Occupational Therapist
Chris Hedlich, MS, OTRL, SCLV
Location
Grand Rapids, Michigan
Interviewed By
Dana Laughlin & Mallory VanRegenmorter
Low Vision
Research
Low vision is a “condition causing permanent, uncorrectable vision loss, interfering with a person’s ability to participate in occupational performance” (Barstow, 2018).
Adaptation to the environment, cognition, language, and emotion can all be impacted by low vision (Hyvärinen, 1995).
Vision occurs within a developmental framework and follows a bottom-up approach. This means that vision develops in a hierarchy beginning with lower level skills and evolving to become more complex. Because of this information, evaluation and treatment should focus first on the lowest level skill impacted. See the graphic for a visual representation of the development of visual skills (Warren, 1993)
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Evaluation of vision includes measurement of visual acuity, contrast sensitivity, visual field, color vision, adaptation, accommodation, and oculomotor function (Hyvärinen, 1995).
Treatment strategies often include organizational strategies, lighting, contrast, glare, filters, magnification, and use of technology (AOTA, 2013; AOTA, 2014).
Pediatric
Children are spending more time using screens which may cause eye strain, headaches, fatigue, and difficulties with posture. Blue light may play a role in this, but more research must be done (Heiting, 2018)
Most evaluations of low vision in children can easily occur during play (Hyvärinen, 1995).
The development of vision in children should be addressed holistically and occur with collaboration between therapists, educators, and physicians in early intervention (Hyvärinen, 1995).
Older Adult
The American Occupational Therapy Association’s (AOTA) Centennial Vision includes the practice area of health and wellness and productive aging. One way this can be targeted is by addressing low vision in older adults (AOTA, 2014).
Low vision in older adults can occur due to normal development, or due to eye conditions such as macular degeneration, glaucoma, diabetic retinopathy, etc. (AOTA, 2013).
Research found that older adults are working longer, often aging in place, and becoming an increased portion of the population. These factors prove the importance of focusing on low vision and its impact on occupational participation in this age group (Ellexson, 2004).
References
American Occupational Therapy Association [AOTA]. (2013). Living with low vision. Retrieved from
https://www.aota.org/About-Occupational-Therapy/Patients-Clients/Adults/LowVision.asp
American Occupational Therapy Association [AOTA]. (2014). Low vision FAQ. Retrieved from
https://www.aota.org/Practice/Productive-Aging/Low-Vision/FAQ.aspx
Barstow, B. (2018). Occupational therapy and low vision rehabilitation: Future directions. British Journal of Occupational
Therapy, 81(1), 3-4. doi:10.1177/0308022617738158
Ellexson, M. T. (2004). Access to participation: Occupational therapy and low vision. Topics in Geriatri Rehabilitation, 20(3), 154-172. doi:10.1097/00013614-200407000-00004
Heiting, G. (2018). How to help children avoid computer vision syndrome. All About
Vision. Retrieved from https://www.allaboutvision.com/cvs/children-computer-vision-syndrome.htm
Hyvärinen, L. (1995). Considerations in evaluation and treatment of the child with low vision. American Journal of
Occupational Therapy, 49(9), 891-897. doi:10.5014/ajot.49.9.891
Warren, M. (1993). A hierarchical model for evaluation and treatment of visual perceptual dysfunction in adult acquired
brain injury, part 1. American Journal of Occupational Therapy, 47(1), 42-54. doi:10.5014/ajot.47.1.