What you should know about: Low vision aids

An individual with low vision has reduced visual function that cannot be corrected with standard glasses or surgery and impairs their performance in visual activities. People with low vision may choose to use assistive technology and other low vision aids, which can help them to maintain or increase their independence in their everyday lives. 

Assistive technology and devices for low vision can take the form of software, magnified video-based devices, smart technology or low-tech optical aids such as specialized glasses and magnifiers. There are also non-optical low vision aids such as large print watches, bold line paper and bump dots. Each person with low vision is different and once a suitable aid is determined for the individual's type and extent of visual impairment, the aids that work best for them can be a matter of personal preference.

If you think you would benefit from the use of assistive technology and other aids for low vision, contact the Waterloo Eye Institute’s George & Judy Woo Centre for Sight Enhancement at 519-888-4708 or email LVclinic@uwaterloo.ca. Patients do not need a referral from a doctor to make an appointment. However, if you are a new patient, you will be asked to complete an intake form and to ask your regular optometrist to share the records from your most recent eye exam. Low vision optometrists need this information ahead of your appointment to help them make your initial assessment more efficient and effective. If you do not have a regular optometrist, you can book a comprehensive eye exam with the Waterloo Eye Institute by calling 519-888-4062.

After your intake form and eye exam report have been reviewed by staff, a patient care coordinator will contact you to book your first appointments. You may need to visit the clinic more than once to gain the full benefit of vision rehabilitation. Patients are encouraged to bring a support person along with them for their low vision appointments. It is useful to have additional help when receiving so much information at once.  

Optometric services, low vision therapists and high tech assessors are typically offered by separate agencies, but the George & Judy Woo Centre for Sight Enhancement combines these services to offer a more comprehensive vision rehabilitation program.

Low vision assessment

To determine eligibility for assistive devices, a thorough low vision examination is conducted by low vision optometrists. This assessment consists of many tests, including but not limited to measuring the patient’s ability to see shapes at a distance and testing whether they can distinguish details at lower contrasts. Overall the goal of this initial assessment is to determine the patient’s functional vision, meaning how their vision impacts their daily life. Additionally, the doctor will want to identify the patient’s visual goals during this assessment. These goals could be driving, shopping for groceries independently or reading books. Essentially, the aim is to answer the question: Why has this patient come in for help? The assessment will continue by determining the best devices and strategies customized for the individual’s type and extent of visual impairment and that help them meet their goals.

Training and support

After an initial low vision assessment, the patient may work with a low vision therapist and high-tech assessor to trial different device options in the clinic. When trying new devices, the patient will consider how easy it is to use, the device’s appearance, how much the device costs and whether it will help them meet their specific goals (e.g. reading books and food labels, watching television, preparing food). This review will allow the patient to see which devices are most comfortable and allow them to accomplish their visual goals most efficiently. Sometimes the process of learning how to incorporate the devices and strategies into everyday activities may lead to frustration for those with low vision. So, it is crucial that counselling services are provided by the clinic in addition to having other available community resources for those needing a little extra support as they adjust.

Once devices have been selected, the patient has an opportunity to receive training on how to use the chosen device(s). The overall objective of this stage is to teach patients with low vision to feel comfortable and confident in their ability to incorporate these aids into their daily lives. 

A loan program of a range of optical aids is also available for clients to trial devices at home in their own environment before purchasing. This allows patients to ensure the aid lives up to their expectations and is suitable for the tasks for which they plan to use it. The low vision therapist will follow up to determine whether the device is compatible with their life. If not, the low vision therapist will enquire  why it did not work and may suggest a return to the clinic to explore other devices. 

Funding

Low vision services are not covered by the Ontario Health Insurance Plan (OHIP), so there is a fee of $240 for the initial low vision assessment appointment. Supplemental health insurance plans, Ontario Disability Support Program (ODSP) and Assistance for Children with Severe Disabilities (ACSD) may cover the cost of the assessment. There are  also funding options available for eligible consumers to help with the costs of vision aids such as the Ministry of Health’s Assistive Devices Program (ADP). Additional funding support is available for consumers receiving benefits from ODSP, Ontario Works, or ACSD.

The University of Waterloo School of Optometry and Vision Science is ranked fifth worldwide in research output for schools of optometry. Low vision research, such as that done by Drs. Tammy Labreche, Shamrozé Khan and Ben Thompson, may focus on low vision service delivery, vision rehabilitation and much more within the low vision field. 

Two common causes of low vision are age-related macular degeneration (AMD) and glaucoma. Patients with these diseases may choose to use low vision aids to help them maintain independence. To learn more about these diseases and find out about relevant research, read our previous public education articles: What you should know about: Macular degeneration and What you should know about: Glaucoma. 

Interested in participating in research? Check out our current studies recruiting participants.