Low Vision Visual Deficit Interventions for Occupational Therapy

Refer to an ophthalmologist or optometrist.

Meanwhile, OTs can provide interventions to enable the use of the client’s remaining visual acuity.

OT Interventions

Increase background contrast

  • Use black on white.
  • Or apply bright colors (e.g., markers, tape).

Increase illumination

  • Using different types of light sources, color temperature, softness, placement, and wattage (higher is better).
  • Without increasing glare.
  • Beware of casting shadows.

Reduce background pattern

  • Use solid colors instead of background surfaces.
  • Reduce clutter in general.

Enlarge objects and features

  • Print instructions in larger print.
  • Relabel frequently used objects, e.g. medications, calendars.
  • Encourage use of magnifiers.
  • Change computer and electronics accessibility settings for low vision.

Reorganize

  • Store or place frequently used items at a convenient eye level.
  • Store less frequently used items lower or higher.
  • Encourage clients to keep items organized.
  • Put items back where they belong.
  • Establish habits and routines to prevent tasks from becoming overwhelming.
  • Modify tasks to reduce the number of steps or its complexity.

Other Interventions

  • Ensure adaptations such as glasses are used and kept clean.
    • Warm water and soap work well to clean glasses.
  • Use sunglasses for bright sunlight and light changes between environments.
  • Minimize and remove fall hazards, e.g., phone charging cords
  • Address psychosocial factors including social isolation, depression, anxiety, substance abuse.
  • Address driving if client drives and potential hazards to self and others.
  • Enhance other senses (auditory, tactile, olfactory) and use other strategies and assistive technologies to achieve the same function, e.g. Amazon Echo instead of using a light switch.

Referral

  • Free library services for low vision, e.g. talking books, magazines, music.
  • Lighthouse Information and Resource Center – www.lighthouse.org
  • Local telephone companies may offer free directory assistance.
  • Pharmacies may provide large-print medication labels.
  • Businesses may provide larger-print products.
  • Refer to an organization for white cane orientation and mobility (O&M) training BEFORE recommending guide dog training.
  • Consider a guide dog for clients with experience using white canes.

Guide Dog Study

First-Time Experience in Owning a Dog Guide by Older Adults with Vision LossLi, K., Kou, J., Lam, Y., Lyons, P., & Nguyen, S. (2019). First-Time Experience in Owning a Dog Guide by Older Adults with Vision Loss. Journal of Visual Impairment & Blindness, 113(5), 452-463.

Resources