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Low Vision: Consider the Cognitive and Physical Clinical Implications

Written By: Catherine Valentino OTD, MAAL, MHSc, BS, FMT

The effects of low vision and vision loss are as diverse and profound as the people it impacts. As we investigate how vision loss plays into both cognitive processing and physical skills for our patients, it is the universal need to maximize independence and quality of life that we, as practitioners, strive to promote. To do this effectively, we must consider a comprehensive approach to evaluation and assessing what our patients engage in throughout the day.

For individuals who suffer from low-vision and age-related macular degeneration (AMD), we are mindful of the vast functional decline they may be facing such as:

  • Visual cognitive processing skills
  • Ambulation and functional mobility
  • Orientation
  • Falls and balance
  • Community mobility including driving
  • Overall safety in environment due to lack of ability to recognize visual cues

When you are treating a patient with potential vision loss, remember to think broader on how these skills impact all of the other facets of their life and daily interactions. The CDC (2020) reports that less than half of the 93 million adults at risk for serious vision loss have seen an optometrist or ophthalmologist in the past year to address their condition. This can make our job particularly challenging as we may be on the front lines for identifying vision as a catalyst for falls or other deficits which bring them into our service.

Maximizing treatment, which will increase adaptive options as well as early training in the process, has been shown to facilitate longer periods of independence throughout the disease process. Moreover, Liu and Chang (2019) recognize the need for low vision interventions to decrease commonly linked, and secondary effects of these conditions. In their study, they highlight low vision and links to depression, anxiety, decreased independence and mobility both in home and in the community.

Consider checking out some of the resources below, as well my course through Summit, where we cover additional conditions, treatments, and in-clinic testing resources: Low Vision – Identification, Assessment, and Treatment to Maximize Functional Skills.

 

  • What is Macular Degeneration – Macular Disease Foundation of Australia: 

 

References:

Centers for Disease Control. (2020). Fast facts for common eye disorders. Retrieved from https://www.cdc.gov/visionhealth/basics/ced/fastfacts.htm

Liu, C., & Chang, M. C. (2019). Interventions within the scope of occupational therapy practice to improve performance of daily activities for older adults with low vision: A systematic review. American Journal of Occupational Therapy, 74(1), 7401185010p1. https://doi.org/10.5014/ajot.2020.038372

Shah, P., Schwartz, S., Gartner, S., Scott, I., & Flynn, H. (2018). Low vision services: A practical guide for the clinician. Therapeutic Advances in Ophthalmology, 10. 1-12.

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