ABSTRACT

With increased life expectancy at birth and especially the rising incidence of age-related macular degeneration, low vision (re)habilitation is becoming more important today. Important factors to consider when presenting rehabilitation and treatment options to patients presenting to low vision centers include the diagnosis of the underlying disease, the patient’s age, their existing visual functions (especially distance and near visual acuity), whether visual loss is central or peripheral, whether their disease is progressive or not, the patient’s education level, and their expectations from us. Low vision patients must be guided to the right centers at the appropriate age, with appropriate indications, and with realistic expectations, and the rehabilitation process must be carried out as a multidisciplinary collaboration.

Introduction

Visual impairment in low vision (re)habilitation may be central or peripheral vision loss or reduced vision due to media opacity. Among these groups, the most common diagnosis in patients presenting to low vision clinics is age-related macular degeneration (AMD), which causes central vision loss.^{1,2,3,4,5,6,7}

The type of rehabilitation required by the low vision patient varies depending on their visual acuity, age, sociocultural status, and especially their diagnosis. The approach to a patient who has central scotoma due to AMD is quite different from the approach to a patient who has tunnel vision due to retinitis pigmentosa. Some cases can involve the coexistence of both central and peripheral vision loss, as in the patient with concurrent diabetic maculopathy and diabetic retinopathy who underwent argon laser treatment to the peripheral retina.

The aim of low vision rehabilitation is for patients to use their residual vision as effectively and efficiently as possible to enable them to live as self-sufficient, independent, and productive individuals, to make their lives easier, and enhance their quality of life. Low vision rehabilitation is not limited to simply recommending aids such as telescopic glasses or magnifying glasses. More important are training in the use these devices and the rehabilitation process. Rehabilitation is a collaborative effort involving many professional groups, such as vocational therapists, psychologists, and social workers, led by an ophthalmologist.

The Vision Research and Low Vision Rehabilitation Center of the Department of Ophthalmology of Ankara University Faculty of Medicine is the first vision rehabilitation center in Turkey to be established within the body of a university, and has facilitated the rehabilitation of 5500 individuals with low vision to date. The center also runs a thesis master’s program on the subject for ophthalmologists.

Conclusion

There are many exciting and promising developments regarding the rehabilitation and treatment of patients with low vision. However, a patient’s age, diagnosis, education level, and sociocultural status should be considered when presenting rehabilitation and treatment options, and patients with low vision should be guided at the right age, to the right centers, and most importantly, with realistic expectations.