Steering patients toward visual rehabilitation

Chicago-Ophthalmologists generally advise their patients to seek visual rehabilitation services when patients have moderate to severe glaucoma, said Mary Lou Jackson, MD.

“Patients with moderate and more severe glaucoma will likely benefit from being advised about options for visual rehabilitation,” said Dr. Jackson, director of Vision Rehabilitation Services, Massachusetts Eye and Ear Infirmary, Boston.

Comprehensive vision rehabilitation addresses the whole person because visual loss affects the whole person, she emphasized.

“Glaucoma impacts the patient’s quality of life in many ways,” she said. “That is, driving, walking, and reading are impacted, as well as the fact that just the diagnosis of glaucoma causes anxiety about blindness.”

She emphasized that visual rehabilitative services should go well beyond the use of magnifiers and should provide technologies to enhance patients’ ability to read; help patients perform independent activities of daily living; increase safety by preventing falls and helping them read eye drop prescriptions; facilitate participation in activities; and address psychosocial issues regarding the patients’ well-being, such as anxiety about Charles Bonnet syndrome visual hallucinations, which are experienced by about 30% of patients with moderate and severe glaucoma.

Ophthalmologists are an important source of help for identifying visual rehabilitation options. Dr. Jackson recommended the SmartSight patient handouts available through the American Academy of Ophthalmology website that can help patients make the most of their remaining vision.

“Just as patients with cardiac disease and stroke can obtain assessment and rehabilitation, patients with glaucoma can also,” she said.

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