Low Vision: Impact and Interventions

About Carol Cummings

Senior Director of Optimum Life Engagement and Innovation

As Brookdale’s Senior Director of Optimum Life and Engagement, Carol believes senior living should empower residents to make choices that bring meaning and purpose to their lives. Early in her nursing career, Carol developed a passion for working with older adults. After 15 years in hospital and home health settings, Carol took a position as the wellness director for a Brookdale community, a role she describes as her dream job. Her work in the community led to her current role where she supports the well-being of residents through program and service design and education related to Optimum Life, the foundation of how Brookdale approaches whole-person wellness. Carol has been with Brookdale for 18 years, and during that time, she’s earned multiple awards for her programs, including the International Council on Active Aging Innovator Award and the Assisted Living Federation of America’s Best of the Best. As a Certified Wellness Coach and Certified Wellness Practitioner, Carol is an avid student and engaging teacher with a passion for challenging aging stereotypes and helping older adults continue to grow and live life with dignity and respect.

For many older Americans, visual impairment or low vision impacts their ability to perform everyday tasks, limits physical activities and robs them of their independence. In fact, in its Special Report on Aging, the American Foundation for the Blind reported that roughly 15% of Americans over the age of 75 suffer from some form of low vision which impacts their daily life.

Low vision is defined as vision that is 20/70 or worse and cannot be fully corrected with medication, conventional glasses or surgery. It is often characterized by partial sight such as blurred vision, blind spots or tunnel vision. New technologies and innovative intervention strategies are helping older people with various forms of low vision to adapt and overcome those challenges and are enabling them to lead more enjoyable and independent lives.

Here are the most common disorders that cause vision loss for older people:

Age-Related Macular Degeneration (AMD): AMD is the leading cause of vision loss among Americans over 65, accounting for nearly half of all low vision cases. It is caused when the part of the eye responsible for sharp, straight-on vision – the macula – breaks down. The result is a loss of central vision.
Diabetic Retinopathy: More than 30 percent of Americans diagnosed with diabetes have some form of diabetic retinopathy. This translates to an estimated 7.6 million Americans with the condition
Glaucoma: With glaucoma, portions of vision are lost over time, usually with no warning signs or symptoms. For many people, a decrease in peripheral vision is the first sign of glaucoma.
Cataracts: More than 20 million Americans have cataracts, according to Prevent Blindness America. A cataract is a clouding of the lens of the eye and causes vision to be blurry. It is one of the main causes of visual impairment among aging Americans.

All of these conditions can adversely impact the person’s ability to handle everyday tasks such self-care and bathing, meal preparation, shopping, money management, communication and leisure activities. But there is hope! These three effective intervention strategies can help improve the quality of life for those with low vision:

Adaptive Low Vision Aids. A person with low vision typically uses multiple devices, depending on the severity of the impairment and the individual’s lifestyle. Here are some examples.
- Optical handheld magnifier: great for reading the small print on pill bottles and in recipes, for example.
- Handheld monocular telescope: can be used selectively and is portable.
- Mounted monocular telescope: spectacle-mounted telescope can be attached to the lens of one’s eyeglasses
Assistive Technology. Some of the most common and effective technologies include:
- Lighting and glare control tools to optimize visual abilities.
- Contrast modification technologies to enhance activity background and safety.
- Visual field training aids/devices to compensate for central and or peripheral visual loss.
- Video magnification devices now include features that interface with a computer allowing the older person to read text, store pictures, and navigate various online features.
Environmental Modification. This intervention focuses on adapting the person’s environment to make it easier for them to manage their low vision and still handle everyday tasks. These include:
- Organizing work areas and reducing clutter.
- Developing organizational systems to provide design simplicity and consistency.
- Providing safety enhancements such as non-skid mats, built-up handles and improved lighting in key areas such as the bathroom and work areas.

These environmental modifications combined with low vision tools and technologies that are more powerful, smaller and affordable than ever and are helping older people with low vision live better and with more independence. With a wide range of products on the market, from magnification to daily living aids, individuals with any type of vision loss or impairment can experience a positive outcome.

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