About LOVRNET Courses

Basic Low Vision Evaluation

Course Description

Basic Low Vision Evaluation is an online COPE-accredited continuing professional education course for doctors who wish to acquire the knowledge and skills needed to provide low vision rehabilitation services. 
 
This course consists of 6 self-paced modules describing the different steps involved in a low vision evaluation such as the patient history, the clinical examination, refraction and magnification. This course also describes the Low Vision Rehabilitation Network (LOVRNET) team approach.
 
Participants who successfully complete this course will learn the components of a basic low vision evaluation as well as find out what resources LOVRNET offers for low vision rehabilitation.
 
This course is approved for 1.5 COPE CE credit hours. To obtain certification of successful completion of the course, the student must achieve a minimum score of 70% on the final examination and complete the course evaluation.

Course Outline

Learning Objectives

  • Identify components of basic low vision evaluation
  • Identify strategies and techniques that will allow incorporation of basic low vision rehabilitation into an existing clinician’s primary eye care practice.
  • Awareness of resources for low vision rehabilitation 

Module 1: Patient History

  1. Intake
  2. History
  3. Chief Complaint
  4. Data telephone interview LOVRNET
    • Lions volunteers
    • Baseline history
  5. The patients expectations
    • Realistic?
    • Looking for  "glasses" fix vision
    • Activities Daily Living
    • Emotional status
  6. General Health
  7. The impact of any comorbidities
  8. Issues of safety, independence and quality of life that are going to be addressed 

Module 2: Clinical Examination (measurement of vision)

  1. Scheduling considerations
  2. Equipment needs
  3. Office space requirement
  4. Acuity
    • Type of chart
    • How to measure
    • Documentation
  5. Reading ability
    • Type of chart
    • How to measure
    • Documentation
  6. Lighting
    • Impact upon function
    • Importance
    • Type
    • Positioning
  7. Contrast
    • Importance of measuring
    • Functional implications
    • Type of chart
    • How to administer
    • Documentation
  8. Visual Fields
    • Functional implications
    • Peripheral 
      • Type
    • Central
      • Type
  9. Clinical endpoints
    • 20/20 for normal vision (visual acuity)
    • Functional vision for low vision patients not just acuity 

Module 3: Refraction 

  1. Auto refractor
  2. Trial frame
    • Review techniques
    • Demonstration trial frame refraction
  3. JND
    • Wider lens range
  4. Distance vision
    • Driving considerations
    • Monocular vs. binocular
    • Functional goals 
      • Mobility
      • TV viewing
      • Facial recognition
  5. Near Vision
    • Bifocals
    • Single vision
  6. Must be billed separately, not a Medicare covered low vision rehab expense

Module 4: Magnification (basic visual aids)

  1. +4D Add reading bifocal
    • Increasing reading power from traditional +2.50
    • Mobility considerations
  2. Separate single vision reading glasses
  3. Introduction magnifiers
  4. Work distance/focal point
  5. Hand Magnifiers
    • Illuminated vs. non Illuminated
  6. Strong reading glasses

Module 5: Practice Management

  1. Patient counseling
    • More than 50% time spent counseling will impact billing codes
  2. Billing codes
    • Medicare codes
    • Time spent impact upon coding
  3. Refraction not covered expense low vision service
  4. Intermediate low vision service
    • Referral for next level low vision rehabilitation service
    • Therapist working with clinician
  5. Technology for the low vision patient
    • Electronic video magnification
    • Voice output devices 
      • iPad
      • Kindle
    • Computer adaptations

Module 6: LOVRNET Team Approach 

  1. Resources will be suggested such as LOVRNET
    • Lion volunteer provide home visit
    • Phone interview follow up monitor needs/progress
  2. Change in vision
    • Difficulty in the performance of ADL tasks
    • Not ready for low vision rehabilitation
    • Emotional status
    • Depression
      • Understanding warning signs
      • Referral for counseling and supportive intervention
  3. Refer Patient to Occupational Therapists who will come to their home
    • Home modifications
    • Safety concerns
  4. State rehab services
    • More comprehensive low vision rehabilitation services
    • Financial support
  5. Community resources
    • Department of Aging
    • Meals on wheels
    • Library of Congress Books on tape
  6. Summary
    • Member of the LOVRNET team
    • Review Basic Low Vision Evaluation
    • Limits of basic levels of service
    • Resources of the Low Vision Rehabilitation Network
      • More complex level of service for low vision patient