Understanding low vision clinics

To understand what low vision clinics do, we must first define the term low vision.  Low vision is impaired vision that cannot be corrected through medical treatment, glasses, or surgery.  Low vision clinicians typically see patients with uncorrectable visual acuity of 20/70 or worse.  Some examples of eye conditions that may result in low vision include age-related macular degeneration, glaucoma, cataracts, and diabetic retinopathy.

Providers at low vision clinics, known as low vision specialists, are dedicated to helping maximize the patient’s remaining vision, improve their quality of life, and maintain their independence.

Services offered by low vision clinics

Low vision clinics offer a range of services to support the low vision patient.  Firstly, a patient is evaluated by a low vision specialist.  At a low vision exam, the specialist uses eye charts and tools to assess the patient’s vision and make recommendations for visual aids.  The exam provides crucial information about how the patient functions in day-to-day life and what types of aids may benefit the patient in maintaining his or her independence.

Typically, the low vision specialist then works together with the patient (and his or her support team) to create a rehabilitation plan centered on helping the patient make the most of his or her remaining vision and complete daily tasks independently.

Finally, the low vision specialist may refer a patient to an occupational therapist (OT), certified low vision therapist (CLVT), vision rehabilitation therapist (CRVT), and/or an Orientation and Mobility Specialist (COMS) who can help implement the rehabilitation plan within the patient’s home environment and/or provide training on visual aids or other types of adaptive equipment.  Additional referrals may be made to social workers or therapists who help patients manage the emotional and psychological challenges of vision loss.

Types of providers

Certain low vision clinics offer specialized services for particular demographics.  For example, the Low Vision Service program at Boston Children’s Hospital is dedicated exclusively to supporting children with visual disorders.  Pediatric optometrists at Boston Children’s help young patients develop independence while staying safe at home and at school.  Another Boston-area organization, The Carroll Center for the Blind, has a special program for senior citizens with low vision.  The program focuses on improving seniors’ quality of life through functional vision assessments, low vision therapy, and vision rehabilitation services.

How a visit to a low vision clinic differs from a regular eye exam

While regular eye exams are crucial for disease detection and prevention, the purpose of a low vision exam is to help the patient improve his or her quality of life.  By assessing the remaining level of vision and understanding the patient’s goals, a low vision specialist is able to recommend the aids, devices and adaptations intended to help the patient regain his or her independence.

Known as a functional eye exam, the assessment done at a low vision clinic determines how a patient’s visual impairment affects his or her day-to-day life.  A low vision exam usually takes 2-3 times longer than a regular eye exam.  Typical problem areas that may be addressed during the exam include crossing streets or seeing traffic, deciphering information on a computer screen or smartphone, and cooking, reading, sewing, or other hobbies.

Note that this type of low vision care may be supplemental to other types of medical treatment such as eye injections, laser therapies, medications or surgeries, depending on the underlying diagnosis.

How to find a low vision clinic near you

Here are some helpful resources for finding a low vision clinic in your area.

• American Optometric Association

Select “Low Vision and Rehabilitative Vision” under the “Special Emphasis” dropdown filter to narrow your search and find an optometrist near you

• Vision Aware

Select the “Low Vision Services” category to find a list of agencies offering low vision services in your state or province

• American Council of the Blind’s Resources for People with Low Vision

Includes a list of organizations, plus brief descriptions of each, at various locations around the U.S.

• Living Well with Low Vision – Prevent Blindness

Includes links to various external directories for locating ophthalmologists, optometrists, retinal specialists, and low vision specialists

For New England states, another good starting point is the “Eyecare” category under the “Resources for Low Vision and Blindness” section on our site’s State Resource pages.  For low vision clinics specifically in Massachusetts, please also see the Low Vision Centers page on the MA Association for the Blind and Visually Impaired (MABVI) website.

Please contact the clinic or provider directly to find out more about the types of services offered.

Visiting a low vision clinic: tips and reminders

Preparing for your appointment

For your first appointment, you’ll want to bring along information about your diagnosed eye condition, a list of medications you are currently taking, and a list of goals and any questions you may have.

It may help to brainstorm your goals and questions with a friend or family member in advance of the appointment.  You may also wish to be accompanied by a loved one who can offer support during the exam, take notes, and help make decisions about your care.

If you are currently using any glasses, magnifiers or other assistive devices, consider bringing these items to the exam so that you can review them with your clinician and discuss the pros and cons of each.

Note that your eyes may be dilated, and there will likely be several vision tests during the course of the appointment.  Since the exam is typically 2-3 times longer than a regular eye exam, you might want to bring a snack, especially if you have diabetes.

The primary components of a low vision examination include: a health and medication history, a vision history, a low vision history, an eye health evaluation, and visual testing, including specialized tests.  For more information on each component, please see VisionAware’s article, “The Low Vision Examination.”

Questions to consider when visiting a low vision clinic

Perhaps you already have specific questions in mind for your provider.  If you need a little help brainstorming, check out the following:

• List of questions from VisionAware to help patients prepare for the low vision exam.
• Printable guide from the National Eye Institute to help patients formulate questions specifically about age-related macular degeneration.  You can also use this guide to keep track of AMD symptoms for yourself or your loved one.

Coverage

Contact the low vision clinic before your appointment to go over insurance-related questions and determine whether the exam and any follow-up appointments are covered.  It is worth noting, however, that many devices and aids are unfortunately not covered by insurance, at least in the U.S.  That being said, you’ll want to bring all forms of insurance with you to the exam.

Setting expectations

MABVI offers some pertinent advice to help low vision patients and family members manage their expectations.  First, it is not uncommon for patients to accomplish a short amount of reading with the help of their clinician at the initial appointment.  Patients and families may become disheartened, however, if the same skills cannot be sustained independently at home.  MABVI reiterates that rehabilitation is a process; one that usually happens slowly over time, and with practice.  It is important to try out a variety of devices, communicate with the clinician on what’s working and what isn’t, and stay apprised of the changes in technology that can remain effective as vision loss progresses.

Final thoughts on low vision clinics

Low vision clinics play an important role in managing care for patients with significant vision loss.  Low vision specialists help patients maximize their remaining vision, improve their quality of life, and maintain independence as much as possible.  Distinct from a regular eye exam, a low vision eye exam is used to determine the patient’s level of functional vision and what types of visual aids or assistive technologies can help the patient achieve his or her goals.  The low vision specialist works together with patients and families to craft a rehabilitation plan that will help the patient implement new aids and routines designed to support their independence.  Other professionals such as occupational therapists or social workers may also be involved in facilitating the patient’s rehabilitation and adjustment to vision loss.

Many online resources (both national and local) are available to help locate a low vision clinic near you.  Once your appointment is made, there are a few steps you can take to prepare and help make the most of your visit.  These steps include brainstorming questions and goals, gathering records on your previously diagnosed eye condition, and verifying insurance coverage.  It is important to keep an open mind going in to your first exam, knowing that it may take some trial and error, along with plenty of practice, to find the right solutions.

Author Information

By Bethany Wyshak. Reviewed by Stuart Flom.

A lighting industry specialist, Stu Flom worked at Dolan-Jenner, a leader in fiberoptic lighting, for 15 years before launching his own company in 1994. As product manager, Stu helped find lighting solutions for clients in such diverse areas as photography, microscopy, robotics and automotive manufacturing. He was also involved in supplying the fiberoptics illuminating the Hope Diamond exhibit at the Smithsonian National Museum of Natural History in Washington, D.C. A member of the International Society for Optics & Photonics (SPIE), Stu was awarded a Certificate of Appreciation by the Society of Manufacturing Engineers and is the author of several publications, including Integrating Optical Fibers in Machine Vision (Proceedings), Designing Fiber Optic Lighting for Machine Vision (Society of Manufacturing Engineers), and Light Up with Fiber Optics (Vision). Prior to his work in lighting, Stu was a special education teacher. Stu’s expertise in lighting and background in education form the backbone of his company. As AdaptiVision’s founder and president, Stu is dedicated to applying advanced lighting technology to assist people struggling with low vision, teaching them how to use technology to achieve greater independence.

Sources

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Carroll Center. (2021, December 8). Senior Low Vision Services – The Carroll Center for the Blind. The Carroll Center for the Blind. https://carroll.org/seniors/low-vision-services/

Low vision – Overview – Mayo Clinic. (2023, April 15). Mayo Clinic. https://www.mayoclinic.org/departments-centers/low-vision/overview/ovc-20519042

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Low Vision Service | Boston Children’s Hospital. (n.d.). Retrieved May 11, 2023, from https://www.childrenshospital.org/programs/low-vision-service

The Low Vision Examination. (n.d.). VisionAware. Retrieved May 11, 2023, from https://visionaware.org/your-eye-condition/eye-health/low-vision/low-vision-examination/

What is a Low Vision Exam – IALVS. (2023, January 19). International Academy of Low Vision Specialists – IALVS. https://ialvs.com/what-is-a-low-vision-exam/

What to expect from a low vision exam – Massachusetts Association for the Blind and Visually Impaired. (2019, August 22). Massachusetts Association for the Blind and Visually Impaired. https://www.mabvi.org/services/referrals/low-vision-centers/what-to-expect-from-a-low-vision-exam/