Westchester Low Vision
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Low Vision / Westchester / New York
Non Optical and Rehabilitation Page


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Non Optical Aspects of Low Vision Care:


Other measures available include sunwear evaluations, lighting and environmental design consultations to maximize function in the patient's real world setting, and visual therapy to enhance performance.


Lighting


Proper lighting is often crucial to optimize visual performance in patients with low vision.  Most of the time, at the end of the low vision exam, we will recommend task lighting to enhance a patients ability to read printed materials.  This is particularly important when the materials in question are of poor contrast, such as newsprint.  We evaluate the amount of light that works best for each patient as the exam proceeds, and may further recommend a particular type of lamp.  Mostly, we recommend reflector lamps, which concentrate the light onto the patient's work area.  We may also recommend a particular type of bulb, with either regular soft white bulbs, or neodymium bulbs being the most often recommended.
Most of the patients we see have more than one problem.  For example, many of the patients with Age Related Macular Degeneration also have cataracts of varying degree.  A strong level of illumination is usually required for the retinal problem, but the cataract causes glare from this higher illumination.  The doctor must then consider further adaptations to allow for maximum illumination on the task while minimizing glare.
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Absorptive Lenses


Many Low vision patients also suffer from glare outdoors in
the sun.  In severe cases, even indoor lighting may prove a problem for some patients.  During the low vision exam, these problems are explored both by patient history and by observations and testing.  When necessary, a trial of different absorptive lenses is done to find the best lens to reduce glare without compromising vision.  While this is to some extent a trial and error process, the expertise of the doctor and his staff will assist the patient in making the correct choices.  Unlike the selection of sunwear in a drugstore or optical store, our offices have not only many more colors of absorptive lenses, but we carry each of these colors in several densities as well.  This is because the need for a glare protective lens of a certain darkness will vary with lighting conditions.
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Visual Training


Many of our patients require not only adaptive devices for their vision loss, but training in how to better use their remaining vision.  The complicated term for this is Neuro-muscular re-education.  It consists of eccentric viewing training for patients with central scotomas (blind spots), scanning and localization training for patients with peripheral vision loss, eye hand coordination training for patients who's vision loss has effected this area, and often, after stroke or head trauma, specialized training for conditions known as neglect and postural or gait difficulties.  All low vision evaluations look for any of these problems that often accompany vision loss, and training is provided as needed.
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Other Vision Rehabilitation services:


Social Services and referrals for Orientation and Mobility Training and Activities of Daily Living Programs are provided as indicated after your low vision examination.


Social Services can assist with both psychological adaptation to your vision loss, and with finding assistance for related difficulties you may be having.  For example, if a patient is having housing problems, problems managing their home, problems with an employer, or problems with insurance or disability coverage, a social worker can help you navigate the bureaucratic paperwork jungle.  In addition, more than a third of patients who lose vision become depressed from the loss.  It is a normal reaction, but one that you can be helped to deal with.  It isn't necessary to suffer alone.
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Rehabilitation Teachers


Rehabilitation Teachers help patients to adapt to difficulties in their work or daily living activities.  through the use of training and adaptive devices, many if not most patients with low vision can continue on their jobs, and continue to manage a home and remain independent.


Orientation and Mobility


Orientation and Mobility teachers more specifically work with any travel difficulties a low vision patient may experience.  They can help if you have trouble seeing curbs or steps while walking, trouble crossing streets and seeing cars or traffic signals, or trouble finding your way around unfamiliar areas.
Often, an O&M teacher will work with a low vision patient who has had a telescope prescribed, to make sure they can use it safely and efficiently in the street environment.


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