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Vision Loss Among Older People . The Vision Rehabilitation Service Delivery System: What You Need to Know & How to Refer. Presented by. Alberta L. Orr and Priscilla Rogers National Center on Vision Loss . Vision Loss Among Older People .

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vision loss among older people

Vision Loss Among Older People

The Vision Rehabilitation Service Delivery System:

What You Need to Know &

How to Refer

presented by

Presented by

Alberta L. Orr and

Priscilla Rogers

National Center on Vision Loss

vision loss among older people3
Vision Loss Among Older People
  • Because of the growth in vision loss in the older population in the U.S., vision loss has become a public health issue.
  • There is a national vision rehabilitation service delivery system in every state.
  • As staff of the Aging and Disabilities Resource Centers, you need to become familiar with these services so that you can become an effective referral sources for this population to the vision rehabilitation service delivery system.
the growing population
The growing population
  • There are already 6.5 million older people age 55 and older who experience age-related vision loss.
  • This number is expected to double as the remainder of the baby boom generation reaches its senior years in 2030.
  • The first set reached age 65 on January 1, 2006.
leading causes of age related vision loss
Leading Causes of Age-Related Vision Loss
  • Most older people experience vision loss as a result of one of the following eye conditions:
    • Macular degeneration
    • Glaucoma
    • Diabetic Retinopathy
    • Cataracts
    • Hemianopia-vision loss due to stroke
impact of each eye condition on vision
Impact of Each Eye Condition on Vision

Macular Degeneration

People with macular degeneration lose their central vision which makes it difficult to read, recognize faces, and do other close-up work.



impact on vision
Impact on Vision


People with

glaucoma lose the peripheral or side vision which makes mobility difficult. It can also make it difficult to find the next line of text.


impact on vision8
Impact on Vision

People with cataracts experience overall blurring of their visual field, but cataract surgery has a 95% success rate.


impact on vision9
Impact on Vision

Diabetic Retinopathy

People with diabetic retinopathy also experience overall blurring but with dark spots which block vision.


impact on vision loss
Impact on Vision Loss


This condition is a result of damage to the optic pathways in the brain, which can result from acquired brain injuries due to stroke, tumor or trauma. It can cause vision loss in half of the field. 

Right Homonymous


Lighthouse International

assessing vision loss
Assessing Vision Loss

Suggested Vision Component for Assessment Instrument

1. Has your vision become worse in the last 3 months?

____Yes _____No _____Sometimes

2. Have you experienced any of the following problems?

  • Sudden hazy or blurred vision
  • Recurrent pain in or around the eyes
  • Double vision
  • Seeing flashes of light
  • Seeing halos around lights
  • Unusual sensitivity to light or glare
  • Changes in the color of the iris
  • Sudden development of persistent floaters in the eye
assessing vision loss12
Assessing Vision Loss

3. If so, have you seen an eye doctor?

____Yes _____ No _____Unsure

4. ______macular degeneration



______diabetic retinopathy


5. What is the severity of your visual impairment? (Select only one)

____ No Light Perception or LP only

____Other Legal Blindness

____Other Severe Visual Impairment

____ Declined to answer or doesn’t know

assessing vision loss13
Assessing Vision Loss

If you have not seen an eye doctor in the last few months or are experiencing problems with your vision, please complete the following questionnaire.

The purpose of the questionnaire is to help identify people who may be experiencing a vision problem and who could benefit from seeing an eye care professional, either an optometrist or an ophthalmologist. People who use glasses or contact lenses should answer the questions in terms of how they see when wearing their glasses or contact lenses.

(Note: This does not include the use of magnifiers or any other special low vision devices.)

(Source: Arlene R. Gordon Research Institute, Lighthouse International).

assessing functional vision
Assessing Functional Vision

Functional Vision Screening Questionnaire—on ADRC website

  • Consists of a series of 15 questions to help you determine how the person is functioning visually—such as being able to read newspapers or books, being able to see faces, being able to see TV, to see prices when shopping, being able to get around home or neighborhood.
  • Scoring and understanding the results: Scores are indicated next to the answer for each item. After completing the questionnaire, total the number of #1s the older person provided. People who score 9 or above should be encouraged to seek an eye examination from an optometrist or ophthalmologist and possibly to obtain vision rehabilitation services.
vision rehabilitation services
Vision Rehabilitation Services
  • Independent living skills training in adaptive ways to carry out routine daily activities
  • Communication skills such as reading & writing
  • Modification of the home environment to make it safe and functional
  • Outdoor orientation and travel skills training
vision rehabilitation services16
Vision Rehabilitation Services

Independent Living Functional Assessment Developed to Address IADL’s & Visual Impairments (PDF) or (Word)

American Foundation for the BlindThis tool includes major IADL items that generally affect persons with visual impairments. The American Foundation for the Blind developed the tool through its National Standardized Minimum Data Set project. It can be used as a pre/post instrument.

vision rehabilitation professionals
Vision Rehabilitation Professionals
  • Orientation and Mobility Specialists teach orientation to the outdoor environment and how to travel using a long white cane. Some also teach electronic travel aids. They teach people how to get to bus routes and frequent destinations.
vision rehabilitation professionals18
Vision Rehabilitation Professionals
  • Certified low vision therapists teach newly visually impaired older persons how to use magnification and telescopic optical devices for close up and distance vision.
  • They work closely with a low vision specialist, either an ophthalmologist or optometrist with a specialization in low vision.
vision rehabilitation professionals19
Vision Rehabilitation Professionals

Rehabilitation teachers teach adaptive techniques for carrying out routine daily activities, such as pouring liquids, safety tips for cooking, and methods for household management, such as cleaning and person management, such as grooming techniques

optical and non optical devices
Optical and Non-Optical Devices
  • Optical devices such as magnifiers and telescopes mentioned above are designed to help an individual with low vision make the best use of his or her remaining vision.
  • There are also many non-optical devices such as writing guides for signature, check writing and addressing envelops that can help make tasks easier.
  • These devices can be found in specialty catalogs.
  • Get to know your colleagues in the vision rehabilitation field in your state and in your community. There is a Chapter 2 program in every state.
  • This will help you know what services they provide and how the services are delivered so that you can be an informed referral source.
  • Make sure they know what you do too!

The American Foundation for the Blind web site addresses the needs of family members, consumers and professionals.

The site contains information about coping with age-related vision loss, how to find vision rehabilitation services in every state and location, and information about how to find specialized aids and equipment.

afb s online directory of services
AFB’s Online Directory of Services

AFB’s directory has information on more than 1,500 organizations, agencies, and product manufacturers.

It includes state and province listings of organizations in the U.S. and Canada.

The online edition is fully searchable and includes a handy step-by-step “how to” guide, quick links to agency web sites.


The National Eye Institute website has a wealth of information on eye diseases and the latest research. It contains vision simulations to help you understand how people with a variety of vision problems see.


This web site, developed by Lighthouse International and sponsored by Pfizer Ophthalmics, contains valuable information for consumers and professionals about prevention, rehabilitation, research, and technology. Vision simulators are also available through this site.


The Talking book program--Through a national network of cooperating libraries, the National Library Service administers a free library program of braille and audio materials circulated to eligible borrowers in the United States by postage-free mail.

Eligibility: Any resident of the United States or American citizen living abroad who is unable to read or use standard print materials as a result of a temporary or permanent visual or physical limitation may receive service.

Contact: 1-888-NLS-READ