Occupational Therapy for Low Vision

Patients with low vision can experience difficulties with occupational performance.

Occupational therapy practitioners (OTPs) play a crucial role in improving the lives of individuals with low vision. Low vision is characterized by visual deficits that cannot be fixed with glasses, contact lenses, or other standard treatments like medicine or surgery. In 2011, the AOTA referred to low vision rehabilitation as an emerging field for OTPs. Occupational therapy for low vision focuses on enhancing the functional independence and overall quality of life of individuals with low vision.

Understanding low vision

Low vision can result from various eye conditions, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other retinal disorders. Patients with low vision can experience difficulties with occupational performance in areas such as:

• Leisure such as playing sports and drawing.
• Activities of daily living such as cooking, medication management, and managing pet care.
• Community mobility such as driving or using public transportation.
• Vocational activities such as
• Academic activities such as reading and writing.

The most common types of low vision are:

• Central vision loss (inability to see things in the center of your vision)
• Peripheral vision loss (inability to see things out of the corners of your eyes)
• Night blindness (inability to see in low light)
• Blurry or hazy vision

Occupational therapists are vital in addressing occupational performance impact and empowering individuals to regain functional performance ability.

Recommended course: An Introduction to Low Vision Rehabilitation for Occupational Therapists

Occupational therapy for low vision: The assessment

The first step in occupational therapy for low vision involves a comprehensive assessment to understand the individual's unique needs and challenges. Occupational Therapists (OTs) build an occupational profile for each client then administer informal and formal assessments to gather additional information about a client’s functional performance. This holistic approach ensures a customized intervention plan that addresses the individual's specific circumstances.

Intervention strategies

Occupational therapists employ a variety of intervention strategies to address the functional limitations associated with low vision. These strategies aim to enhance remaining vision, develop compensatory techniques, and promote adaptive strategies for daily activities. The therapy intervention is an iterative progress requiring regular reassessment and modification of intervention plans to address changing needs.

Some common intervention approaches include:

Assistive technology

Introduction and training in the use of assistive devices to support independence in activities like communication and information access. Examples include:

• Electronic screen readers
• Talk-to-text programs
• Adjust computer and cell phone settings to accommodate for low vision.

Environmental modifications

OTPs can suggest modifications of home and work environments to reduce hazards, increase occupational performance, and support aging in place.

• Recommendations for optimizing lighting conditions to improve visibility.
• Increasing the color contrast of stairs, knobs on the stove, buttons on the microwave, etc.
• Recommendations from work-from-home jobs that utilize skills.

Adaptive techniques

Teaching adaptive techniques for daily activities, such as

• Organizing physical belongings to be retrieved in the manner they are used.
• Organizing schedule based on time of day for increased safety and visibility.
• Meal preparation schedule for when help is available so meals can be consumed when assistance is not available.
• Use of grocery delivery services.
• Providing guidance on using tactile cues and auditory information to compensate for visual deficits.

The impact of adaptive strategies on daily life

Home and community mobility

Environmental modifications enhance safety and reduce the risk of accidents, promoting greater mobility.

• Removal of throw rugs to reduce tripping hazards.
• Increased lighting in low visibility areas of the home.
• Use of high-contrast colored tape or tape with tactile features on needed items to increase the ability to distinguish between needed items.

Education and practice in navigating the community can decrease isolation and increase engagement in community activities. An OTP can work with a client to determine free and paid community resources that increase the efficiency, efficacy, and safety of community navigation.

• Use of voice assistance when crossing the street.
• Resource education about trained animal assistance for community navigation.
• Education regarding ride-share and other forms of public transportation.

Social participation

Occupational therapists address social isolation by developing strategies for individuals to engage in social activities. Adaptive communication techniques and assistive devices support participation in conversations and community events.

Educational and vocational support

Occupational therapy facilitates the integration of individuals with low vision into educational and vocational settings. The use of assistive technology and adaptive techniques fosters success in academic and work environments.

Interprofessional practice: A collaborative approach to low vision rehabilitation

While occupational therapy offers valuable support, individuals with low vision may still face challenges that fall outside the scope of occupational therapy services. Interprofessional practice (IPP) provides a well-rounded, best practices approach to care for clients with low vision.

Occupational therapy for low vision is a dynamic and collaborative process that empowers individuals to overcome the challenges associated with visual impairment. By addressing the unique needs of each individual, occupational therapists contribute to enhancing functional independence and improving overall quality of life. The combination of visual rehabilitation, assistive technology, environmental modifications, and emotional support creates a holistic approach that fosters resilience and adaptation in the face of low vision.