EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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microchips, and other miniaturized electronics that are embedded with- in contact lenses." Parent compa- ny Novartis (Basel, Switzerland) is concentrating development efforts on diabetes to measure tear fluid and presbyopia to provide accommoda- tive vision correction. Referring the patient Mr. Otterness advises those with low vision to "always" start the discus- sion on new technology aids with an ophthalmologist. About 60% of the patients in low vision clinics are referred by a physician—the rest self-refer or have heard about services from family members, Dr. Goldstein said. With a dearth of low vision specialists, "vision rehabilitation has not been very accessible within ophthalmol- ogy. The vast majority of patient referrals are from retina specialists," she said. Despite the challenges of service provision, patients interest- ed in improving their visual ability function will go to great lengths to seek low vision services once they are made aware that rehabilitation services exist. Now, new technologies are being incorporated into vision rehabilitation services, like the Implantable Miniature Telescope (VisionCare Ophthalmic Technolo- gies, Saratoga, Calif.) for end-stage age-related macular degeneration. In fact, Dr. Goldstein said, patients are evaluated for surgery at low vision centers for eligibility and likelihood of vision rehabilitation success post-implantation. In her experience, people who begin vision rehab with 20/60 or better or 20/200 or worse are the ones who fare best and gain the most from vision rehabilitation. "Every rehab plan has to be tailored," she said. Both patients and referring physicians need to under- stand that low vision specialists will not improve vision given the nature of chronic vision impairment. "We make every day activities easier to perform," Dr. Goldstein said. "The challenge is setting patient expecta- tions." EW References 1. Goldstein JE, Chun MW, Fletcher DC, Deremeik JT, Massof RW; Low Vision Re- search Network Study Group. Visual ability of patients seeking outpatient low vision services in the United States. JAMA Ophthalmol. 2014;132(10):1169–1177. 2. Goldstein JE, Jackson ML, Fox SM, Deremeik JT, Massof RW for the Low Vision Research Network Study Group. Clinically meaningful rehabilitation outcomes of low vision patients served by outpatient clinical centers in the United States. JAMA Ophthal- mol. 2015 Apr 9. Doi: 10.1001/jamaophthal- mol.2015.0693. [Epub ahead of print] Editors' note: Dr. Goldstein and Mr. Otterness have no financial interests related to their comments. Contact information Goldstein: jgolds28@jhmi.edu Otterness: potterness@icloud.com 3360 Scherer Drive, Suite B, St. Petersburg, FL 33716 800-637-4346 • Tel: 727-209-2244 • Fax: 727-341-8123 Email: Info@RheinMedical.com • Website: www.RheinMedical.com *Developed In Coordination With Jared R. Younger, M.D. Special Acknowledgement To John R. Shepherd, M.D. Angleo Con il Cartiglio, Bernini Younger* 360 Degree Capsule Polisher ACBF 1359 Rev.A Product #08-13230 • Special Angulated Shaft Allows Quick & Easy Polishing Of Both The Anterior And Posterior Capsules With One Instrument. • Designed To Polish Both The AC & PC The Full 360 Degrees. • The Unique Angulation Eliminates The Need For Using Two Instruments, Or Using One Instrument But Having To Exit And Enter Through A Side Port Incision To Complete The Polishing. • Reusable, Autoclaveable, Made In The USA, And Available For A 30-Day Surgical Evaluation Without Obligation. Call 727-209-2244 For More Information, Or Scan For Video P o s t e r i or V i e w A nt e ri or V i e w Activity-function connection T he Low Vision Rehabilitation Outcomes Study evaluated 779 patients across the U.S. in low vision centers, and researchers found "Forty-seven percent of patients receiving usual low vision rehabilitation experience a clinically meaningful effect," Dr. Goldstein said. She outlined a number of non-visual factors affecting "visual ability," a multidimensional construct, including physical ability, depression, and cognitive ability. Further, visual functioning cannot be quantified by acuity alone Physicians should first determine the patient s rehab goal when seeking care for low vision cases. "A goal may not necessarily be to read a food package. It may be more likely the individual wants to be able to prepare a meal that would involve chopping, pouring, cutting, and cleaning," she said. As low vision rehabilitation requires a patient- centered approach, setting clear goals and treatment expectations are pre-requisites to achieving rehabilitation success. EW