Article Date: 3/1/2010

Low Vision, High Gratification
From the AOSA

Low Vision, High Gratification

Low vision care can be incorporated into any practice, new or established, with just a bit of conscious effort.

By Remi J. Miljavac, Vice President, AOSA

Choosing which path to take after graduation from optometry school can be overwhelming. But keep in mind that it's never too late to add a new facet to your practice or hone a long-forgotten skill. Whether you're just starting out or simply ready for a change, you might want to consider low vision. Dust off your trial frames and dig up that old magnifier — you know you have one somewhere! We're going to spend a little time thinking about the low vision patient.

How Common is Low Vision?

The AOA estimates that between 1.5 and 3.4 million adults in the United States are visually impaired, so there is undoubtedly a need for low vision care. As the baby boomer generation ages, that number will continue to climb. The risk of developing low vision increases with age, along with the likelihood of having one of the top four causes of low vision. These include: age-related macular degeneration, cataracts (that cannot be removed), glaucoma and diabetic retinopathy. Diabetes is projected to be on the rise indefinitely and is now seen with more frequency in younger patients. A greater prevalence of diabetic retinopathy is sure to follow.

Use Low Vision Devices

I spoke with Kathleen Boland, OD, a Clinical Assistant Professor in Primary Care and Community Services at the University of Missouri-St. Louis College of Optometry, to find answers to my low vision questions.

Dr. Boland says less than $500 will buy you a supply of low vision devices, which would be a wonderful investment for any optometrist.

Items that ranked high on her must have list included: several illuminated, handheld magnifiers of various strengths, a few stand magnifiers, some contrast acetate sheets and a gooseneck lamp or two. Show patients how these optical devices may help them. They can learn how to make the most of their remaining vision by familiarizing themselves with these options.

Dr. Boland says the most satisfying component of low vision care is surprising patients who believed they had no hope. "Many patients with low vision come into the office thinking — or having been told — there's no way to improve their vision," she says. "They're extremely relieved when they see there are ways to improve their vision and their quality of life."

Privilege and Responsibility

It's our privilege to provide vision care; let's not shut the door on some of the patients who rely on us most. Patients with low vision have a special set of needs that presdisposes them to fear and despondency.

Specializing in low vision isn't the only way we can assist patients — all optometrists can be of service regardless of their chosen modality. Always remember to take the time to counsel and educate your low vision patients. We owe them appropriate referrals and resources, which may include low vision rehabilitation with a trained low vision clinician or occupational therapist, a psychiatric referral if need be, local support agencies, and so on. Make sure patients understand that help is out there—and you are willing to help them find it. nOD

Remi Miljavac is a 3rd year optometry student at the University of Missouri-St. Louis College of Optometry. She received her BS in Biology from Rockhurst University, in Kansas City, Mo. Remi is the newly elected Vice President of AOSA. She hopes to return to Kansas City after graduation to join a partner practice. E-mail her at

Optometric Management, Issue: March 2010