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20 November 2023Low vision is characterized by vision that due to pathological conditions is inadequate, limited or blurred even with conventional-simple glasses or contact lenses. We could describe as low vision the set of vision problems that are not amenable to surgery and are not treated with medication.
A person has normal vision when his visual acuity is 10/10, and his field of vision for each eye separately is about 160 degrees horizontally and 135 degrees vertically.
People with low vision due to a condition and not due to a refractive abnormality (eg myopia, hyperopia, astigmatism) have blurred vision, visual acuity lower than 4/10 or loss of peripheral vision, and their field of vision is less than 20 degrees.
Low vision can be:
- Hereditary
(Stargardt’s disease, retinitis pigmentosa, cone dystrophy, Leber amaurosis, albinism, glaucoma) - Congenital
(nystagmus, retinopathy of prematurity) - Acquired
(macular degeneration, diabetic retinopathy, cataracts, ocular toxoplasmosis, thyroid retinopathy)
Low vision can also lead to:
- An injury
- Multiple sclerosis
- Brain tumor
- Stroke
- Monitoring the solar eclipse without the use of protective glasses
- Welding without a protective mask
- Side effects from medication
According to the World Health Organization (WHO), people with impaired vision reach 246 million of whom about 65% are over the age of 50. The number of patients with low vision will likely have doubled by 2030 as average life expectancy increases.
The main cause of significant impairment of vision is macular degeneration. About 50% of people with impaired vision have macular degeneration, a retinal disease that sometimes progressively and sometimes suddenly destroys the central vision that is necessary to see clearly in detail and colors.
Types of low vision:
- Loss of central vision
(macular degeneration, diabetic retinopathy, myopic maculopathy, central retinal artery occlusion, central vein occlusion, Stargardt’s disease, cone dystrophy) - Loss of peripheral vision in both glaucoma and retinitis pigmentosa, peripheral vision is limited and the visual field is reduced, creating in many cases tubular vision and difficulty in orientation.
- Noctalopia
Permanent decreased visual performance in low light and at night.
Vision loss is chronic and most often affects middle-aged and old people (81%) and more rarely young people and children. People with low vision are unable or have great difficulty performing daily activities such as driving, reading, walking, recognizing facial features, watching TV or the whiteboard in the classroom.
Can low vision be prevented?
In 85% of cases it is preventable. When vision loss is not sudden it is possible to prevent it in the following ways:
- Annual check-up by the Optometrist specialized in low vision
- Systematic use of sunglasses protecting from the sun and harmful ultraviolet radiation
- Protection of the eyes from the destructive blue radiation emitted by mobile phones, the computer screen and the TV, with special computer glasses
- Balanced diet and consumption of fruits, vegetables and foods rich in antioxidants. Limiting the intake of fatty and processed foods as well as sugar
- Quitting smoking
How low vision affects the mental and physical health of the patient?
Low vision can push the patient to de-socialize and often even to isolation. It can contribute to both the creation and faster progression of psychic and mental illnesses. Daily and necessary activities such as reading books and newspapers, working, walking, cooking, caring for other people, but also occupations that act as a source of joy, fun, rest and temporary removal from reality due to impaired vision, are not enjoyed. Abstinence leads to depression and isolation.
Apart from psychic and mental illnesses, low vision often becomes a cause of falls and accidents as vision is primary for maintaining balance. In recent years, at the same time as the rapid increase in cases of macular degeneration, fractures have doubled. Glaucoma, cataracts and macular degeneration make it difficult for the patient to perceive space, calculate distances and size, as well as orientation. Vision is absolutely necessary to maintain quality of life and independence.
Who is the specialist in low vision?
The advanced and innovative Low Vision Rehabilitation Center has been operating since 1996 and is directed by Ms. Tatiana Skoutari, MSc in Low Vision Optometrist, assistant professor at the University of Complutense Madrid specializing in low vision. Ms. Skoutari is one of the few Optometrists in the world with a university specialization in the field of low vision and unique in Europe.
Ms. Skoutari evaluates the remaining vision and trains daily people with impaired vision from Greece and abroad.
How can people with low vision be helped?
In 85%-90% of cases with low vision, vision reduction could not only be avoided, but on the contrary, visual acuity could be improved by using special glasses made in America by the company that manufactures NASA’s optical media.
Patients with low vision need low vision aids for short distances to carry out their daily tasks, as well as low vision aids for long distances. Both the detailed low vision exam that will lead to the selection of the most appropriate aid for the needs of the patient, as well as the training in the use of low vision aids is done in Greece exclusively by the special Optometrist Mrs. Tatiana Skoutari.