VISUAL REHABILITATION

for patients with diabetic retinopathy

 VISION REHABILITATION SERVICES
1.Low Vision Therapists
• instruct individuals in the use of residual vision with optical devices, non-
optical devices, and assistive technology
• help determine the need for environmental modifications in the home,
workplace, or school
2.Vision Rehabilitation Therapists
• teach adaptive independent living skills
• enabling adults to confidently carry out a range of daily activities
3.Orientation and Mobility Specialists
• teach the skills and concepts needed in order to travel independently and
safely in the home and in the community (use of a long cane, electronic
travel devices, public transportation, and sighted guide, human guide, and
pre-cane skills)
LOW VISION AIDS
 COMMON VISUAL PROBLEMS
1. Seeing faces
2. Reading bus numbers from a distance
3. Reading fine newsprint, mails, or bills
4. Writing in a straight line
5. Reading low contrast material
6. Increased intolerance to light
7. Inability to move about alone outdoor after dusk
8. Locating food in a plate
9. Seeing the time on a wristwatch
10.Differentiating between coins of similar dimensions
11.Seeing in dim illumination
 OPTICAL DEVICES
DEVICES ADVANTAGES DISADVANTAGES

SPECTACLE • psychologically more acceptable • uncomfortable with the close/ fixed

reading distance
MAGNIFIERS • for long term reading tasks
• difficult to use with eccentric viewing

• slow & uncomfortable for prolonged

• for short-term reading tasks reading
HAND MAGNIFIER • inexpensive • less effective for patients with
• readily available in the market. limited dexterity or hand tremors.

FOLDABLE POCKET • for spot reading, such as bills,

medicine or price labels
MAGNIFIER
• easy to carry

STAND MAGNIFIER • for patients with hand tremors

• patients with constricted visual field

DISTANCE TELESCOPES • cosmetic blemish

GLARE CONTROL can be controlled with devices such as sun wear or absorptive filters, tints and
DEVICES ultraviolet and anti- reflective coatings
 Spectacle magnifier

Stand magnifier

Hand magnifier

Distance telescope

Foldable magnifier

Tinted glass
 NON-OPTICAL DEVICES
• Patients with DR have impaired contrast sensitivity → problems in her/his
ADL
• Non-optical devices do not use lenses but improve viewing conditions
through bright illumination and contrast.
• The devices are:
1.Reading stands - better for the posture as most optical devices have to be
held at a short reading distance.
2.Reading lamps - improve the contrast and provide focused illumination
3.Felt-tip pens - have dark and thick writing that improves the contrast
4.Signature guides - enable a person to sign properly
5.Notex - enables a person to differentiate between currency of various
denominations.
6.Reading guide / Typoscope - helps patients in localizing the text
 Reading stand

Signature guide

Reading lamp

Typoscope

Felt-tip pens
 OTHER DEVICES / METHODS
• Electronic Magnification Closed Circuit Television (CCTV)
• provides maximum contrast
• uses a camera to capture the image and project it on to a television screen
• magnification can be as high as 60 times
• Computer Software Magnification and Screen Readers
• can use innovative software’s such as : computer magnification software & screen
readers - so that they do not have to depend on vision
• Non-visual Devices and Adaptive Techniques
• senses other than vision are used to perform daily activities
• examples include talking books, tape recorders, talking wrist watches and calculators,
folding and support canes, and tactile markings
• Viewing Techniques
• eccentric viewing or looking at the side of an object instead of directly is an adapted
viewing useful
CCTV

Tactile marking

Foldable cane
VISION REHABILITATION
 VISION REHABILITATION
• Teaches adaptive independent living skills that enable
adults to perform a range of ADL including :
• home management
• home modifications
• home mechanics and repair
• personal self-care – including taking medicine
• financial management
• leisure activities
• enhancing communication skills (using the
telephone, reading and writing, and Braille)
ORIENTATION AND MOBILITY
TRAINING
 ORIENTATION
AND MOBILITY TRAINING
• The goals:
• Getting around safely inside the home
• Learning the route to the mailbox
• Taking a walk around the block
• Shopping independently
• Using public transportation to get to work
• Traveling around the world independently
• The methods:
• Using other intact senses
• Using the canes
• Using guide dogs
 CONCLUSION
• Use the lowest possible magnification to solve
the required visual task.
• Select the design of the low vision device (i.e.,
hand-held, stand, etc.) appropriate to the visual
task.
• Different low vision devices need to be used for
different visual tasks.
• No single low vision device can offer a solution
for all eye conditions and all visual
 REFERENCES
1. Khan, S. A. (2007) Low Vision Rehabilitation and
Diabetic Retinopathy. Saudi Journal of
Ophthalmology, Volume 21, No. 3.
2. Vision  Associates for World Action in Rehabilitation
& Education
http://www.visionaware.org/vision_rehabilitation_s
ervices