II. Epidemiology
-
Incidence of Low Vision increases with age
- Affects 3-4% of patients over age 40 years old
- Affects 7% of patients over age 65 years old
- Affects 25% of patients over age 80 years old
III. Symptoms: Normal changes related to aging
- Presbyopia
- Decreased contrast sensitivity
- Decreased dark-light adaptation
- Delayed glare recovery
IV. Symptoms: Abnormal
- See Acute Vision Loss
- Loss of central Vision
- Loss of peripheral Vision
- Generalized loss of Vision
V. Causes: Common (over age 40 years)
- See Acute Vision Loss
- Age-Related Macular Degeneration (54% of all blindness in U.S.)
- Cataracts (most common cause of blindness worldwide)
- Glaucoma
- Diabetic Retinopathy (present in up to 10% of diabetes patients at time of initial diagnosis)
VI. Exam
- See Visual Acquity
- Intraocular Pressure
- Amsler Grid
- Funduscopic Exam
VII. Interpretation
- Low Vision
- Central Vision 20/70 in best seeing eye with best correction OR
- Total Visual Field loss of 140 degrees
- Mild Vision Loss
- Vision 20/30 to 20/70
- Visual Field <30 degrees
- Moderate Vision Loss
- Vision 20/80 to 20/160
- Severe Vision Loss (legal blindness)
- Vision 20/200 to 20/400
- Visual Field <20 degrees
- Profound Vision Loss
- Vision 20/500 to 20/1000
- Near Total Blindness
- Can detect hand motions
- Light Perception intact
- Total Blindness
- No light Perception
VIII. Evaluation: Indications for eye care specialist referral
- Acute Vision Loss (emergent)
- Uncorrected Vision <20/50 or
- One line difference (on Snellen Chart) between eyes
IX. Management: Vision Enhancing Devices
- See specific conditions
- Magnification Devices for reading
- High powered prismatic spectacles
- Handheld magnifier
- Stand magnifier
- Magnification Devices for more intricate activities
- Telemicroscopes (spectacle-mounted telescopes)
- Telescopes
- Adjunctive Vision devices
- Filters to enhance contrast
- Filters to reduce glare
- Electronic vision Assistive Devices
- Video magnifiers
- Computer voice synthesizers to read text
- Other options
- Large print books
- Audiobooks
X. Prevention
- See Preventive Eye Examination
- Low Vision may be preventable in up to 40-50% with periodic Vision Screening
- See Home Modifications for Vision Impaired Patients
-
General measures
- Tobacco Cessation
- Sunglasses (limit ultraviolet light exposure)
- Control comorbid conditions
XI. Complications
- Major Depression
- Social withdrawal and isolation
- Loss of independence
- Increased Fall Risk
- Hallucinations
- Higher risk of older adults being institutionalized
- Higher risk of medication errrors
- Increased all cause mortality
XII. Resources
- American Council of the Blind
- American Foundation for the Blind
- Jewish Guild for the Blind
- Lighthouse International
- National Federation of the Blind
- Prevent Blindness America
- VisionAWARE
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI) | Reduced ability to perceive visual stimuli. |
| Definition (MSH) | Vision considered to be inferior to normal vision as represented by accepted standards of acuity, field of vision, or motility. Low vision generally refers to visual disorders that are caused by diseases that cannot be corrected by refraction (e.g., MACULAR DEGENERATION; RETINITIS PIGMENTOSA; DIABETIC RETINOPATHY, etc.). |
| Concepts | Disease or Syndrome (T047) |
| MSH | D015354 |
| SnomedCT | 155146008, 193698004, 246635007, 40031005 |
| English | Subnormal Vision, Vision, Low, Vision, Subnormal, Reduced vision, Decreased vision, Poor vision, Vision dim, Vision decreased, Diminished Vision, Vision, Diminished, Reduced Vision, Vision, Reduced, Vision, Low [Disease/Finding], dim vision, Decreased;vision, Poor;vision, dimming vision, Low vision, Low Vision, Darkened vision, Dim vision, Dim vision (disorder), poor; vision, vision; poor, Decreased vision, NOS, Low vision, NOS, decreased vision, poor vision |
| Dutch | gezichtsvermogen verminderd, slecht gezichtsvermogen, gezichtsvermogen zwak, gezichtsvermogen; slecht, slecht; gezichtsvermogen, Gezichtsvermogen, verminderd, Verminderde visus, Visus, verminderde, Visusdaling |
| French | Mauvaise vision, Vision diminuée, Vision obscurcie |
| German | schlecht sehen, Sehvermoegen vermindert, Sehen schwach |
| Italian | Visione ridotta, Vista scarsa, Visione indistinta |
| Portuguese | Visão diminuída, Visão deficiente, Visão obscura, Baixa Visão, Visão Reduzida, Visão Subnormal |
| Spanish | Visión escasa, Visión disminuida, Visión oscurecida, poca visión, visión disminuida, visión débil (trastorno), visión débil, Baja Visión, Visión Reducida, Visión Subnormal |
| Japanese | 視力低下, 視力不良, ｼﾘｮｸﾌﾘｮｳ, ｼﾘｮｸﾃｲｶ, ぼんやりとした視界, ﾎﾞﾝﾔﾘﾄｼﾀｼｶｲ |
| Czech | Slabozrakost, Snížený zrak, Nejasné vidění |
| Swedish | Synnedsättning |
| Polish | Widzenie osłabione |
| Hungarian | Látás, gyenge, Látáscsökkenés, Rossz látás |
| Russian | ЗРЕНИЕ ПОНИЖЕННОЕ |
Ontology: Blind Vision (C0456909)
| Definition (NCI) | The lack of vision. It is caused by neurological or physiological factors. |
| Definition (MSH) | The inability to see or the loss or absence of perception of visual stimuli. This condition may be the result of EYE DISEASES; OPTIC NERVE DISEASES; OPTIC CHIASM diseases; or BRAIN DISEASES affecting the VISUAL PATHWAYS or OCCIPITAL LOBE. |
| Definition (CSP) | inability to see or the loss or absence of perception of visual stimuli; condition may be the result of eye, optic nerve, optic chiasm or brain diseases effecting the visual pathways or occipital lobe. |
| Concepts | Finding (T033) |
| MSH | D001766 , D015354, D014786 |
| SnomedCT | 40031005, 139548004, 277675000, 397540003 |
| LNC | LA17710-7 |
| English | Blindness, BLINDNESS, Cannot see, Loss of vision, Unable to see, UTS - Unable to see, Blind Vision, Blindness [Disease/Finding], blindness, blind, blind vision, Blindness NOS, Blindness (finding), Blind (finding), Blind, Blindness, NOS |
| French | CECITE, Cécité SAI, Aveugle, Déficience de la vision, Déficience visuelle, Cécité, Vision basse, Non-voyance, Vision diminuée, Vision faible, Vision réduite |
| Portuguese | CEGUEIRA, Cegueira NE, Cego, Cegueira |
| Spanish | CEGUERA, Ceguera NEOM, Ciego, ciego, ciego (hallazgo), ceguera (trastorno), ceguera, Ceguera |
| German | BLINDHEIT, Blindheit NNB, blind, Blindheit, Sehverlust, Sehschwäche, Sehvermögen, herabgesetztes, Sehvermögen, vermindertes |
| Dutch | blindheid NAO, blind, Blindheid, laag; visus, blindheid, Amaurose |
| Italian | Cieco, Cecità NAS, Visione ridotta, Ipovisione, Cecità |
| Japanese | 失明ＮＯＳ, ｼﾂﾒｲ, ｼﾂﾒｲNOS, 視覚消失症, 盲, 亜正常視覚, 黒内障, 失明, 低視力, 低視覚, ロービジョン, 視覚-亜正常, 視覚-低 |
| Swedish | Blindhet |
| Czech | slabozrakost, zrak subnormální, slepota, vidění snížené, Nevidomý, Slepota, Nevidomost NOS |
| Finnish | Sokeus, Heikentynyt näkö |
| Russian | AMAVROZ, SLEPOTA, ZRENIE PONIZHENNOE, ZRENIE SUBNORMAL'NOE, SLEPOTA TSENTRAL'NOGO PROISKHOZHDENIIA, АМАВРОЗ, ЗРЕНИЕ СУБНОРМАЛЬНОЕ, СЛЕПОТА, СЛЕПОТА ЦЕНТРАЛЬНОГО ПРОИСХОЖДЕНИЯ |
| Croatian | SLJEPOĆA |
| Polish | Ślepota, Obniżenie jakości widzenia, Wzrok słaby, Wzrok subnormalny, Widzenie obniżone |
| Hungarian | Vakság, Amaurosis k.m.n., Vak |
| Norwegian | Redusert synsevne, Blindhet, Synshemning, Svekket syn, Nedsatt syn, Synssvekkelse, Svakt syn, Synsnedsettelse |
Ontology: Optical low vision aid (C0730385)
| Concepts | Medical Device (T074) |
| SnomedCT | 313024004 |
| English | Optical low vision aid, Optical low vision aid (physical object) |
| Spanish | lentes para visión escasa (objeto físico), lentes para visión escasa |
