There are many different types of low vision aids, all of which are to help the visually impaired see and function more efficiently in their daily environment. Low vision aids for the elderly such as bioptic telescope glasses help them to continue seeing well enough to drive a car. Low vision devices such as microscope glasses can help the visually impaired to read and write. There are many electronic low vision devices that enlarge print for reading, take pictures of fast food menus or the page of a book and actually read it to the person.
Low vision sunglasses which have specific filters that reduce glare and enhance contrast. Patients with low vision usually have a vision condition or disease and it’s vital to protect the existing vision and structure from harmful UV rays. Low vision sunglasses come in a variety of forms to compliment other low vision aids being used simultaneously. Cocoons are a common fit over style sunglasses that go over other glasses. Wrap around sunglasses help block side glare and flip up to allow for switching quickly between clear and filtered. An orange filter blocks 100% of the scattered blue light which makes for optimum clarity and can be used indoor and outdoors. It’s used mostly for reading and driving. Yellow provides clarity and contrast and is used mostly for driving in low light situations. Amber reduces glare by filtering 96% of the blue light and is great for contrast. It’s a favorite for outdoor daytime use. Rose lenses are also great for outdoor use and help with contrast and are probably the most comfortable on the visual system which is why it is also prescribed for migraine headaches.
Bioptic telescopes are what are used for driving, the optics of these low vision aids are miniaturized to fit in the top of a pair of glasses. The head is tilted down to view or spot things through them and then returns to the main lens for normal function. Bioptics are great for being mobile because they won’t make the user dizzy. Bioptics can be used in 46 out of 50 states for driving. In those states that they aren’t allowed for driving they are still great for everyday use for spotting and details in the distance without having to take them off to move around.
Telescope low vision aids are handheld spotting scopes. They are usually monocular and can be fixed focused, autofocused, or focusable. These are more cumbersome than the spectacle mounted telescopes but offer more versatility of range and magnification. These can be great for kids just learning how to use the telescopes and getting accustomed to their uses and functions. Once used to them it will be easier to move to a spectacle mounted telescope.
Full field telescopes glasses offer a large field of view and are mounted straight in front of the eyes for activities such as TV viewing or playing cards. They can also be converged and the focal point set for reading or near work. These can also be a complete low vision system, with the addition of lens caps that fit on the end of the telescope glasses, they can be focused at multiple distances for intermediate or near use. Full field telescopes are usually used in stationary situations. They are difficult to move around with them on because they have a tendency to make the user dizzy.
Escoop glasses are a unique low vision tool used for cutting glare, slightly enlarging all things viewed and can shift the visual image to a healthier part of the damaged retina for clearer viewing. These glasses are great for driving at dusk or even night driving. They can help a patient on the border of not being able to pass the vision portion of the drivers test to squeak out that extra line of acuity needed to pass due to the small amount of magnification compared to regular glasses. They can be made clear, or with a yellow or orange tint.
Low Vision Microscopes have high plus powered or convex lenses in them and provide near magnification for reading or near tasks like sewing. They come as handheld magnifiers, stand magnifiers for low vision glasses.
[SH] Low Vision Magnifiers
Handheld magnifiers come in a variety of sizes, powers and lighted and unlighted versions. They are a form of a microscope with high plus powered lenses. The stronger the power the more magnification but this also reduces the field of view, meaning you see less content. For example 4x low vision aid magnifiers will magnify words two times more than a 2x, but will have to be held two times closer and will have a field of view half the size.. So instead of maybe three words being in view at a time only one and a half are in view. These come either lighted or non lighted and even have wireless charging docks for the lighted versions.
Stand Magnifiers also have plus (convex) lenses in them and are mounted in a rigid frame or stand for placing on a table or bench. This allows for hand free functionality. They are used for reading, writing, or any hobbies or near tasks that can be done at a table. These low vision aids are great for paying bills, needle work, model making etc. Most stand magnifiers come illuminated but can also be ordered without illumination. They are great low vision aids for children because they don’t require them to hold them like hand held magnifiers and the reading material doesn’t have to be held super close as with microscope glasses.
Electronic Magnifiers include things like closed circuit televisions, video magnifiers, large print computer programs like zoom text, screen readers such as Jaws or Virtual Vision. Computer tablets with the feature of being able to enlarge print has also made them an invaluable low vision aid. Electronic devices are great options when considering low vision aids for children. Children are fast learners and adapt well to new low vision devices especially electronics.
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Wearable visual aids for low vision such as Iris Vision , See Boost, and Vision VR are great low vision tools for people with advanced vision loss. The advantages of these, some offer autofocus, larger fields of view compared to optical low vision devices, audible text reading, virtual reality movie viewing and many other high tech features. The disadvantages are size, they tend to be quite bulky, technically challenging for the elderly and expensive.
One non optical electronic device is called the Orcam. The Orcam is a vision aid for the blind, it reads text, recognizes faces,identifies barcodes, recognizes money, products and colors. This is a voice activated device that uses artificial intelligence and attaches to any pair of glasses. It quickly can read text from your phone or a book, it stores faces for recall later and can help you maintain your independence by helping you to shop on your own and continue to live an independent life.
One of the best selling electronic low vision aids is called the Ruby XL HD by freedom scientific. This Ultra portable device puts crystal clear high definition magnification in the palm of your hands and it goes with you anywhere. It has a 5 inch screen and can magnify up to 14 times while still maintaining clarity. It is good for magnifying newspapers, books, photographs, medications, labels, and more. While many electronic devices aren’t so easy to learn to use, the Ruby XL is very user friendly and is a preferred low vision aid for the elderly. It has easy to use large print buttons and with high contrast colors on it for easy navigation. It allows for color modes to enhance contrast for different ocular conditions. It has a convenient flip out handle for a good grip while reading packaging labels or prescription bottles. It comes in two models one of which is red with colored buttons and the other is grey with high contrast black and white buttons.
Radios are great low vision aids for people that are visually impaired. Everything from weather emergency talking radios, large dial radios, and alarm clock talking radios.
Good lighting has been shown to reduce eyestrain by up to 51%. 3 out of 4
people suffer from eye strain, studies have shown low levels of light or harsh lighting conditions could be the cause. Good lighting not only reduces eyestrain and makes your eyes feel better but can make your overall mood and productivity better too! Good lighting can also help determine true colors, for example have you ever gone to the window to determine if a sock was actually black or blue? One of the leading manufactures in home, office and low vision lighting is the OTT light. The company’s proprietary ClearSun LED lights help to eliminate the high peaks and valleys in typical LED light spectrums. Which reduces eye strain greatly and provides natural color like that of the sun. Their product line consists of table and desk lamps, Floor lamps, travel and portable lighting, lighted magnification ( basically a lighten stand magnifier), and lighted make up mirrors.
Lighting control is also very important depending on the condition or pathology.
Ocular albinism, aniridia, and achromatopsia require low lighting conditions. Filters to reduce light are used in these cases. Other conditions such as glaucoma, age related macular degeneration, retinitis pigmentosa, optic atrophy, and nuclear cataracts require high illumination.
Natural light is usually sufficient for children with low vision, however artificial light like one of the OTT lights provides better control of the illumination. Fluorescent lighting provides light more in the cooler range of the spectrum which causes more eye strain and glare. So incandescent light in the range of 60-75 watts is preferred because it provides more of a continuous spectrum and less of the blue light waves.
Care should be taken to avoid reflective surfaces while reading and the lighting source should be positioned at shoulder height and on the side of the better seeing eye, this should form a 45 degree angle with the visual axis. If natural light is being used, one should sit with their back to the window or on the side leading to the best lighting conditions.
Wearing side shields on glasses, polarized lenses, caps and visors can help reduce glare and control reflection.
With most ocular conditions it’s important to protect the eyes from ultralight radiation, it should be filtered below 400 nm, which will minimize the loss of color descrimination and visual acuity. Filters can be put in glasses lenses, clip ons, and even in contact lenses. Absorptive lenses in yellow for low light levels and amber for higher intensity lighting.
The success a patient will have with an optical low vision aid is dependent on their visual acuity. Usually these low vision devices are used if the acuity is 20/200 or better. If a lot of magnification is needed a low vision system like a telescope is recommended with the minimum required power to keep the maximum field of view. The field of view will have a great influence on successful adaptation to the telescope. For conditions where the central vision is compromised oftentimes the patient will need to be trained how to use the technique of eccentric viewing. This should be taught before the patient is dispensed the telescope.
Low vision aids for near vision should be used when the object is having to be held too close or when the patient has to accommodate too much (focus). Up until second grade reducing the distance from the object to the eye is recommended if the acuity is 20/200 or better. From this stage on a stand magnifier, hand magnifier, electronic magnifier, or microscope glasses should be introduced. If the acuity is worse than 20/200 the optical low vision aids should be introduced earlier. When the acuity is 20/800 or worse, braille and a computer with a talking system should be used.
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