Vision Rehabilitation Services

Introduction

As one of the primary professionals in a position to diagnose partial vision loss, the retinal specialist is often a gatekeeper for vision rehabilitation. This role is particularly important because patients may not find, or even be aware of, vision rehabilitation services without some direction from their ophthalmologist. And vision rehabilitation, whether simple or multidisciplinary, can significantly improve patient function and quality of life. Although research is just beginning to formulate the evidence-base to support vision rehabilitation interventions, ensuring that ophthalmologists respond to their patients' vision loss by offering information about rehabilitation is a current standard of care in parallel with how neurologists offer stroke rehabilitation or cardiologists recommend cardiac rehabilitation.

Historically, rehabilitation for the visually impaired was aimed at blind or severely visually impaired children and young adults, focusing on services such as instruction in Braille reading, white cane use, and using sight substitutes such as audio books. Limited services for those with less severe vision loss focused on optical devices and refractive correction; alternatively, patients simply purchased a magnifier in a local store. Today, blind rehabilitation services offered by state societies or other agencies need to be separated in our thinking from the very different rehabilitation options that are available for patients with partial vision loss. Changing demographics, new technologies, and increased knowledge from rehabilitation research, such as the impact of central scotomas on reading performance, have significantly expanded the scope of vision rehabilitation beyond blind and optical rehabilitation. The ophthalmologist therefore should be advising patients early in their disease process about comprehensive vision rehabilitation services.