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“There is life after vision loss.”

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All About Vision

LOW VISION SERVICES AT Low Vision Clinic of Florida


Low vision can affect both children and older individuals, but is more common in the elderly, who are at greater risk of eye diseases such as glaucoma, macular degeneration and cataracts, which are some of the most common causes of the condition.

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Low Vision Causes and Treatment in Dunedin

Low vision is considered significant vision impairment that usually results from serious eye disease or an injury. The vision loss, which is characterized by either reduced visual acuity (to 20/70 or worse) or reduced field of view, can't be fully corrected with glasses, contact lenses, medication or surgery.

What causes low vision and how does low vision affect eyesight?

Among the leading causes of low vision are heredity, eye injury or brain injury, or eye diseases such as glaucoma, macular degeneration, cataracts, diabetic retinopathy, or retinitis pigmentosa. Depending on the severity and type of vision impairment, the patient may have some useful vision.  Typically the impairment includes a significant reduction in visual acuity to worse than 20/70, hazy, blurred vision, blind spots or significant visual field loss and tunnel vision. Sometimes the extent of vision loss is considered to be legal blindness (20/200 or less visual acuity in the better eye) or almost total blindness.

How does low vision affect daily life?

With significant vision loss it can become challenging to complete common daily tasks including reading, writing, cooking and housework, watching television, driving or even recognizing people.

When low vision is diagnosed it can come as a shock. Initially, it is an adjustment to learn how to function with impaired vision but the good news is there are numerous resources and products available to assist. Because low vision often results in one’s inability to work, function independently, drive and resume normal life, many patients feel isolated and depressed.

Visual Rehabilitation and Visual Aids

Low vision means that a minimal amount of sight remains intact. There are millions of people who suffer from the condition and manage to function with the remaining vision available to them through the use of visual rehabilitation or visual aids.

What are visual aids?

These are devices that help people with low vision function by maximizing their remaining eyesight. This often involves the use of magnifiers (handheld, mounted or stand-alone), telescopes and other tools to enlarge the images of objects to make them more visible. Some visual aids reduce glare and enhance contrast which makes it easier to see. Other low vision aids act as guides to help the person focus on non-visual cues, such as sound or feel. Finding the right visual aid is a matter of consulting with a professional and experimenting with what works for you and your daily needs.

How to make life with low vision easier

  1. Ensure that you have adequate lighting in your home. This may require some trial and error with different lights and voltages to determine what works best for you.
  2. Use a magnifier. There is a vast selection of magnifiers available, ranging from hand-held to stand magnifiers. Binoculars and spectacle mounted magnifiers are also an option.
  3. Your optometrist or low vision specialist can recommend specialized lens tints for certain conditions such as retinitis pigmentosa or cataracts, which enhance vision or reduce light sensitivity.
  4. Use large print books for reading. Alternatively, try digital recordings or mp3’s.
  5. Make use of high contrast for writing. Try writing in large letters with a broad black pen on a white piece of paper or board.
  6. Adding a high-contrast stripe on steps (bright color on dark staircase, or black stripe on light stairs) can help prevent falls in people with low vision, and may enable them to remain independent in their home.
  7. Find out by researching what other technology is available to help make your life simpler.

If you or a loved one has low vision, don’t despair. Consult with our eye doctor about the best course of action to take to simplify life with low vision.

Treatment of Macular Degeneration

While there is no cure for macular degeneration, treatments do exist that can delay the progression of the disease, preserve existing vision and sometimes even improve vision loss.

Currently, there are no approved treatments to prevent or cure dry AMD, although there is evidence that indicates that certain nutritional supplements, including omega 3 fatty acids, lutein and zeaxanthin, can prevent the progression of the disease to the more advanced wet form, which can cause more severe vision loss.

There are a couple of options for treating wet AMD to slow the progression of vision loss which include medicated injections and laser therapy. These therapies are designed to stop the development of new blood vessels, to destroy existing ones and to prevent leakage into the macula – the main dangers with wet AMD.

Unfortunately, while much research continues to be conducted, currently there is no treatment and no way to fully regain vision lost by AMD. Those who have suffered significant vision loss can benefit from the many low vision devices on the market which utilize your existing vision to assist in maintaining your independence. Such devices include standing and hand-held magnifiers and telescopes and other aides that can help to improve your vision.

If you have been diagnosed with AMD, regular vision tests are essential. Close monitoring and adherence to treatment can not only prevent further vision deterioration but can sometimes even improve vision.

Symptoms & Risk Factors of Macular Degeneration

Macular Degeneration can cause low vision and debilitating vision loss, even blindness if not diagnosed and treated in the early stages. Because the disease often has no obvious symptoms early on, it is critical to have regular comprehensive eye exams, particularly if you are at risk.

Symptoms of AMD

Macular degeneration is a disease in which the macula slowly breaks down, resulting in a gradual progressive vision loss, at least in its’ early stages. Frequently there are no symptoms and the disease is only diagnosed when a doctor detects signs such as a thinning macula or the presence of drusen in a comprehensive eye examination. Early vision loss can include blurry, cloudy or distorted central vision or dark spots in your central field of view. With advanced stages, vision loss can be severe and sudden with larger blind spots and total loss of central vision.

Risk Factors for Macular Degeneration

Age is the most prominent risk factor for AMD, as the disease is most common in individuals over the age of 60 (although it can happen in younger individuals as well). Other risk factors can increase your chances of developing the disease such as:

  • Genetics and Family History: Research shows that there are actually almost 20 genes that have been linked to AMD, and they suspect that there are many more genetic factors to be discovered. Family history greatly increases your chances of developing AMD.
  • Race: Caucasians are more likely to get AMD than Hispanics or African-Americans.
  • Smoking: Cigarette smoking can double your likelihood of developing AMD.
  • Lifestyle: Research shows that UV exposure, poor nutrition, high blood pressure, obesity and a sedentary lifestyle can also be contributing factors.
  • Gender: Females have a higher incidence of AMD than males.
  • Medications: Certain medications may increase the chances of developing AMD.

To reduce your risks of developing AMD it is recommended to make healthy choices such as:

    • Regular eye exams; once a year especially if you are 50 or over.
    • Stop smoking.
    • Know your family history and inform your eye doctor.

 

  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure.
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
  • Wear 99% -100% UV-blocking sunglasses.

 

The first step to eye health is awareness. By knowing your risk, taking preventative measures and visiting your eye doctor on a regular basis, you can greatly reduce your chances of facing this debilitating disease.

Forms of Macular Degeneration

There are two forms of macular degeneration, dry (non-neovascular) or wet (neovascular). The term neovascular refers to the growth of new blood vessels.

Dry AMD (non-neovascular)

Dry AMD is the most common form of the disease, making up about 85%-90% of all cases of AMD. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is an early stage of the disease and is less severe than the wet form,.

Dry AMD occurs when the aging tissues of the macula begin to thin out and break down. Tiny pieces of white or yellowish protein called drusen begin to appear, which are thought to be deposits from the macular tissue as it deteriorates. The appearance of these drusen are often what leads to a diagnosis of AMD during an eye exam.

With dry AMD vision loss happens gradually, however, the dry form can progress to wet AMD rapidly. There is currently no cure for dry AMD, however there is research that shows that some people can benefit from supplemental vitamin therapy including antioxidants, lutein and zeaxanthin.

Wet AMD (neovascular)

Wet AMD is less common occurring in only about 10 percent of those with AMD. AMD is classified as Wet AMD when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, resulting in blind spots and a loss of central vision. Wet AMD can cause more damage to vision and permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD. Usually vision loss happens faster and is more noticeable than in dry AMD so the quicker it is treated, the more vision you can preserve.

Overview

Macular Degeneration, which is also known as Age-related Macular Degeneration (AMD), because it is usually associated with aging, is a leading cause of vision loss in adults aged 50 and older. The disease is characterized by a gradual loss of central vision and can occur in one eye or both eyes simultaneously.

Understanding AMD

Macular Degeneration is a disease that damages the macula, which is the center of the retina responsible for sharp visual acuity in the central field of vision. The breakdown of the macula eventually results in the loss of central vision and the ability to see fine details. While AMD doesn’t result in complete blindness, the quality of vision is severely compromised leading to what we refer to as “low vision”.

The loss of central vision can interfere with the performance of everyday tasks such as driving, reading, writing, cooking, or even recognizing faces of friends and family. The good news is, there are many low vision aides on the market now that can assist in helping you to perform these tasks.

Wet and Dry AMD

There are two types of AMD, wet and dry.

Dry AMD is the most common form of the disease. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is less severe than the wet form, but can progress to wet AMD rapidly.

Wet AMD is when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, causing distortions in vision. Wet AMD can cause permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD.

Are You at Risk?

Awareness about the disease, the risk factors and prevention are critical, even for younger generations because taking care of your eyes while you are young will help to reduce the risks later on in life.

The biggest risk factor for AMD is age. Individuals over 60 are most likely to develop the disease however it can occur earlier. Additional risk factors include:

  • Smoking: According to research smoking can double the risk of AMD.
  • Genetics and Family History: If AMD runs in your family you are at a higher risk. Scientists have also identified a number of particular genes that are associated with the disease.
  • Race: Caucasians are more likely to have AMD than those from Hispanic or African-American descent.
  • Lifestyle: Obesity, high cholesterol or blood pressure, poor nutrition and inactivity all contribute to the likelihood of getting AMD.

Prevention of AMD:

If you have risk factors, here is what you can do to prevent or slow the progression of AMD:

  • Regular eye exams; once a year especially if you are 50 or over.
  • Stop smoking.
  • Know your family history and inform your eye doctor.
  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure.
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
  • Wear 99% -100% UV-blocking sunglasses.

The first step to eye health is awareness. By knowing your risk, taking preventative measures and visiting your eye doctor on a regular basis, you can greatly reduce your chances of facing this debilitating disease.

Low Vision Aids for Computer Users

Concerned Business Man at Desk with Computer

Low vision is a condition, often caused by a number of eye diseases which damage parts of the eye, in which individuals have significantly reduced vision. Individuals with low vision have some sight, but usually it is not sufficient to get by in daily life without some assistance. Often they are not able to read, drive, cook or work on a computer without a visual aid. Today there are many low vision aids available on the market to help those with low vision to function independently in performing daily tasks.

Computer use is one activity that often requires assistance and the good news is the technology to aid computer users with low vision is always improving.

Here are some devices and programs on the market to help:

Text Magnifying:

There are a number of ways to enlarge the text on your computer screen in addition to handheld magnifiers.

Via Your Computer Operating System: Both newer generation Windows and Mac operating systems have screen magnifiers built in. These do not have as many capabilities as purchased screen reader programs but for many with mild low vision, they may be sufficient.

Via Browser: When using the Internet most browsers (Chrome, Safari, Firefox and Internet Explorer) allow you to change the size of the page or text on the screen to suit your needs. To enlarge the text on a PC simply hold down the Control (“Ctrl”) key on your keyboard and either tap the “+” key or roll the wheel on your mouse. To reduce the size tap the “-” key or turn the mouse wheel in the opposite direction. On a MAC, you press command and shift at the same time along with the “+” or “-” keys.

Additionally, the browser might have a drop down option under the “view” tab that allows you to Zoom the screen in or out or make the text larger or smaller. Keep in mind that if you are using a larger higher quality screen, this will enable you to see bigger and more clearly as well.

Screen magnification programs: there are a number of free and paid software programs that will enlarge the text, picture and images on your computer screen.

Screen Readers and Text to Speech Programs:

There are a number of programs that enable you to “read” what is on the computer without needing to see it – these are designed for people that are totally blind as well. These programs work by scanning the text and icons on a page and converting it to speech which is read aloud. Some of these programs also have a cursor on the page that moves along with the voice.

Up to date Microsoft and Apple operating systems do have simple, built in screen readers but they may be limited. The Chrome browser and Android devices do as well. Nevertheless depending on your abilities, you may prefer to purchase a program with more comprehensive options and usability.

If you are looking for something simpler, text-to-speech programs exist in which you select a portion of the text you want to read and the program reads it for you.

Screen Contrast

Adjusting your screen to the highest contrast will enable the letters and images on the monitor to stand out. Font should be adjusted to achieve a dark text on a light background. Further it is advisable to reduce glare as much as possible. This may require adjusting window shades and indoor lights or even purchasing an anti-glare screen to reduce glare that can’t be eliminated.

Hardware

You can purchase special keyboards, mice and monitor magnifiers made specifically to enhance usability for those with low vision. Purchasing a large LCD screen for your monitor will also help to enhance visibility.
Computers can be a window to open our world to information, connections, work and play. Individuals with low vision can access all of this as well with the assistance of specialized software, devices and programs using the strengths and senses that they do possess.

Ask your eye doctor for more information about how we can help.

How to Cope with Low Vision

adjusting the lighting can help with low vision

Reduced vision is defined as vision that can not be corrected completely using either contact lenses, eyeglasses, or surgery, and is blurry (at the level of at least 20/70), or limited in its view field. Low vision is sometimes caused by injury to the eye or brain, and it can be inherited. However the main cause of low vision is eye disease, including diabetic retinopathy, glaucoma and macular degeneration.

If you have low vision you have some sight. However completing normal activities, including driving and reading, can be hard or even impossible.

Low vision is a condition that the elderly suffer from, although it is possible for children and middle-aged patients to have low vision. After a life of seeing normally, losing your vision can be hard, or even traumatic, and can potentially lead to frustration, or even depression.

Low Vision, Working and Independence

What is especially hard about low vision is that many people are unable to work, and lose their existing jobs. In 2010 the U.S. Census Bureau’s American Community Survey showed that the employment rate for Americans with low vision was 24 percent.

If you have low vision, you probably feel disconnected from the rest of the world. With low vision, it’s hard to read, see images on television or a computer screen, and impossible to drive. You may not be able to be independant and run your own errands, shop for food, or visit friends and family. Sometimes people with a vision impairment suffer with this burden alone, while others must rely completely on friends and relatives on a daily basis.

There are many devices and ways to manage low vision, which can help people suffering with low vision to continue leading productive and independent lives. Some of the devices that can help make the most out of remaining vision are magnifiers, both handheld and mounted on eyeglasses, and telescopes.

Symptoms of Low Vision

Signs that it is time to see an eye doctor include loss of peripheral vision, blurry vision, sensitivity to light, night blindness, needing more light to see, spots or floaters, and reading difficulty. This symptoms could indicate that a cataract is beginning in your eye. Or these problems could be signs of an eye condition such as glaucoma, retinitis pigmentosa, or macular degeneration. Make sure to see your eye doctor before any eye condition becomes so serious that vision loss occurs.

If it’s not possible to correct your vision loss with surgery, medical treatment, or eyewear, your eye doctor will send you to a specialist in low vision care. A low vision specialist, who is usually an optometrist, will evaluate your vision loss. Once he or she determines the type and degree of vision loss you are suffering from, this specialist can create a treatment plan including low vision aids, and guidance in using devices that help you to live with vision loss.

Additionally, a low vision specialist has knowledge of many different types of aids for low vision, including large-print and audio books, specially-designed lights, and signature guides that are used to sign checks and other documents. Sometimes eye care professionals that are treating vision loss recommend counseling to help their patients learn to live with the changes that low vision brings.

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