1. Dr. Becky Kammer, Chief 714-449-7415 rkammer@scco.edu
Eye Care Center at the Southern California College of Optometry MaryAnn Walls Low Vision Center
Dr. Becky Kammer, Chief

2. What is Low Vision?
Patients may be blind or just partially sighted (visually impaired) 20/70 or worse in better eye
Legally Blind is 20/200 or worse with best correction on

3. What can Rehabilitative Optometry do to help?
Help patients see to read
Help patients see to drive
Help patients meet specific vision goals

4. Main Rehabilitation Goal
Improve independence and quality of life

5. How does the exam flow?
Patient’s come for at least 2-3 visits where a full eye exam is given and then devices are introduced to meet goals
First Visit: Team is introduced to patient
Occupational therapist
Student doctor
Faculty professor
OT will schedule a home evaluation before patient returns for second visit.

6. Second Visit
OT summarizes their home visit for Dr. and the second optometric visit is planned for the patient.
More visual goals are evaluated, devices are ordered
Possibly more training visits with OT are scheduled in the meantime

7. Dispensing Visit
Patient’s glasses or devices are given to patient and basic training in office is provided
OT schedules 2-4 more home visits to make sure patient uses device correctly and is using residual vision correctly (eccentric viewing training if needed)
OT reports back to Dr. for follow up

8. EXAM COMPONENTS Case history
Summarize to obtain basic goals
Sustained Near: Reading continuous text
Spotting Near: Seeing bills, shopping
Sustained Distance: Watching TV
Spotting Distance: Driving, seeing signs
Illumination and Glare: often need enhanced contrast indoor, need better lighting indoor

9. EXAM COMPONENTS Functional visual acuities
Distance Vision
Feinbloom chart (Designs of Vision)
Near Vision
Single digit chart (M notation – Lighthouse charts)
Continuous text chart (M notation - Lighthouse)
1M =20/50
0.8M = 20/40 realistic goal

10. EXAM COMPONENTS Trial frame refraction

11. EXAM COMPONENTS Functional visual fields
Several tests available to help determine how much usable vision is present
Nystagmus patients usually have full fields
This is great for rehabilitation processes

12. EXAM COMPONENTS Contrast sensitivity
Testing is critical for determining if low contrast objects can be seen in dim lighting
Poor contrast sensitivity may slow down reading or cause problems driving at night…

13. EXAM COMPONENTS Binocularity
Functional considerations
Depth perception up close (3D)
Many nystagmus patients have no depth perception (or true binocularity)
Most Low Vision patients are functionally monocular

14. EXAM COMPONENTS Calculations to determine the best type of magnification or modifications

15. EXAM COMPONENTS A Few Treatment options
Spectacle plane – high plus/microscope
Loupe – Hand magnifier, stand magnifier, head mounted
Telescopes
Electronic devices
Filters/lighting

16. Glare Treatment Various colored filters (lens tints) NoIR Corning
Plastic Photochromic (Chadwick Optical)
Cocoon’s

17. Electronic Magnification: CCTV

18. Nonoptical aids Relative Size Devices: Large Print Books
Posture and Positioning Devices: Lap boards
Writing Devices:Felt tip pens
Medical Devices: Talking glucometers
Mobility Devices: Cane, Dog guide
Sensory Substitution Devices: Talking clocks

19. Referrals Orientation and mobility
Visual impairment instructor – independent living skills
Department of Rehabilitation
Support Groups/counseling
Braille Institute for ILS classes

20. What’s new in LV? Computer technology with adaptive software
Volunteer at ECC provides one-on-one computer appointments for low vision patients

21. What’s on the horizon for LV?
Blind Art Exhibit in September 05
Research
SCCO is now part of a progressive group that is attempting to initiate clinical trials in the U.S.
Completion of a small multi-center study with hemianopic patients