Yale Medicine-Ophthalmology

‘We teach patients to see all over again’

If you’re curious what it’s like to read a book one word at a time, pay a visit to the Lions Low Vision Center at Yale.

I was and I did. With one end of a high-powered magnifier pressed against my eye, I placed the other end against a copy of A Tale of Two Cities then slowly moved the page sideways.

It. Was. The. Best. Of. Times.

It. Was. The. Worst. Of. Times.

Finding my visual sphere reduced to a circle of glass, I became impatient and soon gave up. I wondered how long it would take to read several hundred pages by grasping a word, instead of a sentence, at a time.

Others, out of necessity, are more patient. In fact, with time and support most people with visual impairment can regain a high degree of function, says David Parke, M.D., associate clinical professor of ophthalmology and a consultant in the low-vision clinic. “Many people with near-blindness live alone and are independent. You’d be surprised at how innovative people can be when they’re motivated.”

The center’s staff trains people with impaired vision to use their remaining visual abilities to the fullest with magnification, glare control, proper lighting and special reading techniques. Telescopic devices, fitted to a pair of glasses, expand the field of vision, enabling a person whose peripheral vision has been lost to walk through a doorway without hitting the doorjamb or to shop for groceries without jostling people in the aisles.

Monocular telescopes, small enough to carry in a pocket or purse, help people with limited vision to spot a bus, read the writing on signs in a supermarket or watch television. Low-power magnifying glasses, used by people with moderately low vision, encompass a column of newsprint. Closed-circuit television units magnify print, pictures and maps up to 60 times their original size and can be equipped with voice output. The Lions Clubs subsidize the cost ofvisual aids for people living on small incomes.

Time is needed for the brain to process the limited information it receives from impaired eyes. It perceives the world in an entirely new way. The compensatory skills the patient must acquire are improved only by diligent, systematic practice, according to Dr. Parke. “Learning to realign their eyes correctly to avoid blind spots and to use subtle visual clues represents a new talent. We teach patients to see all over again.”

In addition to evaluation at the Yale center, occupational therapists visit patients’ homes and suggestimprovements, like better lighting, to meet their needs. Mobility experts teach patients to move about with limited vision, and social workers refer them to other supportive agencies.

“Patients need to know that there will not be a return to the quality of vision they once enjoyed,” Dr. Parke says, “but they must be encouraged to believe that their visual performance can be measurably improved.”

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