What is low vision?
Low vision is a subset of optometry that deals specifically with patients who have been diagnosed with some sort of vision condition or eye disease that affects ones clarity of sight. For some patients with low vision sometimes regular glasses, contact lenses, surgery and medication may not improve the vision. Our doctors will check to see if better glasses can be prescribed however and demonstrate a variety of low vision aids to help assist you with your goals.
How is your exam different from other offices?
Our doctors of optometry have been trained specifically to assist those with various conditions and have competed a formal residency in low vision or have been trained specifically to assist those who suffer from vision impairment. In addition to performing a low vision refraction exam to determine if the vision can be improved with better glasses, our doctors concentrate on specific activities of daily living that may be difficult for those with a variety of vision conditions. Some of these activities may include difficulty reading, walking around, watching TV, using the computer, seeing faces, and more. Our doctors may perform specialized tests not performed at regular exams including peripheral vision testing, eccentric fixation training, location of central blind spots, glare testing, color vision testing, contrast testing, and demonstration of various low vision aids. Our goal is to enhance the level of vision you have left and to maximize your independence.
What ages of patients do you see?
All ages, vision loss can affect infants as well as the elderly. We have patients as young as 3 months and as old as 112.
How can you examine children?
We have a pediatrics program where our low vision specialists use a variety of specialized equipment to test for glasses, assess side vision, evaluate for eye turns, and can estimate what your child may see. Rather than using traditional letter charts we may use special non verbal charts or other charts that can measure vision by matching shapes or images.
What are some of the eye diseases you deal with?
Some of the more common diseases our doctors work with are patients with vision impairment secondary to macular degeneration, glaucoma, vision loss secondary to diabetes, optic nerve problems, cataracts, patients with vision loss secondary to strokes, and a variety of congenital conditions just to name a few.
Do I need a referral?
No, not necessarily. Anyone can come in and make an appointment. However referrals are great and any information you can share about your eye condition will greatly help our doctors and help us to better serve you. We do have a one page referral form so if you have an ophthalmologist you follow up with and they can fill it out, great please bring it in and it will help us to save some time on the case history portion of the exam.
Do you take insurance?
Yes we take straight Medi-Cal and Medicare. Do you have your insurance information and we can see if you are elegible for an exam and let you know what is covered.
Do I need to bring anything with me to my exam?
No not necessarily, but there are some things that we would like you to bring if possible. Please bring in any recent glasses, magnifiers, or other low vision aids you currently use so we can analyze them and see how you perform with them. Please bring in a list of your medications if you are taking anything. Please bring in anything that you would like to see better. If you want to read your Bible, bring it in, music sheets, mail, bills, bring them all in. There is no better way to see if our low vision aids will work on what you are trying to do than if you bring in the actual things you are having difficulty with!
Will the doctors be able to prescribe me stronger glasses to “fix my vision”?
No, not necessarily to fix your vision. Usually if you have an eye condition or disease glasses will not “fix the problem.” Glasses simply focus light on the back of ones eye. During the examination the doctor will take measurements and see if the vision may be improved with an updated prescription, but it is not guaranteed that glasses alone may do everything. During the exam the doctor will see if improved glasses can be prescribed, and discuss what next if glasses alone don’t get you to do what you want; i.e. What other options may be available? Similar to a handyman carrying a toolbox for different tasks sometimes low vision patients may have to use several devices that are task specific.
Am I still eligible to drive with my vision condition?
It really depends on the test results. If you are deemed to be legally blind, then unfortunately the answer is no. However, if the vision measures better than the legal blindness limitation, you may be eligible for a specialized DMV form to be filled out by the doctor. The DMV requires specialized testing including not only the best corrected visual acuities, but also peripheral vision, central vision, color vision, glare sensitivity, contrast testing, and more. If you are eligible the doctor can fill out what is called the DMV 962 form. The form itself does not guarantee a license; that determination is made exclusively by the DMV and you will have to most likely perform a behind the wheel test with them so they can assess your driving safety behind the wheel. The DMV has the right to also limit a license such as no night driving or no freeway driving at their discretion.
What is legal blindness and how do I know if I qualify?
Legal blindness in the US is defined by two ways. The first way is to qualify is that in your best eye, with the best corrected glasses or contacts, the vision cannot be corrected to better than 20/200. If one eye is worse than 20/200 but the second eye is better, you do not qualify for legal blindness, both eyes have to measure worse than 20/200. The second way to qualify for legal blindness is a severe constriction of peripheral vision (tunnel vision) that measures less than the central 20 degrees (regardless of visual acuity). In the second example if the patient has central vision that is 20/20 but has less than the central 20 degrees he or she is still qualified as being legally blind.
What are some of the things the doctors can help me with?
To be honest we won’t really know until you are examined. But our doctors are very comprehensive and demonstrate the different tools and options to help with specific goals. For example if one is having problems watching television we may try glasses, telescopes, head mounted telescopes, bioptic lenses, or monoculars. For reading it may be a specialized pair of near focusing glasses, illuminated hand or stand magnifiers, loupes, or even possibly electronic video magnifiers (CCTVs). For computers it may be specialized intermediate focusing glasses, filters, head mounted telescopes or even specialized computer software. In essence, we cater the examination to you and really try to demonstrate what is available to assist you based on your difficulties, vision, and condition.
Why can’t I just buy a magnifier off the shelf?
You can, however the magnifiers you purchase over the counter may be of poor quality, may not have an illumination source, and may not be an appropriate strength. With magnifiers, the stronger the magnifier, the smaller the area of the lens. The trick is to have the appropriate strength prescribed that allows you to read what you need, while maximizing the viewing area. During the examination the doctors perform a variety of tests to determine the appropriate strength of magnifier you need.
Why are your examinations so long?
We allocate a large chunk of time to work with our patients so we can get at the heart of some their visual difficulties and demonstrate tools, technology as well as other solutions to assist them. Each patient also receives an intake where they are educated about some of the other services that may be available to them. For example, if you are deemed to be legally blind you may be eligible for certain benefits such as a parking placard, social security benefits, or free audio books.
What are some of the other services offered at CPS? Will I be charged for these services?
Vision loss is a complex and difficult thing for the individual and their families. We try to offer comprehensive services to address all aspect of vision loss. In addition to simply prescribing glasses, magnifiers, filters, and telescopes, we also offer training with orientation and mobility specialists, independent living skills training to help with cooking, marking appliances, organizing items around the house, perform lighting evaluations in ones residence, offer diabetic training for those with vision impairment, as well as counseling services and support groups. All of these services are included with your examination.
So do I still need to see my other eye doctor/ophthalmologist?
Yes, yes, and yes. Most of our patients are followed closely by their ophthalmologists. Your ophthalmologist is and will continue to monitor your eye health and performs a dilated fundus examination (DFE) where they are looking at the internal health of your eyes. They will try to prescribe any medications and may recommend and perform surgeries as an attempt to improve ones condition. While our doctors are qualified to look at and evaluate the internal health of your eyes, we devote the majority of our examination to focus on functional goals to improve and maximize your remaining sight.
What is a CCTV and can it help me?
A CCTV or closed circuit television is a specialized electronic video magnifier that acts similar to a projector. It is used to help with reading. The user puts their newspaper, book, or whatever they want to read on a tray and a camera captures the image and projects it on a monitor. The CCTV can magnify (upto 100x), provide enhanced contrast, and can provide a wider field of view than traditional low vision aids. It may help you, but our doctors will cover all the other options first including the possibility of glasses, magnifiers, or telescopes. If appropriate, they can also show you examples CCTVs and some of other assistive technology options. There is a variety of assistive technology available including CCTVs, distance CCTVs, portable CCTVs, computer magnification and screen reading software, and even cameras that can take a picture of text and read it to you. We have a whole assistive technology room dedicated to the latest and greatest in low vision.