hands on - Focus on Low Vision
Why the Time is NOWl
by Stephanie K. De Long

Low vision has finally come of age. Ten years ago, it was called slow vision, referring to both patients and the time demands on ECPs who care for the partially sighted.

Today, however, those involved in the field speak in much more positive terms, using phrases like "vision rehabilitation" and "regaining visual independence." In other words, the picture of low vision is brighter than ever.

Though Eyecare Business has always supported the category, during the last year we have had more and more readers asking for information about low vision. It's clear that, when it comes to this category, the time is now. Here's why.

Boomer burst. More than 15 percent of the population between the ages of 45 and 64 suffers from signs of low vision. With millions more soon entering that age group, the number of individuals experiencing early signs of low vision will be exploding. And the disorder that will create havoc with the vision of most of those people will be age-related macular degeneration (ARMD). The National Advisory Eye Council predicts that more elderly individuals will become legally blind--with best corrected visual acuity of 20/200 or worse--as a result of ARMD than from both diabetic retinopathy and glaucoma combined.

Living longer. According to the Council, 30 percent of people over age 75 suffer from low vision.

Add the fact that Americans are living longer than ever, and the result is more people suffering from low vision.

How many more? Today, some 40 million people worldwide suffer from low vision. That number is expected to more than double by 2010 and triple by 2028.

Underserved population. Less than half of those in the U.S. who are afflicted with low vision will ever receive any low vision rehabilitation services. A major reason is lack of consumer knowledge. Lighthouse International reports that 35 percent of Americans over the age of 45 are not aware of any vision rehabilitation agency services in their area.

Under-trained specialty. If those without treatment suddenly sought medical care, there are currently not enough low-vision trained optometrists and ophthalmologists available to manage their care. And that doesn't begin to address the patients, families, and caregivers who will be seeking help by the end of this decade.

Savvy seniors. Boomers are unlike previous generations of seniors in two important ways--they are accustomed to relying on technology, and many have the resources to pay for care, even if services are not covered by health care programs. That will mean a rise in receptiveness to vision rehabilitation and visual aids.

Lifestyle dispensing. Low vision is the ultimate multiple-pair specialty. Currently, about one-third of vision-impaired adults over age 44 use at least one optical device. The number of per-patient devices is increasing, and recommendation by the ECP is based on what the patient most wants to accomplish--seeing a grandchild, watching TV, reading the paper, and/or seeing out-of-doors without visual discomfort.

In low vision, it's not about dispensing one pair of prescription glasses for everyday wear and a second pair of sunwear. Instead, a patient may require several devices. The combination might include a video magnifier for reading, a handheld magnifier to read price tags in the store, and a medical filter to reduce outside glare.

Economic incentive. It's becoming too expensive for the U.S. not to increase treatment and training for the visually impaired. Why? Because unemployment among the visually impaired is high--only 42 percent of the working age visually impaired are employed.

Proposed legislation. Legislative initiatives are gaining more support. To find out more, visit www.medi-carenow.org, and encourage your U.S. representative or senator to support The Medicare Vision Rehabilitation Services Act, which would standardize Medicare coverage for doctor-prescribed rehabilitation services and therapy.

While telling patients that nothing can be done is far from true, it's misleading to tell them they can be cured. Experts say it's important to strike a balance when discussing care with the visually impaired. Though initiatives are under development, the reality is that, for the foreseeable future, a program combining devices and vision rehabilitation will be the preferred treatment for most ARMD.