1. 1 Low Vision Rehabilitation Suleiman Alibhai, O.D. Doctor of Optometry Lions Clubs International IAG Mission Myanmar, 2013

3. Prevalence of Blindness and Low Vision in US Population over age 40

5. 5 Glossary of Terms Vision Rehabilitation Low Vision Legal Blindness Visual Disorder Visual Impairment Visual Disability Visual Handicap

6. 6 Anatomy of the Eye

7. 7 Vision Rehabilitation Services provided to a visually impaired individual to improve their safety, independence, ability to become educated or employed and quality of life.

8. 8 Looking Inside the Eye

9. 9 Low Vision Any level of vision that interferes with the individual’s ability to perform normal daily living activities such as reading, writing, driving, grooming, walking etc.

10. 10 Legal Blindness Vision that cannot be improved beyond 20/200 in the better seeing eye using conventional lenses or a visual field that extends to 20 degrees or less in diameter in the better seeing eye.

11. 11 Visual Disorder The anatomical or pathological condition affecting the eye: Corneal astigmatism from keratoconus Nuclear sclerosis form a cataract Retinal detachment from diabetic retinopathy Disciform scar from macular degeneration

12. 12 Cataract

13. 13 Visual Impairment The measurable impact of the visual disorder on the eye: Diminished visual acuity Reduced contrast sensitivity Loss of peripheral visual field Slower reading speed

14. 14 Cataract Diagram

15. 15 Visual Disability The impact of the visual impairment on performing normal daily activities: Inability to read the mail, prices, recipes etc. Compromised communication from an inability to recognize faces. Inability to get around safely and independently.

16. 16 Cataract Vision

17. 17 Visual Handicap The impact of the disability on the individual’s ability to function in society: Need for large print software in order to use a computer. Implementation of a talking sign to identify a bus. Help from a sighted assistant to negotiate a grocery store.

18. 18 Impact of Being Visually Impaired Loss of independence and increased dependence on children, spouse or others Secondary health issues due to depression, anxiety, falls and other injuries Diminished self esteem and feelings of being a “burden” on family and society

19. 19 Leading Causes of Vision Impairment: Diabetic Retinopathy – affects 5.3 million Americans over the age of 18. Age Related Macular Degeneration – leading cause of legal blindness for people over the age of 60, it affects more than 1.6 million Americans. Glaucoma – at least 2.2 million Americans are afflicted.

20. 20 Diabetic Retinopathy

21. 21 Looking Inside the Eye

22. 22 Diabetic Retinopathy

23. 23 Diabetic Retinopathy Vision

24. 24 Glaucoma

25. 25 Glaucoma Vision

26. 26 Looking Inside the Eye

27. 27 Macular Degeneration Dry

28. 28 Macular Degeneration - Wet

29. 29 Macular Degeneration Vision

30. 30 Categories of Visual Aids Enhance near vision Glasses: - Bifocals - Prism glasses - Microscopes Near telescopes Magnifiers Video magnifiers Enhance distance vision Telescopes Video magnifiers

31. 31 Bifocals

32. 32 Microscopes

33. Modifying Size: Near Telescopes

34. Pelli Robson Contrast Sensitivity Chart

35. Modifying Glare and Enhancing Contrast

36. 36 Magnifiers

37. 37 Video Magnifiers

38. 38 Portable Video Magnifiers

39. 39 Portable with Variable Magnification Amigo Optelec Traveler

40. Portable Video Magnifiers combined with laptop computers

41. Video Magnifier and OCR combined

42. 42 Telescopes

43. Modifying Size: Bioptics

44. 44 Head Mounted Electronic Aid

45. 45 Implantable Miniature Telescope Visual prosthetic device Designed to improve vision by rendering central visual field over central and peripheral retina Reduces effective size of scotoma (blind spot) IMT by Dr. Isaac Lipshitz

46. 46 Retinal Image 52 - 60° Wide Angle Implant Central Visual Field Projection

47. 47 Low Vision Technology of Future Measure and map extent of visual loss Write software algorithm to compensate for – Resolution and visual field loss – Glare and contrast – PRL and scotoma Head mounted system with eye tracker and mini computer worn by patient Software modified as vision changes Alternatively a digital prosthetic implant