Surgical excision of subfoveal neovascular membranes in age-related macular degeneration.
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Biomedical subjects
Publications and source records attributed to D C Fletcher.
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Loss of vision is a common physical impairment in America today. Comprehensive low vision rehabilitation programs can have dramatic results in increasing the independence and productivity of affected persons. Rehabilitation efforts must be tailored to the type of vision loss and to specific functional implications. Every effort should be made to enhance the residual vision. Activities of daily living, orientation and mobility, and psychological concerns must be addressed.
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1. Ophthalmic professionals should avoid using the term "blindness' when referring to lesser levels of vision loss. Vision loss describes any type or degree of change in vision; blindness is total loss of sight. 2. Ophthalmologists deal with anatomy and organ function whereas rehabilitation counselors address the socioeconomic and skills aspects of vision loss. Successful visual rehabilitation must be a team effort with good communication between all professionals. 3. The replacement of the simple dichotomy between "legally sighted" and "legally blind" by normal vision, low vision, and blindness provides a more accurate and less stigmatizing classification.
1. To predict function and prescribe low vision aids, accurate measurements are needed. The routine measurement range can be extended by moving test charts normally used at 20 ft to a closer distance; 1 m is recommended, which gains a factor of 6. 2. Some practitioners recommend testing all reading at a standard distance, but they differ in the distances they recommend. Using a variable distance and recording the distance with every measurement allows for patients' preferred distances. 3. If the distance and letter size are properly recorded, the same visual acuity score should be calculated for all distances. Inches and J numbers, the most prevalent measurements, make visual acuity calculations impossible, but by adopting metric measurements, calculations are far easier.
Driving requires several different sets of abilities, the interaction of which is complex. The combination of these factors, rather than any single factor alone, may make it inadvisable to issue a driver's license. Although vision is the predominant source of information for the driver, visual abilities are only one of the factors to be considered when judging the overall driving ability of an applicant. The final determination can only be made through on-the-road evaluation and cannot be based on the evaluation of vision alone. Individual evaluations should include a review of the past driving record and of nonvisual driving-related abilities, as well as observation of on-the-road performance by a qualified driving instructor or driving evaluator.