By Rebecca Salowe
Scheie Vision Annual Report 2019
This past year, the Scheie Eye Institute hosted community screenings for low vision, which provided eligible patients with low vision devices to take home.
Low vision refers to any significant vision loss that cannot be corrected with existing treatments. This condition affects more than five million Americans, and is increasing in prevalence with the aging population.
Even with correction from glasses or contact lens, low vision patients may still find everyday tasks such as reading the mail, writing, or cooking difficult to complete. As a result, low vision has been associated with impaired quality of life, depression, loss of independence, barriers to employment opportunities, decreased mobility, falls, and general life dissatisfaction.
Low vision devices, such as magnifiers, allow patients to use their existing vision to live as independently as possible. Studies show significant improvements in perceived near tasks, social functioning, reading ability, and quality of life when patients use these devices.
However, many patients with low vision have difficulty obtaining these devices. “Access and insurance issues are big barriers,” said Ranjoo Prasad, OD
, a low vision optometrist and Director of the Penn Center for Low Vision Rehabilitation. “Transportation and knowledge of services are big obstacles too.” In fact, Medicare and most insurance plans do not reimburse for low vision devices.
Recognizing this need, the Department applied for and received a generous grant from the UPenn Hospital Board of Women Visitors in 2018. The requested funds were used to purchase a number of low vision devices to distribute to eligible patients at community screenings.
The screenings were organized by Dr. Prasad and Marquis Vaughn, Community Outreach Coordinator. The first event, conducted in October 2018 at Robert Vaux Junior High School, provided patients with more basic aids (i.e. no prescription required) as part of a glaucoma screening. The second event, which took place in February 2019 at Pleasant Grove Baptist Church, was focused entirely on low vision and provided training on more complex devices.
At this event, interested community members were first asked to fill out a screening form. The goal of this form was to assess functional vision and to identify other areas of difficulty. “For example, we asked the patients questions about if they had trouble paying bills, bumping into things, seeing up close, and more,” said Marquis.
The form also included questions about mental health, as well as practical issues such as housing and insurance. “The questions about mental health and housing are pertinent,” said Dr. Prasad. “When someone loses their vision, they experience grief. We also want to make sure they are safe in their homes.” Patients who reported struggles or requested help in these areas were directed to the appropriate resources.
After completing the form, each patient received an eye screening with Dr. Prasad. Patients with signs of another disease, such as glaucoma, were referred to the appropriate specialist at Scheie. “For example, we detected signs of glaucoma in a young lady in her late 30s,” recalled Marquis. “She happened to come to the event with her sister, who heard about it from a flyer. We made sure that she attended her scheduled appointment at Scheie with the glaucoma specialist and stayed in touch with her.”
For the patients identified as having low vision, the final stage of the screening involved training on suitable devices. Dr. Prasad worked closely with each low vision patient to determine the device(s) that best fit his or her needs. “We did not want to just give devices away,” explained Dr. Prasad. “We needed to assess their needs and acuity, and prescribe them something appropriate.”
Most patients received stand magnifiers, which provide 360-rotation and magnification of large areas of text, and/or LED handheld magnifiers. In addition, patients were prescribed reading glasses and lubricant eye drops if symptomatic for dry eyes.
“The patients were very excited and could not believe that we were actually giving these devices to them,” said Marquis. “A lot of patients immediately tried them on books, papers, or anything they had on them.”
Low vision patients were typically scheduled for a follow-up visit at the Penn Center for Low Vision Rehabilitation at the Ralston House. In addition, these patients were invited to join the monthly Vision Loss Support Group, which provides open discussions, information on relevant resources, and emotional support to low vision patients.
At one of the events, patients also received free blood pressure screenings from a team sent by the Penn Presbyterian Outreach Council. Dr. Prasad and Marquis hope to include more external groups that offer non-eye related services at future events. “It’s great to have collaborative events so patients can gain access to multiple resources,” said Marquis. “It also helps more people become aware of the event.”
The team also encouraged attendance by making the screenings into social gatherings with food and entertainment. They even invited local government leaders, with Councilwoman Jannie Blackwell attending one of the screenings to provide her support.
In the week following the low vision screening, each patient was contacted about the next steps listed in his or her chart, whether it be scheduling a specialist appointment, attending the Vision Loss Support Group, or connecting with another resource. Marquis reviewed the individual plan with each patient and offered assistance with follow-up. “This truly tells us the success of the screening,” said Dr. Prasad. “Vision care must involve a comprehensive team to positively impact our patients.”
The next low vision screening event is planned for early 2020.