News reports from the conference

Vision rehabilitation "more than magnification"

"There's a lot more to good low vision rehabilitation than magnification."

That was the main message delivered by Dr. Donald Fletcher from the Frank Stein and Paul S. May Center for Low Vision Rehabilitation at the California Pacific Medical Center and Smith-Kettlewell Eye Research Institute, San Francisco, in forthright plug for an area of ophthalmology that he says many view as being "boring and tedious."

In his plenary address, Fletcher also discussed the importance of a team approach to assisting patients with limited vision, including involvement of occupational therapists - and the patient.

"One of the most important team players is the patient, and too often we don't include the patient," he said.

Fletcher said low vision clinics have traditionally been just viewed as places to dispense magnification aids to patients to assist them with reading. He noted that a U.K. study has demonstrated that dispensing a free magnifier to a patient in a general clinic without further follow-up resulted in three-quarters of the devices never being used.

"It's tough to use a magnifier to read," he said, and patients need to be assisted in understanding their residual visual capacity and develop compensatory skills as part of a comprehensive management program.

Having a therapist determine a patient's interests and working with them to adapt so they can continue with these interests if possible is important, he said, as is training to allow patients with low vision to complete daily tasks. Fletcher said a study with 220 patients at his centre showed five hours of rehabilitation resulted in three-quarters of patients regularly using their magnification assistive devices and reporting a positive impact on completing common daily tasks, such as self-care and meal preparation.

Fletcher urged his audience to embrace a more collaborative approach to care as has been done successfully by other specialties such as cardiology and orthopedics.