High Support for Low Vision

When eye diseases such as macular degeneration, retinitis pigmentosa and glaucoma impair vision so much that it impacts daily life, patients often feel a sense of loss and despair. At the Gavin Herbert Eye Institute, our Low Vision Rehabilitation Program experts strive to restore hope and help patients get back to what they love to do. Southern California’s only low-vision rehabilitation service at an academic medical center, our program is led by two experienced specialists, optometrist Karen Lin, OD, and occupational therapist Nilima Tanna. “Our goal is to help the patient maintain or achieve independence and be able to participate in meaningful activities,” says Tanna. “We focus on maximizing a person’s ability to use their remaining vision, to empower them with education about contrast and lighting, and teach them compensatory strategies. It’s not a cookiecutter approach.” During an initial consultation, Lin reviews information from the patient’s referring ophthalmologist, then performs a comprehensive examination to assess the patient’s visual strengths and weaknesses. “For example, one person may have good peripheral vision even if central vision is lost,” Lin says. “Another may struggle with reading only when the contrast is low.” Armed with these insights, she suggests strategies and tools — from simple magnifiers to high-tech desktop reading devices — to help each person make the most of their existing vision.

Bringing it home

Discussing such tools in a doctor’s office and using them in daily life are two entirely different experiences. A unique aspect of the low-vision rehabilitation service is that Tanna teaches patients how to use these tools and strategies in their own homes. “Often they’ve been struggling for so long they think it’s normal,” says Tanna, who has worked with low-vision patients for more than 20 years. “But everyone has different visual acuities and a different sweet spot in their vision they can use, even with macular degeneration or retinopathy.” In a typical 75-minute session, she observes how the patient functions in their home and assesses what they want and need to accomplish. Do they want to be able to “spot read” labels and bills or peruse books and magazines? “It’s about getting to know each person, their social support network and how they’re coping with their impairment psychologically,” she says. “If they also have cognitive issues, how do we adjust to make things simple enough for them to participate in a rehabilitation process?”

Leveraging Existing Vision

Many of Tanna’s patients are working professionals or serve on boards, so they need to be able to read reports and make presentations. Others are retired and may rely on their vision to play tennis or sew. “I really want to know what their day-to-day life is like so that I can understand who they are and what their goals are,” she says. After setting realistic goals and establishing a care plan, Tanna makes one or more home visits to help each patient adjust their lifestyle and use vision tools and personalized techniques that enable them to continue the activities they enjoy. She also works with them to make adjustments as their vision changes over time. “At the end of the day,” she says, “we want our patients to thrive and have a good quality of life.”