Low Vision: What it is and How You Can Function with the Right Treatment Plan

Service members are often exposed to a variety of hazards in combat, training, or daily activities—on and off duty—including situations that may affect their vision. This can be caused by eye injuries and disease, leading to vision impairments and blindness.

According to U.S. Navy Capt. Todd Lauby, branch chief for the Defense Health Agency’s Vision Center of Excellence, one of VCE’s primary goals is to focus on optimizing vision-related medical readiness of service members.

“Catching eye diseases and vision disorders early through periodic visits to an optometrist would bolster readiness by maximizing the visual performance of warfighters,” said Lauby. “Many eye diseases and injuries such as glaucoma, cataracts, keratoconus, and ocular trauma can be treated with medicines and/or surgery to prevent further vision loss so that service members can remain on active duty,” he said.

Lauby added that service members who have certain eye conditions are able to remain on active duty, depending on several factors. “If the disease or injury can be surgically corrected, or vision can be restored with medically indicated specialty contact lenses or glasses, they may remain on active duty. We also must consider how much vision loss has occurred, and what the vision standards are for their occupation. If there are no vision standards for their job, we must think about whether they’re still able to perform their duties,” Lauby explained.

Some eye diseases like glaucoma and macular degeneration, and injuries to the eye can cause a condition called low vision. A person with low vision has a reduction in visual function while retaining some vision.

“Being legally blind, or having permanent vision loss, is when your vision is not correctable by traditional eyeglasses, contact lenses, or refractive surgery, such as LASIK—laser eye surgery or laser vision correction. It is irreversible, explained Dr. Sally Dang, an optometrist who specializes in low vision work for VCE.

She added that you don’t have to be legally blind to have functional vision challenges.

“Sometimes, having low vision means you are still able to physically do things, but you just can’t see well enough without assistance,” said Dang.

William Boules, section lead of rehabilitation and reintegration for VCE, said low vision often impacts the ability to complete daily tasks—such as reading, shopping, cooking, writing, or have difficulty recognizing faces.

According to Dang, levels of low vision can be mild, moderate, and severe.

“The more severe the vision loss, the more adaptive technology is needed. This is where VCE and the Department of Veterans Affairs really capitalize on having resources,” said Dang.

Resources for Low Vision and Blindness

The DHA and the Veteran’s Health Administration provide a number of services and resources to service members and veterans with low vision and blindness.

“The VCE provides information to people who need it,” said Boules. “There are articles and videos on the website for those who want to know more about living with low vision or blindness.”

These vision care resources include ways to connect to providers, low vision eye exams, facilities, eligibility, and TRICARE benefit information.

Boules said service members with low vision can be referred to the VCE or VA to access resources, rehabilitation, or adaptive technologies.

Treatment Goals Important to Rehabilitation

A rehabilitation program will usually revolve around individual goals set by patients and providers.

“A treatment plan, or plan of care, is most successful when there is a specified goal,” said Dang. “For example, when the patient says they want to walk, they want to see better while walking or being able to catch a bus. Then we focus on orientation and mobility, and/or seeing eye dog training.”

“It’s important to adapt the rehab to their goals,” she added.

Vision rehabilitation is often provided by occupational therapists, certified low vision therapists, and orientation and mobility instructors.

Adaptive Technologies Help Visually Impaired Navigate Life

Adaptive technologies can be used to aid in vision impairments caused by a disability, including blindness. These technologies are generally designed to help improve the functional capability of a person with disabilities and can be used to improve their awareness of one’s surroundings, functioning, or independence.

Forms of adaptive technologies used by individuals with vision loss and visual dysfunctions include:

• Screen readers and other stand-alone reading machines used to detect and read aloud text from a computer or document
• Voice-to-text software that converts a person’s speech into text on a computer or device
• Keyboards with enlarged characters or braille on each key
• Mobile applications for a smart phone or tablet, such as GPS/navigation, book readers, dictation, money readers, and home-assistive devices such as thermostats
• Wearable devices such as spectacle-mounted technology
• Implanted devices such as the Argus II retinal prosthesis system
• E-readers with large-sized fonts

If a service member or veteran wants to learn more about accessing services or resources through the VCE or VA, they may speak with their vision care services coordinator or VA liaison, said Boules.

As one of several centers of excellence within the DHA, the VCE leads and advocates for programs and initiatives with the interrelated goals of improving vision health, optimizing readiness, and enhancing the quality of life for service members and veterans. VCE promotes collaboration, facilitates integration, and serves as an advocate for vision across the Department of Defense and Department of Veterans Affairs health care systems. VCE also collaborates with other federal health care organizations, academia, and private sector organizations.

“We help people learn how to use their functional vision,” said Boules. “We help people learn how to live independently and successfully.”