Dr. Resource Articles

As eyecare professionals look for new growth opportunities, many are viewing low vision in a new light. "Low vision adds another dimension to your practice because it combines optics and functioning, and it is more dynamic than many other areas," explains Paul Freeman, O.D., a veteran low vision specialist from Pittsburgh.

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Ashley Risner, OD, was fresh from her residency when she joined an established OD's office for the purpose of expanding the practice to include low vision. That was just a year ago. Now, the practice continues to boom, and she has 139 new patients coming to the office for low vision treatment.

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If you ask doctors why they practice low vision, you'll probably get answers like "helping people," "serving the community" or "providing a service that no one else does." Very few will answer "to make money." In fact, when I ask doctors why they don't practice low vision, the answer I most frequently hear is, "I can't do it and be profitable."
And indeed, this seems to be what optometry schools teach even professors of the subject perpetuate the myth that low vision practice should be a charitable endeavor, or at best, a labor of love.

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The idea that all low vision patients are the elderly could not be further from the truth. While it is true that many low vision patients suffer age-related macular degeneration and other diseases common to older people, low vision is very fair-minded. Low vision practitioners report that a good deal of their patients are indeed children.

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Forty years ago, doctors treated the visually impaired for what was called subnormal vision. I know that because I began my career as an optometric educator almost that long ago. Fortunately, we have come a long way from those days. And now, the terminology in keeping with the treatment has evolved into vision rehabilitation or more specifically, low vision rehabilitation. That fundamental change makes this the most exciting time for the optometrist, ophthalmologist, or other health care and rehabilitation/ education professional to become involved in the care of this underserved patient population. As this new science has developed, we have seen more and more professionals from a broad range of differing disciplines becoming involved in the rehabilitative care of the visually impaired. And, they all seem to refer to themselves using the term low vision specialist in one form or another.

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The coverage of the emerging and evolving subspecialty of low vision in Eyecare Business chronicles its growth. We first covered the low vision market segment in the early 1990s, calling it, "The Best Kept Secret in Optical." Since then, we have published some 50 articles on the category.

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During low vision office visits and device dispensing, efficiency counts not only in the practice, but also with senior patients. The number of visits, cohesiveness of education, and additional services available can make or break a low vision practice. Taking tips from veterans, EB has put together this primer to help you and your patients get the most for the investment.

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Rehabilitation for the blind and visually impaired got its jumpstart during World War II when young, newly blinded or visually impaired veterans needed jobs and life skills retraining. Blind rehabilitation moved into civilian life in the '60s with the onset of retinopathy of prematurity, in which premature babies were blinded by the oxygen that saved their lives. Blind rehabilitation services were provided through government and school programs, as well as by some private, nonprofit agencies. These services were conducted outside the medical system and the college- and university-trained professionals supplying them were not medically credentialed.

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As the incidence of age-related macular degeneration (AMD) increases, more patients will need help dealing with visual loss and the quality-of-life issues that affect patients with low vision. Often, patients are confronted with a diagnosis of AMD without the proper education about what the effects of their disease will be and how they can live with decreased vision.

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It is estimated that approximately 1 in 28 adults over the age of 40 in the United States have low vision, a number that is expected to increase significantly over the next 20 years due to an aging population.1 Although, by definition, people with low vision have some usable vision, they often have difficulty using their remaining vision to complete necessary tasks, particularly those with small or low contrast visual details. Reading and writing legibility are almost always significantly compromised. Difficulty performing these 2 tasks creates limitations in many other daily activities such as grooming, meal preparation, medication management, financial management and shopping.

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