What is Low Vision?



Low vision is when your best corrected vision (with conventional glasses, contact lenses, LASIK, or cataract surgery) 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 (e.g., ARMD, glaucoma, stroke), congenital (e.g., albinism, nystagmus) or traumatic causes (head injury, eye injury, etc).


Tasks may include regular everyday activities like reading, writing, driving, or watching television. Tasks may also include specialized activities relating to occupation or recreation.



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What Causes Low Vision?



Medical conditions can cause reduced vision. The leading causes are macular degeneration (ARMD), diabetic retinopathy, inoperable cataracts, glaucoma, stroke.


The low vision specialty eye doctor does not replace your regular eye doctor but works with the other eye doctor as part of the team to help you use the vision that you have in the best way possible.


A low vision eye doctor has compassion and empathy for what the patient and family are going through as well as the knowledge, resources and experience to help them adjust to the difficult situation.


Dr. Huggett, who practices the low vision specialty, has has extensive training in low vision at the University of Houston, Houston TX, the Lighthouse of Houston, Houston, TX, Lighthouse International in Manhattan, NY and in Corona, CA under RIchard Shuldiner, OD, FAAO of the International Academy of Low Vision Specialists.


Dr. Huggett only accepts patients he believes he can help and uses the highest quality, state-of-the-art telescopic, microscope, and prismatic magnifying eyeglasses as the primary means of helping the patient.



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What is a Low Vision Specialist?



A low vision specialist 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. A low vision eye doctor understands how to work with patients and families who can be extremely upset, fearful, and even depressed. It's a doctor who has the patience and 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 future.


The low vision specialty eye doctor does not replace your regular eye doctor but works with the other eye doctor as part of the team to help you use the vision that you have in the best way possible.


A low vision eye doctor has compassion and empathy for what the patient and family are going through as well as the knowledge, resources and experience to help them adjust to the difficult situation.


Dr. Huggett, who practices the low vision specialty, has has extensive training in low vision at the University of Houston, Houston TX, the Lighthouse of Houston, Houston, TX, Lighthouse International in Manhattan, NY and in Corona, CA under RIchard Shuldiner, OD, FAAO of the International Academy of Low Vision Specialists.


Dr. Huggett only accepts patients he believes he can help and uses the highest quality, state-of-the-art telescopic, microscope, and prismatic magnifying eyeglasses as the primary means of helping the patient.



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How is a Low Vision Exam Different?



A low vision examination is quite different from a regular eye exam. It is a longer examination usually lasting one hour or more. It is a "vision and function" examination, therefore medical testing like dilation is usually omitted when possible.


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 the level of vision. Careful refraction is performed to find out if a new "regular" eyeglass prescription will help and to determine the basic focusing of the eyes.


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 persons' task requirements.



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What is the Free Telephone Consultation?



the free telephone consultation is provided by Dr. Huggett to limit the time, expense and disappointment of people who probably cannot be helped by low vision care. Dr. Huggett asks the right questions on the telephone which enables him to determine if a person is qualified for low vision services. "If not, why put the patient through the time and expense only to be extremely disappointed?" says Dr. Huggett.

Dr. Huggett uses the free telephone interview to speak to every patient personally. He asks questions regarding to vision, functional abilities, goals, motivation, health, and mobility to determine if an appointment is in the best interest of the caller.



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How much will this cost?



The low vision examination cost will vary depending upon what Dr. Huggett needs to do. But most of the exam is typically covered by Medicare B and supplemental insurances depending upon your plan. Please check your policy if you have questions regarding your coverage.

One important part of the examination is never covered by Medicare B called refraction. The refraction is the separate procedure that determines the ability of your eyes to focus and will assist Dr. Huggett in determining your prescription. Some Medicare B supplemental insurances will cover this procedure. Again, please check with your insurance policy if you have questions regarding your coverage.

Medicare does not cover low vision devices. Low vision devices are an out of pocket expense.

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 telescope 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.



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When do I get my glasses?



It usually takes three to six weeks for specialized glasses to be fabricated. Arrangements can be made to have them made sooner in some circumstances. If a person has a special event happening and needs the glasses, the lab can usually accommodate your need.



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How do I know the glasses will work after I get them?



During the evaluation, the patient will use the acutal low vision telescope, microscope or 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.

We never order glasses until the patient knows they work.



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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. Dr. Huggett offers a change in the glasses for up to six months and no or nominal charge to the patient. It is interesting that changes are actually rarely needed.



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Can't I just buy a hand magnifier?



This is a frequently asked question and has a simple answer in most cases: No. The more complex answer follows.

First, you must understand that all magnifiers have a certain amount of magnification power to them.

Technically, they are "plus" lenses and have a specific dioptric power. Every manufacturer has a different way of marking the "power" of the magnifier. A "5X" magnifier from Company A may be 20 diopter while from Company B it is 16 diopters. It is the diopters that count, not the "X".

In "prescribing" a hand held or stand magnifier, teh low vision doctor must:
  • Determine the level of vision of the patient.
  • Determine the size of the print needed to be seen.
  • Determine the illumination requirements.
  • Work with different levels of diopters to determine what is the best for the patient.
  • Determine the patients' capacity to hold the magnifier in focus, keep it steady, and move it across the page.


Without going through these steps, it is simply trial and error, which may work for buying shoes, but not for visual functioning.



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In Florida we have the number one rated eye hospital, the public Bascom Palmer Eye Institute

www.bascompalmer.org

Additionally, St. Luke's Cataract and Laser Institute, a private eye hospital with an international reputation that is unmatched.

www.StLukesCataract.com Serving patients from 77 countries for over 40 years.



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Where can I get more information regarding macular degeneration?



The best centralized location with the latest information regarding macular degeneration is found at www.mdsupport.org.

Here you will find the latest news and the link to the International Macular Degeneration Support Group (IMDSG) www.mdsupport.org/nsg.html which holds a monthly live presentation.

This presentation is recorded and is available to watch; There is no cost for this service.

This service is supported by MD Support www.mdsupport.org, MD Foundation www.amd.org, and Macular Degeneration Research www.ahaf.org/macular



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