Westchester Low Vision
LOWVISIONDOC.COM
Low Vision / Westchester / New York
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DEFINITIONS PAGE:
What is Low Vision?
Patients with reduced vision or loss of side vision
which cannot be corrected with standard glasses or contact lenses are known
as low vision patients. More than 75 percent of these patients are 65 years
or older. Functionally, Low vision can be any loss of vision which makes
daily tasks, like reading, writing, watching television and walking, difficult.
About one out of every 20 Americans has low vision. Low vision Rehabilitation
allows people with vision loss to lead a more productive and enjoyable
lifestyle. What Causes Low Vision? Conditions which may benefit from Low
Vision Services include: macular degeneration, cataract, glaucoma, diabetic
retinopathy, optic atrophy, retinitis pigmentosa, the ocular effects of
stroke, and a variety of other vision disorders.
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What is a Low Vision
refraction?
Many patients referred for Low Vision Services confuse
the term "refraction" with the simple term use applied to routine measurement
for glasses. A "refraction" in a low vision office, refers to all
of the measurements, calculations, trials , and prescription of magnification
to suit the patients needs. This is often referred to as a "low vision
refraction" or a "complex refraction". The reason these terms are
used is that Medicare (copied by most health insurance) does not cover
refractive services. In 1965, Low Vision was covered by medicare.
In 1966, organized ophthalmology convinced medicare that refractive services
were not "medical" or "medically necessary" , a point I cannot disagree
with. Medicare, however, threw out the baby with the bath water,
so to speak. And now discriminates openly against visually impaired
seniors nationwide. If you have a bad leg or back, medicare will
pay for beds or wheelchairs, but if you lose your vision you are on your
own. AARP appears to be unwilling to take up the fight on this issue.
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Does my health
insurance cover a Low Vision exam?
Generally, most insurance covers the part of the exam
related to your eye pathology, but not the part of the exam related to
the refractive services. Read the answer above this to find out why.
The medical part of the exam is covered because some medical testing must
be done whenever you enter a doctor's office. To not do the testing
would leave the doctor open not only to potential litigation, but also
to charges by the state licensing boards in most states. The refractive
charges are only covered by some "vision" care plans. The reason
their are two charges is the amount of time spent on the refractive services
with a low vision patient. Charges for refractive services are required
by medicare, or they will assume that the eye exam charge includes the
refractive component. If medicare arrives at this conclusion, they
will reduce the fee paid to the eye doctor by about 25%. More and
more eye doctors have been burned by this reduction and are beginning to
charge refraction fees even for routine eye exams. In Low Vision
care, the refractive parts of the exam are greater than in a routine exam,
hence the higher charge.
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What Can you expect
during a Low Vision Evaluation?
Our comprehensive low vision evaluation carefully
assesses the patient's current visual status, identifies the goals and
visual needs, and designs an individualized rehabilitation program to meet
these needs. Rehabilitative measures include the prescription of spectacles
and / or a full range of low vision devices such as hand and stand magnifiers,
telescopes, microscopes and electronic magnification systems. We also have
a Technology Center, in which we can evaluate patients for computer adaptations
and modifications, and other state-of-the-art high-tech devices such as
computer screen enlargement software, print to speech systems such as the
Kurzweil Omni and JBliss-VIP, and portable video systems such as the V-max.
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. Social Services and referrals
for Orientation and Mobility Training and Activities of Daily Living Programs
are provided as indicated. Increasing Chances for Success: The type of
low vision aids prescribed and the training given in using them properly
are all significant factors in achieving success with low vision care.
To benefit most from low vision care, it is important to have a realistic
understanding of these aids and what they can do. Low vision aids do not
restore sight but help to use remaining sight more effectively. The most
important ingredient, however, is the person with low vision. His or her
desire and motivation will go a long way in assuring success in the effective
use of a low vision aid. As part of the blind rehabilitation network, the
optometrist plays an integral role through diagnosis and management of
the low vision patient and prescription of optical, non-optical and electronic
devices to provide this population with optimal use of remaining vision.
Optometrists who provide comprehensive low vision care establish clinical
treatment plans including, but not limited to, prescription, training,
education and interdisciplinary consultation.
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Why do you need to see
a low vision specialist after you have seen other
doctors regarding your eye condition?
You may have already
seen a number of doctors in an attempt to treat your sys condition.
Doctors today are part of a system that rewards increasing specialization.
A "retinal specialist", for example, often does not even refract his or
her patients, much less provide specialized rehabilitative services.
The system actually results in better overall care for the patients.
Low Vision services are unlike any services you may have received before.
Our assessment and treatment are functional or "goal" oriented and we have
available a host of specialized devices and special training to help you
to meet those goals. A low vision exam typically takes AT LEAST an
hour to complete, much longer than most doctors spend with their patients.
Who Provides Low Vision
Care ?
Most low vision specialists
are Doctors of Optometry with at least some additional training and experience
in the field. There are a few Ophthalmologists who specialize in
Low Vision also (about 4 nationally that I am aware of). Most doctors
do NOT practice low vision care because it is NOT a lucrative field.
Those of us who specialize in Low Vision are generally not doing it for
the money, but because we find helping those who have lost vision
to be extremely rewarding and satisfying.
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