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All About Vision

Low Vision

Low vision is significant vision impairment that usually results from serious eye disease or an injury. The vision loss, which is characterized by either reduced visual acuity (to 20/70 or worse) or reduced field of view, can’t be fully corrected with glasses, contact lenses, medication or surgery.

Low vision can affect both children and adults, but is more common in the elderly, who are at greater risk of eye diseases such as glaucoma, macular degeneration and cataracts, which are some of the most common causes of the condition.

Patients with low vision may have complete central or peripheral vision loss, blurry vision, poor low-light vision, loss of light sensitivity and/or loss of contrast, making daily activities such as writing, watching TV, driving or reading difficult or impossible. Since the vision loss can’t be corrected, low vision requires significant adjustments to daily life and the help of techniques and specialized low vision aids to help you maximize your remaining vision to increase independence and quality of life.

What are causes of low vision?

  • Eye diseases such as: glaucoma, macular degeneration, cataracts, diabetic retinopathy, and retinitis pigmentosa
  • Eye injury or brain injury
  • Heredity

How does low vision affect eyesight?

Low vision is partial vision loss which varies from person to person. Depending on the severity and type of vision impairment, the patient may have some useful vision. Typically the impairment includes a significant reduction in visual acuity to worse than 20/70, hazy, blurred vision, blind spots or significant visual field loss and tunnel vision. Sometimes the extent of vision loss is considered to be legal blindness (20/200 or less visual acuity in the better eye) or almost total blindness.

How does low vision affect daily life?

With significant vision loss it can become challenging to complete common daily tasks including reading, writing, cooking and housework, watching television, driving or even recognizing people.

When low vision is diagnosed it can come as a shock. Initially, it is an adjustment to learn how to function with impaired vision but the good news is there are numerous resources and products available to assist. Because low vision often results in one’s inability to work, function independently, drive and resume normal life, many patients feel isolated and depressed.

Visual Rehabilitation and Visual Aids

Low vision means that a minimal amount of sight remains intact. There are millions of people who suffer from the condition and manage to function with the remaining vision available to them through the use of visual rehabilitation or visual aids.

What are visual aids?

These are devices that help people with low vision function by maximizing remaining eyesight. This often involves the use of magnifiers (handheld, mounted or stand-alone), telescopes and other tools to enlarge the images of objects to make them more visible. Some visual aids reduce glare and enhance contrast which makes it easier to see. Other low vision aids act as guides to help the person focus on non-visual cues, such as sound or feel. Finding the right visual aid is a matter of consulting with a professional and experimenting with what works for you and your daily needs.

How to make life with low vision easier

  1. Ensure that you have adequate lighting in your home. This may require some trial and error with different lights and voltages to determine what works best for you.
  1. Use a magnifier. There is a vast selection of magnifiers available, ranging from hand-held to stand magnifiers. Binoculars and spectacle mounted magnifiers are also an option.
  1. Your optometrist or low vision specialist can recommend specialized lens tints for certain conditions such as retinitis pigmentosa or cataracts, which enhance vision or reduce light sensitivity.
  1. Use large print books for reading. Alternatively, try digital recordings or mp3s.
  1. Make use of high contrast for writing. Try writing in large letters with a broad black pen on a white piece of paper or board.
  1. Adding a high-contrast stripe on steps (bright color on dark staircase, or black stripe on light stairs) can prevent falls in people with low vision, and may enable them to remain independent in their home.
  1. Find out what other technology is available to help make your life simpler.

If you or a loved one has low vision, don’t despair. Be sure to consult with your eye doctor about the best course of action to take to simplify life with low vision.

Orthokeratology (CRT & VST)

Orthokeratology, commonly called ortho-k, is a method used to correct myopia (nearsightedness) by wearing rigid gas permeable contact lenses overnight, so that no vision correction is needed during daytime hours.

Gas permeable (GP) lenses specialized for ortho-k are inserted at bedtime and worn as you sleep. Throughout the night, the lenses reshape your cornea gently so that your vision becomes clear on the following morning. The correction is temporary, and ideally no eyeglasses or contact lenses will be needed on the next day or two. In order to maintain sharp visual acuity on a daily basis, you need to wear the ortho-k reshaping lenses every night.

At present, three brands of orthokeratology contact lenses are approved for use by the FDA. Euclid Emerald, usually prescribed for myopia management, Paragon Vision Sciences, who produces “Corneal Refractive Therapy” (CRT), and Bausch and Lomb, who manufactures “Vision Shaping Treatment” (VST).

Candidates for Ortho-K

Ortho-k is very suitable for nearsighted people who are not appropriate candidates for vision correction surgery, such as children. Individuals of all ages with healthy eyes can try ortho-k, namely because it can be discontinued at any point without permanent effects to the eyes.

People who require vision correction and engage regularly in sports or work in extremely dusty, dirty environments will also appreciate the convenience of ortho-k.

Vision Results from Ortho-k

Success rates for ortho-k are generally higher for more mild vision prescriptions. The ideal goal is to provide 20/20 vision without any need for eyeglasses or contacts during the day.

According to FDA trials conducted on both CRT and VST lenses, more than 65% of ortho-k patients were provided with 20/20 visual acuity. A whopping number of more than 90% of ortho-k patients achieved 20/40 vision or better (this is the legal requirement for driving without vision correction in most states). Consult with your eye doctor to find out if your vision prescription is within range for successful ortho-k treatment.

Note that although improvement in vision is generally reported within a day or two of wearing ortho-k overnight, the full effects may not be experienced until the lenses are worn for a few weeks. During this transition period, your vision will probably not be as crisp as it was with regular contacts or eyeglasses, and glare or halos around lights may be visible. Until ortho-k works fully, a temporary pair of eyeglasses may be required for specific actions, such as driving at night.

How Does Ortho-k Feel?

Although some people have trouble wearing regular gas permeable contact lenses during the day, ortho-k GP lenses are worn while sleeping – so discomfort and awareness of the lenses in your eyes is generally not an issue.

Is Ortho-k expensive?

Professional fitting for ortho-k requires a series of visits to your eye doctor. A number of pairs of contact lenses are also generally needed. GP lenses that are special for ortho-k are more costly than standard contacts. In sum, the fees for ortho-k add up to a higher total than regular contact lenses.

LASIK after Ortho-k

Refractive surgeries, such as LASIK, are possible after treatment with ortho-k lenses. Yet because ortho-k works to reshape your cornea, you are required to stop wearing the lenses for approximately several months before undergoing LASIK. This allows your eyes to return to their original shape.

It’s important to inform your LASIK surgeon if you’ve been wearing ortho-k lenses, and you will be advised as to how long of a wait is necessary before having the laser procedure.

Low Vision

Low vision is significant vision impairment that usually results from serious eye disease or an injury. The vision loss, which is characterized by either reduced visual acuity (to 20/70 or worse) or reduced field of view, can’t be fully corrected with glasses, contact lenses, medication or surgery.

Low vision can affect both children and adults, but is more common in the elderly, who are at greater risk of eye diseases such as glaucoma, macular degeneration and cataracts, which are some of the most common causes of the condition.

Patients with low vision may have complete central or peripheral vision loss, blurry vision, poor low-light vision, loss of light sensitivity and/or loss of contrast, making daily activities such as writing, watching TV, driving or reading difficult or impossible. Since the vision loss can’t be corrected, low vision requires significant adjustments to daily life and the help of techniques and specialized low vision aids to help you maximize your remaining vision to increase independence and quality of life.

low vision San JoseWhat are causes of low vision?

  • Eye diseases such as: glaucoma, macular degeneration, cataracts, diabetic retinopathy, and retinitis pigmentosa
  • Eye injury or brain injury
  • Heredity

How does low vision affect eyesight?

Low vision is partial vision loss which varies from person to person. Depending on the severity and type of vision impairment, the patient may have some useful vision. Typically the impairment includes a significant reduction in visual acuity to worse than 20/70, hazy, blurred vision, blind spots or significant visual field loss and tunnel vision. Sometimes the extent of vision loss is considered to be legal blindness (20/200 or less visual acuity in the better eye) or almost total blindness.

How does low vision affect daily life?

With significant vision loss it can become challenging to complete common daily tasks including reading, writing, cooking and housework, watching television, driving or even recognizing people.

When low vision is diagnosed it can come as a shock. Initially, it is an adjustment to learn how to function with impaired vision but the good news is there are numerous resources and products available to assist. Because low vision often results in one’s inability to work, function independently, drive and resume normal life, many patients feel isolated and depressed.

Visual Rehabilitation and Visual Aids

Low vision means that a minimal amount of sight remains intact. There are millions of people who suffer from the condition and manage to function with the remaining vision available to them through the use of visual rehabilitation or visual aids.

What are visual aids?

These are devices that help people with low vision function by maximizing remaining eyesight. This often involves the use of magnifiers (handheld, mounted or stand-alone), telescopes and other tools to enlarge the images of objects to make them more visible. Some visual aids reduce glare and enhance contrast which makes it easier to see. Other low vision aids act as guides to help the person focus on non-visual cues, such as sound or feel. Finding the right visual aid is a matter of consulting with a professional and experimenting with what works for you and your daily needs.

How to make life with low vision easier

  1. Ensure that you have adequate lighting in your home. This may require some trial and error with different lights and voltages to determine what works best for you.
  1. Use a magnifier. There is a vast selection of magnifiers available, ranging from hand-held to stand magnifiers. Binoculars and spectacle mounted magnifiers are also an option.
  1. Your optometrist or low vision specialist can recommend specialized lens tints for certain conditions such as retinitis pigmentosa or cataracts, which enhance vision or reduce light sensitivity.
  1. Use large print books for reading. Alternatively, try digital recordings or mp3s.
  1. Make use of high contrast for writing. Try writing in large letters with a broad black pen on a white piece of paper or board.
  1. Adding a high-contrast stripe on steps (bright color on dark staircase, or black stripe on light stairs) can prevent falls in people with low vision, and may enable them to remain independent in their home.
  1. Find out what other technology is available to help make your life simpler.

If you or a loved one has low vision, don’t despair. Be sure to consult with your eye doctor about the best course of action to take to simplify life with low vision.

There’s More To Child Learning Than Just 20/20 Vision

Even if your child has “20/20” eyesight he may be experiencing vision problems. These problems may be causing learning problems and substandard educational results. A child’s visual acuity ( how well s/he can see the wall chart) is an essential aspect of good vision but there are other factors which may prove more important. You may already be aware that a nearsighted child has little trouble reading or that good grades in school can be acquired even if much of the teacher’s board cannot be seen by the student.

Questions Related to Eyesight and Learning

Eye movement skills: Do your child’s eyes move across the page in a book smoothly and accurately?

Eye focusing abilities: Does your child change focus from near to far and back again -between reading text from a far-away white or black-board and writing on paper?

Eye teaming skills: Are your child’s eyes working together as a focus unit -do they come together for proper eye alignment for reading?

Binocular vision skills: Are your child’s eyes blending visual images from both eyes into a single, three-dimensional image?

Visual perceptual skills: Does your child identify and understand what s/he sees, co-relating importance, connecting with previous visual memorized information?

Visual-motor integration: Is the quality of your child’s eye-hand coordination balanced? Visual-motor integration is important not only for legible handwriting and the ability to efficiently copy written information from a book or board but also for sports. Deficiencies in any of these can be detrimental to a child’s learning ability and / or school performance.

Vision Problems Do Affect Kids Learning

Undetected learning-related vision problems in children are common. A child with an untreated vision problem may be misdiagnosed with behavior problems or ADHD/ADD when in reality they have a vision problem. Vision problems, in extreme cases, ignored or misdiagnosed, can become the true root cause of a child becoming the victim or aggressor in a school bullying tragedy.

Left untreated, vision problems will hinder your child’s learning in school. Studies have shown that at least 13% of children between the ages of nine-thirteen suffer from moderate to severe convergence insufficiency, the ability to bring one’s eyes together, which is crucial for good reading. Studies demonstrate clearly that one out of four school-age children suffer from at least one learning related vision problem.

Learning-Related Vision Problems

Signs and Symptoms

Some of the most common roadmap symptoms of learning-related vision disorders are:

  • Double vision, particularly during or after reading
  • Poor handwriting
  • Hyperactivity or recklessness during class
  • Word and letter reversals
  • Easily distracted during reading
  • Poor reading comprehension
  • Poor overall school performance
  • Circumventing of reading
  • Blurred vision, especially after reading or working closely
  • Eye Strain or frequent headaches

Call us to schedule a comprehensive child’s vision exam if your child exhibits one or more of these signs or symptoms and is exhibiting these types of problems in school.

Comprehensive Child Vision Exam At River Oaks Optometry

A comprehensive child’s vision exam includes tests performed in a routine eye exam, plus specific additional tests for detecting learning-related vision problems.

Extra tests would include accommodation, binocular vision, and ocular motility testing. In addition to these, depending on the type of problems your child is having, our River Oaks optometrist may recommend other testing, either in our office or with a child’s vision and/or vision development specialist.

Vision Therapy

Special reading glasses or vision therapy may help your child if s/he has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses. Vision therapy entails eye exercises and other activities especially tailored for each patient to improve vision skills.

Learning Disabilities and Vision

Although children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom, vision therapy is a treatment for vision problems; it does not correct a learning disability. A child’s learning ability and school performance may indicate learning disabilities and/or vision problems.

Once your child’s comprehensive vision exam is completed, we will advise you about whether a program of vision therapy could be helpful. We will refer you to a children’s vision or education/learning specialist if we do not provide the specified additional services your child needs.

Sports and Specialty Eyewear Fitting

If you are serious about your sport or require specialty eyewear for your job or hobby, it’s worth scheduling a specialty eyewear fitting with your eye doctor. In addition to safety and eye protection, top athletic and occupational performance requires optimal visual acuity as well as a number of other visual functions such as peripheral vision, depth perception and hand-eye coordination. Sometimes color vision, eye tracking, night vision and light adaptation are also critical to performance. Your eye doctor will be able to do a full assessment of your vision while understanding your personal vision needs in order to recommend the best possible eyewear solution for you.

A standard comprehensive eye exam will not usually test for some of the additional visual and perceptual skills you need for serious sports or work environments. Your eye doctor will need to know the details about the skills required and conditions you face, in order to assess the best performance eyewear for your needs.

While off-the-rack sports or performance eyewear could be sufficient for your needs, if you have particular vision requirements or engage in certain types of activities, you might be a lot better off with a personalized fitting. Every aspect of the glasses from the fit, to the lens tint, to the size and the style can play a role in enhancing your safety, vision and performance, when it’s the right fit. This is why it makes more sense to fit the glasses to the individual rather than the individual to the glasses.

A sports performance exam may also identify some areas of your vision that could use improvement. When it comes to performance, especially for professionals, it is important to know where your visual skills and abilities stand and to be able to make improvements when possible. Many eye doctors offer vision skills enhancement training for particular vision skills such as hand eye coordination or visual processing speed using computer simulations and other techniques. This type of training can enhance your performance whether it is in hitting a fastball, shooting a puck or aiming for a bullseye.

When it comes to sports and performance, you vision should be a given. With a specialty eyewear fitting you can find the eyewear that offers the most, comfort, safety, protection and vision enhancement for your particular needs.

 

LASIK, often referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism.