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Low Vision RehabilitationLow Vision Rehabilitation

Suleiman Alibhai, O.D.Doctor of Optometry

Lions Clubs International IAG Mission Myanmar, 2013

Prevalence of Blindness and Low Vision in US Population over age 40

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Glossary of TermsGlossary of Terms

Vision Rehabilitation Low VisionLegal BlindnessVisual DisorderVisual ImpairmentVisual DisabilityVisual Handicap

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Anatomy of the EyeAnatomy of the Eye

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Vision RehabilitationVision Rehabilitation

Services provided to a visually impaired individual to improve their safety, independence, ability to become educated or employed and quality of life.

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Looking Inside the EyeLooking Inside the Eye

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Low VisionLow Vision

Any level of vision that interferes with the individual’s ability to perform normal daily living activities such as reading, writing, driving, grooming, walking etc.

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Legal BlindnessLegal Blindness

Vision that cannot be improved beyond 20/200 in the better seeing eye using conventional lenses or a visual field that extends to 20 degrees or less in diameter in the better seeing eye.

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Visual DisorderVisual Disorder

The anatomical or pathological condition affecting the eye:

Corneal astigmatism from keratoconusNuclear sclerosis form a cataractRetinal detachment from diabetic

retinopathyDisciform scar from macular degeneration

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CataractCataract

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Visual ImpairmentVisual Impairment

The measurable impact of the visual disorder on the eye:

Diminished visual acuityReduced contrast sensitivityLoss of peripheral visual fieldSlower reading speed

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Cataract DiagramCataract Diagram

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Visual DisabilityVisual Disability

The impact of the visual impairment on performing normal daily activities:

Inability to read the mail, prices, recipes etc.

Compromised communication from an inability to recognize faces.

Inability to get around safely and independently.

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Cataract VisionCataract Vision

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Visual HandicapVisual Handicap

The impact of the disability on the individual’s ability to function in society:

Need for large print software in order to use a computer.

Implementation of a talking sign to identify a bus.

Help from a sighted assistant to negotiate a grocery store.

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Impact of Being Visually Impact of Being Visually ImpairedImpaired

Loss of independence and increased dependence on children, spouse or others

Secondary health issues due to depression, anxiety, falls and other injuries

Diminished self esteem and feelings of being a “burden” on family and society

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Leading Causes of Vision Leading Causes of Vision Impairment:Impairment:

Diabetic Retinopathy – affects 5.3 million Americans over the age of 18.

Age Related Macular Degeneration – leading cause of legal blindness for people over the age of 60, it affects more than 1.6 million Americans.

Glaucoma – at least 2.2 million Americans are afflicted.

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Diabetic RetinopathyDiabetic Retinopathy

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Looking Inside the EyeLooking Inside the Eye

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Diabetic RetinopathyDiabetic Retinopathy

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Diabetic Retinopathy VisionDiabetic Retinopathy Vision

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GlaucomaGlaucoma

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Glaucoma VisionGlaucoma Vision

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Looking Inside the EyeLooking Inside the Eye

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Macular Degeneration DryMacular Degeneration Dry

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Macular Degeneration - WetMacular Degeneration - Wet

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Macular Degeneration VisionMacular Degeneration Vision

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Categories of Visual AidsCategories of Visual Aids Enhance near vision Glasses: - Bifocals - Prism

glasses -Microscopes Near

telescopes Magnifiers Video

magnifiers

Enhance distance vision

Telescopes

Video magnifiers

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BifocalsBifocals

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MicroscopesMicroscopes

Modifying Size: Near Telescopes

Pelli Robson Contrast Sensitivity Chart

Modifying Glare and Enhancing Contrast

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MagnifiersMagnifiers

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Video MagnifiersVideo Magnifiers

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Portable Video MagnifiersPortable Video Magnifiers

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Portable with Variable Portable with Variable MagnificationMagnification

Amigo Optelec Traveler

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Portable Video Magnifiers combined with laptop computers

Video Magnifier and OCR combined

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TelescopesTelescopes

Modifying Size: Bioptics

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Head Mounted Electronic AidHead Mounted Electronic Aid

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Implantable Miniature TelescopeImplantable Miniature Telescope

Visual prosthetic deviceDesigned to improve vision by rendering central

visual field over central and peripheral retinaReduces effective size of scotoma (blind spot)

IMT by Dr. Isaac Lipshitz

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Retinal ImageRetinal Image

52 - 60°

Wide Angle Implant Central Visual Field Projection

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Low Vision Technology of Low Vision Technology of FutureFuture

Measure and map extent of visual loss Write software algorithm to compensate for

– Resolution and visual field loss– Glare and contrast– PRL and scotoma

Head mounted system with eye tracker and mini computer worn by patient

Software modified as vision changes Alternatively a digital prosthetic implant