www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 39 VISION IMPAIRMENT By the Numbers More than HALF OF ALL AMERICANS who haven’t sought out eye care say that they haven’t done so due to a lack of awareness or high health care costs. It is estimated that 93 MILLION adults in the United States are at risk for serious vision loss, but only around half have been to an eye doctor in the past year. In 2012, 4.2 MILLION Americans above the age of 40 had uncorrectable vision impairment. This number is expected to more than double within the next 30 YEARS due to diabetes and other medical issues and to the rising age of the U.S. population. The National Institute for Occupational Safety and Health found that every day, around 2,000 WORKERS in the United States endure eye injuries related to their job that require medical treatment. Source – The Centers for Disease Control and Prevention. Around 12 MILLION people above the age of 40 in the United States have some form of vision impairment – including 1 MILLION who are blind, 3 MILLION with vision impairment after correction and 8 MILLION who have vision impairment due to uncorrected refractive error. “I receive doctors’ referrals from retinal specialists, glaucoma specialists, ophthalmologists and sometimes optometrists,” said Gormley. “When I receive the referral, I already know what the visual diagnosis is, then I call the patients and set up an appointment for an in-home low vision evaluation. My first appointment is up to two hours.” The questions Gormley asks during the initial evaluation concern what the patient’s typical day is like. Can you put toothpaste on a toothbrush? Can you cook a meal? Can you see your clothes to get dressed? She does a contrast assessment where she determines if the patient can differentiate the foreground from the background in different lighting conditions or if there is a problem with glare. She also tries to get a good idea of a patient’s ability to read specific sizes of newspaper print. Many people with low vision lose some of their independence and confidence when they are no longer able to continue living their lives as they once did. Gormley addresses this issue when she shows patients how to adapt their daily activities to their vision level, but she also discusses coping skills and self-management tools, such as social support from family members or community resources. Part of managing vision impairment is learning how to communicate with others and finding ways to control the emotions that can accompany vision loss. One of the biggest issues that can come with vision impairment is the inability to drive, but patients might also be unable to participate in their favorite activities and hobbies. “Then you have to look at adapting activities or exploring new activities to get involved in,” said Gormley. “Those are many of the things that I discuss and the process I go through during an evaluation. At the end of the evaluation, I really see myself as a partner with patients, and I ask them, ‘what are your top three goals that you'd like to work on?’ If they're reasonable goals, that's what we do first.” Fortunately, many patients can continue using technology even with vision loss, depending on their impairment level. Some only need magnifying reading glasses or task lamps that can be positioned in a way to maximize the ability to see print. Gormley said that others can use magnifying tools that change the contrast or size of text, making it easier to read. There are plenty of apps that help make screens more visible, as well as magnifying text or reading printed text out loud. Virtual assistants such as Siri or Google can understand voice commands and help users operate their devices. Gormley said it’s especially rewarding to help patients find ways to use their phones or computers to communicate with their loved ones. “My philosophy and mission are to bring quality of life back to people,” said Gormley. “And in doing that, the first thing that's most important to me is giving people hope that they can live with this and do better than they think they can. I have become friends with many people I have served through the years. I learn a lot from the people that I help. It’s very personal for me. It's not just about offering a service – it's offering hope and building relationships.”
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