Low Vision & Opticians

The RNIB (Royal National Institute for the Blind) tells us that approximately 2 million people in the UK suffer from low vision and the difficulties associated with the condition. For a better understanding of what exactly low vision is and what an optician can do for you to help, read on.

What is low vision?

Low vision describes an instance where someone’s eyesight can’t be corrected by traditional corrective lenses or surgical methods. It can be a consequence of old age, but also a number of conditions that will be described shortly. Blindness is very rarely complete (what is called black blindness because the sufferer sees nothing but blackness), and in fact there is some leftover eyesight that can be maximised. An optician is able to assess and suggest tools to make the most of this residual vision, granting more personal freedom and awareness to anyone suffering from low vision.

Causes of low vision

Low vision can be a consequence of old age, but more often it occurs because of either trauma or a number of conditions which reduce vision over time. These include:

  • Cataracts – A cataract can occur in either one or both eyes, and is essentially a clouding of the eye’s own lens which focuses light from objects to form an image. Cataracts affect the older population, and the chances of developing the condition increases as you get older. The lens is usually clear and crystalline to accurately focus light on to the back of your eye where it forms an image. When it becomes cloudy, light scatters through the lens and your vision appears misty and diminished. When this condition presents, you should always consult an optician and then ophthalmologist (eye doctor) straight away as it gets progressively worse.
  • Age related macular degeneration – Affects a part of the retina called the macula. Your retina is basically the back of your eye, and is responsible for converting light focused onto it by your eye into a signal that can be delivered to the brain and interpreted as images. As the macula is a fairly small and central region of the retina, only part of your vision is affected by the disease, namely your central vision. It can present as distortion or blurriness of your central vision, or in more extreme cases (or over time) a blank patch.
  • Retinopathy (or Diabetic retinopathy) – is a condition which typically presents as a complication of diabetes (although not necessarily) which causes loss of vision or, if untreated, blindness. Retinopathy is essentially damage to the retina caused by blood vessels supplying the structure to become damaged and leak, resulting in the growth of more vessels that disrupts the structure of the retina. This condition can be quite severe and must be treated quickly. If you are diabetic then you run a high risk of developing the condition, and hence regular full eye assessments are essential.
  • Glaucoma – refers to any condition in which the large nerve carrying information from the eye to the brain, the optic nerve, becomes damaged. The causes for glaucoma vary and include, for example, a change in something called intra-ocular pressure. The eye’s spherical shape is maintained by this pressure, and an increase in it can cause damage to the optic nerve.

Symptoms of low vision

Low vision can be a consequence of a progressive condition as described above. The symptoms tend to be specific to the causative disease, but can include for example a change in your perception of colour. Colours can appear washed out (as in cataracts) or develop a brownish tinge. Your depth perception might be affected and you could find yourself struggling with steps for example. Reading, both books and signs, can become more difficult than you’re used to. In more severe conditions, you could experience a loss of vision that increases in terms of the area affected.

The role of opticians and the NHS in providing for low vision

Regular visits to the opticians are recommended (at least every two years) to check on the health of your eyes and catch any issues early on. An optician (an optometrist in the UK) is able to examine your eyes and vision, and based on their findings, prescribe corrective lenses or refer you to a specialist eye doctor (ophthalmologist) who will provide you with the care you need. The process of finding the cause of low vision usually begins with the optician and progresses to include the ophthalmologist, with your GP involved to provide any extra support or information you need.

If conventional treatments like glasses or surgery can’t correct your vision, then you will be registered as either partially sighted or blind depending on the severity of your condition. This registration will take place at a low vision clinic which can provide you with the support and information you need. As sight loss can be devastating emotionally, a low sight clinic can provide the support you need in that respect. Treatments and eye tests for the partially sighted are funded by the NHS.

Your optician is able to provide low vision aids that can maximise your use of your leftover vision. A low vision aid can be optical, like a magnifier for reading. Magnifiers range in what they offer, and can include illumination for example. Magnifiers are limited to helping you see objects closer to you, and for objects further away, you can get binoculars. Your optician will provide you with different magnifiers and binoculars to see which ones work for you and would suit your lifestyle best. Other examples of low vision aids are non-optical. These can be specialist lamps, or large bold print books to facilitate reading.

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