Low Vision

By Tim Taylor

Take vision for granted

Most of us take our vision for granted. Reading, shopping, watching TV, these are things we do every day without considering what it might be like to not be able to accomplish these simple tasks. Millions of Americans suffer from the condition called low vision, a significant visual impairment that’s characterized by 20/70 vision or worse. A visual acuity measurement of 20/70 means that a person with 20/70 vision who is 20 feet from an eye chart sees what a person with unimpaired, or 20/20 vision can see from 70 feet away. Low vision can occur at any age. And unfortunately, it can’t be corrected with glasses, surgery or contact lenses. Older adults with low vision may have trouble driving, reading, or doing small tasks such as sewing or making crafts. Certain changes in their homes and routines will be necessary to help them stay safe. Many services will provide people with low vision with the training and support they need to live independently.

Vision impairment

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Do you have trouble reading small print in newspapers and books? What about difficulty with recognizing faces? If you have a problem performing tasks like cooking, mowing or driving, or enjoying hobbies like hunting, crossword puzzles or sewing, you may have low vision. This form of vision impairment can cause some to experience tunnel vision while others have spots or holes in their vision. People with low vision have issues with selecting and matching the colors of their clothes. They also have a problem reading traffic signs or the names of stores and restaurants. All of these could be warning signs of vision loss. While the loss cannot be restored, it can be managed with proper treatment and rehabilitation. That’s why anyone who experiences changes in their eyesight should see an eye care professional right away. The sooner the problem is detected by an eye specialist, the greater the chances you’ll have of keeping your remaining vision.

Common in older people

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Low vision can occur at any age but it’s most common in older people. While it can be related to genetics, it’s usually the result of an eye condition or disease. The most common eye conditions that lead to low vision are macular degeneration, glaucoma, cataracts and diabetic retinopathy. With macular degeneration, the patient’s side vision is normal but the central vision is slowly lost. With glaucoma, which causes damage to the optic nerve, there may be tunnel vision and missing areas of vision. Cataracts, a clouding of part or all of the lens, make a person’s vision cloudy or fuzzy, and bright light may cause glare. People with diabetes may suffer from blurred vision, there may be shadows or missing areas of vision, and they may have difficulty seeing at night. Diabetes can cause blood vessels that nourish the retina to develop tiny, abnormal branches that leak. This can interfere with vision and, over time, may severely damage the retina.

Eye examination

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The American Academy of Ophthalmology recommends that you get a baseline eye examination at age 40, the time when early signs of disease or changes in vision may occur. Frequent eye exams can help identify issues that lead to low vision. While there is no cure for low vision, identifying it sooner can help slow its progression and give the patient more time to prepare. A comprehensive eye exam can take up to 90 minutes and will include questions about your family’s medical history and any medications you are taking. Your ophthalmologist will ask you to read a standardized eye chart to determine how well you see at various distances. The doctor will also evaluate how your pupils respond to light as well as your eye pressure with a test called tonometry. The ophthalmologist may put drops in your eyes to dilate or widen them. This will allow the specialist to thoroughly examine your retina and optic nerve for signs of damage from disease.

Aids and devices

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Loss of vision can be frustrating, but Dr. Anna Schlesselman of the UAMS Jones Eye Institute says that there are a number of aids and devices that can help people with low vision. Many patients use magnifiers to assist them in daily activities. Magnifiers on a stand are great for reading books and newspapers, as well as completing tasks like paying bills or reading mail. Handheld magnifiers can be great on the go, for example, at a restaurant while reading the menu. For patients with more severe vision loss, closed caption televisions and other electronic magnification can be very helpful for seeing print, threading needles, or even clipping finger nails. Dr. Schlesselman recommends opening the windows during the day and using higher wattage bulbs to get more light in the house. Some people even carry flashlights with them around the house. An evaluation by an eye specialist can help low-vision patients determine which devices work best for them.

Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.