Vision Rehabilitation and Counseling

Dr. Shahid examines a patient

Low Vision Defined

Low vision means that even with regular glasses, contact lenses, medicine, or surgery, people find everyday tasks difficult to do. Reading the mail, shopping, cooking, and writing can seem challenging. The chief causes of vision loss in older people are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Among younger Americans, low vision is most often caused by inherited eye conditions, infectious and autoimmune eye disease, or trauma.

Our vision rehabilitation service provides expert solutions for all the challenges that individuals with visual impairments face. If a vision loss has made it hard to do a simple task, read mail, pay bills, recognize family and friends, we can help. Vision rehabilitation allow people to lead a more productive life.

Vision Rehabilitation and Counseling

It will probably be a number of years before macular degeneration falls into the category of a truly preventable disease. Many individuals with macular degeneration currently reach the point where no surgery, treatment or medication can reverse or halt the devastating progression of this disease. The purpose of the Vision Rehabilitation service is to help these individuals make the most of their limited vision. To accomplish this, state-of-the-art devices will be employed to improve the quality of life of individuals who have experience a loss of vision.

Visual loss often causes depression in individuals with macular degeneration. This response lessens the individual's ability to make adaptations for their vision loss. While many vision rehabilitation programs simply provide a few vision aids, without significant counseling or other instruction, the Vision Rehabilitation unit of the University of Iowa Center for Macular Degeneration employs and incorporates both psychological and physical rehabilitation in its care of individuals with visual impairments.

Individuals with visual impairments are taught to use their remaining visual abilities, much like physical or occupational therapists would help an individual who has suffered from a stroke. By adapting appliances and utilizing vision rehabilitation devices specifically designed for the needs of the individual, many individuals with visual impairments are able to maintain their independence. Another significant advancement has been the development of techniques for individuals to read using only their peripheral vision.

The University of Iowa is the home of the National Advanced Driving Simulator and Simulation Center. Since its completion in the Fall 2000, this laboratory has been used to study the effects of various degenerative eye conditions on driving skills. This research helps us develop strategies that will allow individuals with macular degeneration, as well as other conditions that cause vision loss, to continue driving safely for as long as possible.

Determining the need for vision rehabilitation services

  • Because of your vision, do you have trouble reading regular size printed materials?
  • Because of your vision, do you have trouble signing your name on a document?
  • Because of your vision, do you have trouble making a phone call without operator assistance?
  • Because of your vision, do you have trouble telling time with a watch or clock?
  • Because of your vision, do you have trouble managing your personal affairs?
  • Do you have trouble recognizing people?
  • Because of your vision, do you have trouble with activities of daily living (i.e. cooking, sewing, shopping or personal grooming)?
  • If you drive, do problems with your sight cause you to be fearful when driving?
  • Because of your vision, do you have trouble with independent travel at home or in the community?

Types of Visual Impairment that can Benefit from Vision Rehabilitation

Low vision affects people at school, on the job, and at home. It makes daily activities like writing, reading, watching television, and walking difficult.

Symptoms of low vision

Blurred vision
  Objects appear out of focus. Causes include macular degeneration, diabetes, corneal disease, and cataracts.
Central field loss
  A darker hazy patch appears in the center of objects. Causes include macular degeneration, and optic atrophy.
Contrast loss and glare problems
  Objects blend with background: lights are distracting or uncomfortable. Causes include glaucoma, cataracts, corneal disease, and albinism.
Multiple field loss
  Dark patches are scattered around objects. Causes include diabetes, glaucoma, retinal detachment, and trauma.
  Objects appear out of shape, crooked, deformed, wavy, or doubled. Causes include macular degeneration, diabetes, and retinal detachment.
Tunnel vision
  Objects in the center of the field of vision are visible: objects on the sides are missing. Causes include glaucoma, retinitis pigmentosa, and stroke.

What to Expect from a Vision Rehabilitation Evaluation at the University of Iowa

Patient with video magnifierYour services begin even before you come to our clinic. After your appointment has been scheduled, our vision rehabilitation educator will contact you to ask questions about your health, eye condition, and visual goals--the things you would like to do, but cannot do now because of loss of vision. We use all of this information to plan your visit.

When you come to our clinic, the vision rehabilitation specialist will evaluate your visual skills, talk with you and your family about problems caused by your visual impairment and explain how you can make the best use of your vision through training, devices and services.

Together, you, the vision rehabilitation specialist and the vision rehabilitation team develop a rehabilitation plan to help you meet your visual goals. Carrying out the plan may take several visits over the next few days or weeks.

During training sessions, the vision rehabilitation educator teaches you new ways to use your vision as well as any recommended devices. You can learn about services available by mail and in your community. We can also arrange for a specialist to adapt your home and integrate your new skills and devices into your daily activities.

Optical devices are available for trial in your home to be sure that they fulfill your specific needs and training in the use of these devices is provided. We will send a full report to your ophthalmologist or optometrist.

Types of Optical Devices used for Vision Rehabilitation

Commonly prescribed vision rehabilitation devices

  • prescription magnification spectacles
  • microscopic spectacles
  • filters to reduce glare and increase contrast
  • hand and stand magnifiers
  • hand held and spectacle mounted telescopic systems
  • electronic magnification including closed circuit televisions that enlarge print and enhance contrast for reading and writing
  • head borne magnification systems, for distance, intermediate and near vision enhancement
  • Vision Rehabilitation Assistive Technology

Other devices available

  • bold tipped pens
  • illumination devices
  • large print books and magazines
  • talking books
  • audio tapes
  • reading stands
  • optical scanners for reading printed text
  • computer software to enhance the video output or electronically read materials presented on the video screen
  • PDF icon Implantable Miniturized Telescope

A Personal Message from the Vision Rehabilitation Team

Our vision rehabilitation service is one of the few centers that provide expert solutions for all the challenges that individuals with visual impairments face. If a vision loss has made it hard for you to do a simple task around your home, read your mail, pay your bills, recognize family and friends, you are not alone. 13.5 Americans (1 in 6), 45 years of age and over, say they are visually impaired (Lighthouse National Survey on Vision Loss, 1995).

We can help. Vision rehabilitation services allow people to lead a more productive lives. Our team of doctors, vision rehabilitation educators, social workers, and occupational therapists are specially trained in vision rehabilitation. Our comprehensive program centers around a treatment plan that meets your needs. We work closely with you, your family and friends, your eye doctor, and the services available in your community. Everything we do; information, evaluation, training and technology, is aimed at helping you live as independently as possible. In addition, a professional social worker provides counseling and guidance for individuals with visual impairments and their families that can help with the special problems of vision loss. Advice and help in getting needed services is available. Occupational therapy assistance is also available to help individuals with visual impairment function more efficiently with their daily living activities.

Many individuals think that treating visual impairment means "just getting a better pair of glasses", but it isn't that simple. A complete vision rehabilitation program is needed to improve visual function and quality of life.

We are proud to be a part of the University of Iowa Center for Macular Degeneration and the Department of Ophthalmology and Visual Sciences. All of us are working to help you achieve your best vision.