What is a Low Vision Specialist?

With advanced training, a low vision eye doctor understands high-powered optics and magnification plus has working knowledge of the multitude of special glasses, magnifiers, electronic and non-optical low vision devices that can help those with reduced vision. Patients and families can be extremely upset, fearful, and even depressed due to loss of independence. Part of the extensive examination involves the time to explain the eye and vision condition and what the future may hold to patients who may be confused, misinformed and/or have an unrealistic view of their daily living tasks. A low vision eye doctor has compassion and empathy for what the patient and family is going through as well as the knowledge, resources and experience to help them adjust to the difficult situation.

An IALVS eye doctor has had extensive training in California with Richard J. Shuldiner, OD, FAAO, a low vision Diplomate and founding member of The International Academy of Low Vision Specialists (IALVS). These doctors only accept patients they believe they can help, and use the highest quality, state-of-the-art telescopic, microscope and prismatic magnifying eyeglasses as the primary means of helping the patient.

What is Low Vision?

Best corrected vision (with conventional spectacles, contact lenses, LASIK, or cataract surgery) which is reduced to the point of interfering with the tasks you want to do. There are two variables in the definition: Vision and Task. Vision may be reduced from medical, congenital, or traumatic causes. Tasks may include regular everyday activities like reading, writing, driving, or watching television. Tasks may also include specialized activities relating to occupation or recreation.

What Causes Low Vision?

Medical conditions can cause reduced vision. The leading causes are Macular Degeneration, Diabetic Retinopathy, Inoperable Cataracts, Glaucoma and Stroke. Congenital defects like Retinopathy of Prematurity can cause reduced vision. Genetic defects like Retinitis Pigmentosa and Stargardt’s disease cause reduced vision. Traumatic injuries sometimes cause reduced vision. If the reduced vision impairs the ability to do the tasks you want to do, then it is low vision.

How is a Low Vision Exam Different?

A low vision examination is quite different from a regular eye examination. It is a longer examination usually lasting one hour or more. It is a “vision and function” examination; therefore medical tests such as dilation are usually omitted. The first part of the low vision examination is conversing with the patient to find out how the reduced vision is affecting their life. The “wish list” is created so the doctor understands what the patients’ goals are. The second part is extensive vision testing. The doctor uses low vision eye charts rather than the regular Snellen “E” chart to measure level of vision. Careful refraction is performed to find out if a new “regular” eyeglass prescription will help. Part three works with magnification, illumination and other optical and non-optical low vision devices. The doctor must determine the best form and level of magnification needed for the person to perform the desired tasks. Telescopes, microscopes, and prisms, with varying levels of magnification and strength as well as other magnification devices are presented to the patient. Illumination levels must be determined as lighting plays a major role in vision. Part four is another conversation with the patient to determine the best form and level of magnification for that particular person’s task requirements.

How Much Will This Cost?

First, it is important to understand that insurance such as Medicare and supplemental do NOT cover low vision care. Expect this to be an out of pocket expense. Usually credit cards are accepted and financing is available. The low vision evaluation cost varies among doctors, but averages around $300.Telescopic spectacles used by members of IALVS range approximately between $1300 and$2500. Microscope and Prismatic glasses used for near tasks range approximately between$500 and $1200.It is important to understand that low vision devices are “task specific.” They are designed for the task the person wants to do. Therefore it may, and usually does, take more than one pair of glasses or magnifiers to handle the various tasks the patient wants to do. It is not unusual for a patient to need bioptic telescope glasses for outdoor travel and/or driving, full diameter telescopic glasses for television and microscope or prismatic glasses for reading. In addition, a hand magnifier and reading lamp may be recommended as well. What is ordered depends upon the patients’ wish list, commitment and financial resources.

When Do I Get My Glasses?

It usually takes two to four weeks for specialized glasses to be fabricated. Arrangements can be made to have them sooner in some circumstances. If a person has a special event happening and needs the glasses, the lab will usually cooperate.

Where Do I Find A Low Vision Doctor?

This is a difficult problem because the profession of optometry does not recognize “specialties”. Therefore, any optometrist can provide low vision services, regardless of experience in this difficult area. Dr. Shuldiner has personally trained and continues to train optometrists to provide low vision care at the highest levels. The Doctors he has trained are members of the International Academy of Low Vision Specialists.

When looking for a qualified Low Vision Eye Doctor, use the information provided in this website about spectacle telescopes, microscopes, hand/stand magnifiers, etc. to ask questions. Does this person use these kinds of devices? Ask how long they have be providing low vision services and how many patients they have helped. Many people have traveled great distances to seek qualified care. Don’t be afraid to travel, if necessary and possible, to get the best care. It is your life we’re interested in.

Do Vitamins Help?

For certain conditions, vitamins may be the ONLY help.

What Is The Free Telephone Interview?

The free telephone interview was developed by IALVS as a way of limiting the time, expense and disappointment of people who probably cannot be helped by low vision care. By asking the right questions on the phone Dr. Bissell can determine if a patient qualifies for low vision services. “If not, why put the patient through the time and expense only to be extremely disappointed?” says Dr. Bissell. Members of the IALVS use the free telephone interview and speak to every patient personally. They ask questions regarding vision, functional abilities, goals, motivation, health, and mobility to determine if an appointment is in the best interests of the caller.

How Do I Know The Glasses Will Work After I Get Them?

During the evaluation, the patient will use actual low vision telescope, microscope and prismatic glasses on the tasks desired. The doctor and the patient will see that they work BEFORE they are ordered. This will be done again when the patient picks up the glasses.  Glasses or devices are never ordered until the patient knows that they work.

What If My Vision Changes After I Get The Glasses?

Almost always, prescriptions and magnification levels can be changed without the need for a whole new pair of glasses. Most doctors offer from six to twelve months of changes at nominal or even no charge to the patient. It is interesting that changes are actually rarely needed.

How Do I Pay For Them?

Since most insurance, including Medicare and supplemental do not cover the expense of low vision care, the patient must bear the expense. Credit cards are accepted at almost every office. Usually financing is available, sometimes with no interest. Discuss this during the free telephone interview. Call 888-552-2020 to discuss how low vision care may improve the quality of your life.

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