devices as found in virtual reality technology. Sometimes a significant improvement in visual performance can be realized with new medical care or simple training techniques.
Low Vision Specialists
Low vision is a very specialized area within the eyecare field. Although both Optometrists and Ophthalmologists can provide low vision care, not every general eyecare practitioner is experienced in this specialty area. Low vision specialists use a variety of specialized testing procedures to identify a patient's visual abilities and they have special knowledge and expertise of the variety of optical devices that are available and how they may be used in the vision rehabilitation process.
During the course of a low vision examination, the eyecare professional's goals are: (American Optometric Association)
- To evaluate the functional status of the eyes and visual system.
- To assess ocular health and related systemic health conditions and the impact of disease or abnormal conditions on visual functioning.
- To provide appropriate optometric low vision intervention to improve the patient's visual functioning, taking into account the patient's special vision demands, needs, and adjustment to vision aids.
- To counsel and educate patients regarding their visual impairment and ocular and related systemic health status, including recommendations for treatment, management, and future care.
- To provide appropriate referral for services that are outside the expertise of the low vision clinician.
Low Vision Examination
A low vision examination defines the extent of the handicap of vision loss for the individual through extensive case history, consulting with other professionals and evaluating the individual's ability to perform tasks and activities. Spectacle microscopes, magnifiers, telescopes, computer adaptive technology, and electronic reading systems are prescribing options for achieving specific vision goals.
The comprehensive low vision examination may include, but is not limited to, the following procedures:
- Comprehensive history - The nature and duration of the vision disorder along with visual, medical and family history. Especially important is the assessement of the vocation, avocational, and educational requirements.
- Distance visual acuity - quantification of the vision remaining.
- Specialized refraction - using hand instruments to better simulate the vision normally used by a low vision patient.
- Visual Fields - performed mostly for functional purposes rather than for diagnostic purposes. Determines the extent of the field of vision (peripheral vision).
- Binocular vision - with low vision, the two eyes will often interfere with one another causing blurred, double, or swimming vision.
- Contrast sensitivity - to determine the visual response to loss of lighting and contrast.
- Near acuity - single letter acuity is determined as well as paragraph or reading material.
Most often, changing the glasses will not improve distance vision dramatically. To improve distance vision we have hand held telescopes. These can be used for short term viewing tasks like when traveling and needing to see signs. These same telescopes can be miniaturized and mounted into a pair of glasses for more continued use like seeing lectures and chalkboards in class. In very limited cases the bioptic or spectacle mounted telescope can be used for driving.
These are reading lenses or lens systems that allow a patient to read small print but require the reading material to be held very close to the eyes.
These are similar to the lenses that are used in the reading glasses of the microscopes but are mounted on a handle or with a stand to allow the patient to see small print at a longer working distance. The disadvantage is the loss of the field of view. Some of these systems have lighting built into them.
Often the simplest of devices such as standard hand held and stand magnifiers are the best solution for improving an individual's ability to use their remaining vision. Shown is an array of common magnifiers that would be used in the clinical setting. Most of these will have better optics and lighting than those found over the counter and more importantly will be correctly prescribed to the patient's acuity and demands of the task or activity being assessed.
There are a number of electronic magnification systems, self focusing telescopes and video displays with virtual reality mountings that can be very beneficial in helping individuals improve vision function. These prescribed devices are especially helpful in letting individuals maintain employment. A big asset to those who are visually impaired is the new and constantly improving video magnification systems.
They range from the standard closed circuit television which allows one to read printed material and do a variety of near tasks under high magnification, yet with comfort and proficiency. Newer systems are designed so that one views a magnified world through a video display mounted as glasses (like virtual reality glasses). Our clinic is constantly updating the technology available for the visually impaired.
Light and Contrast
There are filters or sunglasses designed for the special needs of the visually impaired. These will allow individuals to function in brightly lighted areas or dim areas where they are unable to use their vision at present. Special lamps and lighting is very important to the successful use of most prescribed devices.
Lighting is very important for all patients, no matter what the cause of vision loss. It is important to note that there can be too much light as well as too little light when it comes to maximizing visual performance. The appropriate amount of lighting and type of lighting will be evaluated in the clinical assessment as well as the need for filters and special sun glasses.
Low Vision Services of Kentucky works in conjunction with a specialty contact lens service to provide a variety of unique contact lens prescriptions. Contacts are used with central occluders to prevent diplopia or double vision. Other contacts are used to create an artificial pupil to reduced sensitivity to light (photophobia).
In almost all cases it is important that the individual being prescribed an optical (or even non-optical) device be given some instruction in its use and care. More importantly, the instructional sessions make sure that the intended prescription, which is based on clinical data, actually works for the intended tasks. The instructional sessions will give the patient an opportunity to use the device to read the materials or perform activities they will be using at home instead of just reading some small print on a clinical chart. For example, it will give the individual an opportunity to bring in the quilting project that was discontinued months ago and work with the new optical prescription to verify its practicality before having to purchase the prescription. As with all new devices, the more one uses the device, the more proficient they will become. Our training sessions allow for this time to be spent with the device (or a simulated Rx) in more normal settings such as home and outdoors. It is not until the doctor, instructor and patient are happy with the actual performance with the device, that it will be prescribed.
We cannot replace the eye or its normal functioning. These prescription devices will allow an individual to perform specific tasks or activities. The patient will need to learn to use almost all of these systems and training is provided in this clinic.
The success of the rehabilitation program is totally dependent on the patient's participation and willingness to modify their lifestyle and accept the performance limitations of the prescribed devices. While this may sound very negative, the positive side is that low vision prescriptions will allow the patient the opportunity to do things they would otherwise be unable to do.
Text used with permission by Randall Jose, OD, FAAO
Links to Web Sites of Interest
- Age Related Macular Degeneration, Patient Information
- Macular Vision Research Foundation
- American Academy of Ophthalmology
- Macular Degeneration Network
- American Federation for the Blind
- American Printing House for the Blind
Please call our office with any questions you may have. We appreciate your cooperation, and look forward to seeing you soon.