Low Vision Aid Demonstration
By: Michael R. Politzer, O.D., F.A.A.O., F.C.O.V.D.
One of the greatest challenges in providing low vision care is bridging the gap between the patient’s perception and reality of the care they have received. When our patients leave our office they have an idea of what their low vision aids will look like and how they will be used. Often, patients are surprised or disappointed when their aids are dispensed several weeks later because they do not look as expected nor work as anticipated.
The use of trial low vision aids is necessary and helpful and is the current standard of care. We demonstrate how the aids will help the patient meet their needs and show them what they will look like in the trial frame. However, the trial frame version is far different from the finished product; this is especially true for sophisticated spectacle telescopic or microscopic lens systems. No matter how articulate we are, attempting to describe to a patient how they will see with their new low vision aid or explaining what the aid will look like is a monumental task. There is no more powerful way of resolving this challenge than with the use of demonstration low vision aid systems.
Appropriate demonstration aid systems will duplicate the actual prescribed version, with the exception that no prescriptive power will be included. This means that fully functioning telescopes or microscopes are used; they are mounted in the correct position and manufactured with the exact frame, size, shape and color as the proscribed model.
The procedure for effectively using demonstration systems begins when the low vision aid testing for distant, intermediate and near distances is completed. The patient is then moved from the examination room into an environment that is well suited for evaluating the effectiveness of each aid tested. Examples may include: sitting behind the wheel of a stationary automobile, a TV room, an easy chair for reading, a computer station, work bench, card table, walking down a hallway for mobility, waiting room for viewing people's faces or a functional kitchen.
The doctor should review with the patient their specific needs and goals and then use the appropriate aid for the specific task required and orient the patient to their evaluation environment. Explain that the aid that they will be using for each stated need or goal will be just like the one they will receive. Make sure the aid is properly focused and aligned and then allow the patient to engage in the required task.
Observe the patients response to the aid and listen to their comments. Record hand or eye preference if appropriate and ease of use. Check to see if the patient prefers to use the specific aid with or without their best-corrected spectacle Rx and if they prefer to use the aid with both eyes open or one eye covered. If the patient is undecided, let them do a side-by-side comparison between two different demonstration aid systems or their glasses and the low vision aid demo system.
These critical questions can only be answered accurately when demonstration units are utilized in the appropriate environment. Many patients will have a significant positive response to an aid when both eyes are utilized despite a large difference in best-corrected acuity. Others will prefer to have one eye occluded, or not use the best-corrected spectacle Rx. This information is critical to proper and effective prescribing.
Remember to be specific. Multiple aids are required to meet all of the patient's goals. Patients are much more likely to purchase and use multiple aids when they can "test " them in a real world situation rather than relying on their imagination to make the decision. Patients and their families have more confidence that the aids that are demonstrated will work and the time for training and adaptation will be more efficient and effective.
The cost of providing low vision aid demonstration units for our patients is minimal compared to the benefits they provide. Many manufactures have incentive plans for utilizing demo systems and the cost is balanced out by better patient outcomes.
Make the investment in enhancing your low vision practice. Begin purchasing demo units for your most prescribed aids. Your patients will greatly benefit and thank you.