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

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