Low Vision Rehabilitation

Psychological barriers to process of rehab

• Concealment - px still pretends vision is fine - the eyes still look normal. They may feel the vision loss is seen as a general cognitive decline by others. They may reduce social contact, stay indoors. Younger px may fear losing their job/loss of independence
• Px refusing LVAs - think new glasses will do it. Equate VI with 'blind' and give up. They may have unrealistic expectations as well as other worries like caring for partner/money etc. Practitioner must explain that aids can be difficult to use but be encouraging and REALISTIC - ie don't give them aids they won't use

Prognostic Factors in Predicting Success w/LVA use

You have to wonder what constitutes successful LVA use/assessment - increased VA/confidence/performance of required tasks? Stuff that can be measured: VA, reading speed/acc, frequency of use of LVA.

• VA Studies - success rates vary consid. depending on criteria. Up to 95% of px achieve improvement
• Quality of life studies - Manchester Low Vision Questionnaire
• Attending LV Clinic - 67% px benefit 'a great deal', 22.8% a little, 10.5% not at all

WRT to a successful predictor of LVA use

• VA - poor, improved VA doesn't necess mean that LVA will be any good
• VF - good, extent and location of remaining field important, restricted field tends to have poor prognosis
• Stability of eye cond - good, better chance of success if stable
• Duration of VI - poor prognosis if recent (loss model)
• Cause of VI - poor, depends more on motivation
• Age - Good, younger = better prognosis
• Education/Intelligence, poor, people w/good intel tend to do better, but it's more fluid intel (ie adaptability to new task)
• Motivation - good. PROBABLY THE MOST IMPORTANT FACTOR! Self img/psychological barriers

Px Prefers

• Simple stuff! High spec adds, hand mags, stand mags, illuminated mags