 | William L. Park, OD, FAAO is in private practice in Wichita, KS. He works exclusively with patients referred for low vision evaluation, low vision rehabilitation and neurological vision loss. He is a past Director of Low Vision Services, Lions Research & Rehabilitation Center, Wilmer Eye Institute-Johns Hopkins University. Dr. Park can be reached at William L. Park, OD, LLC, www.parklowvision.com, 610 N. Main, Suite 201, Wichita, KS 67203, (316) 440-1690 or drpark@parklowvision.com. |
Vision
2011-04-01 13:55:00
Vison loss
Question: I have experienced a sudden decrease in my vision due to a recent stroke. I have also had difficulty with my vision for the last year as a result of diabetes and am concerned about my safety. What can I do?
Answer: Vision impairment and blindness are among the 10 most common causes of disability in the United States. The incidence rates of stroke, cognitive impairments and other neurologic disorders increase sharply with age. The risk of stroke more than doubles for every decade after age 55. Thirty percent of all patients who have experienced a stroke have visual field deficits.
Unless vision loss among patients with stroke is addressed through rehabilitation, their participation in activities of daily living may be reduced, while their risk for more long-term and severe disability increases.
People who have vision impairments are twice as likely to have a fall in comparison to those persons who are not visually impaired. Falls are also a common reason for hospital admissions for trauma and account for 90 percent of fractures.
Diabetes is a progressive disease with systemic risks that include increased risk of falls likely due to decreased vision, impaired contrast sensitivity (the ability to see a low contrast object, i.e. facial recognition, walking down stairs), delayed adaptation to changes in illumination, possible impaired range of motion, weakness of extremities and peripheral neuropathy—all of which may result in serious injury and prolonged healing.
I have been following a diabetic patient’s rehabilitative course for two months. She has been in a boot for one year to assist in healing from a fracture and prevent further injury. During this time, she has gained 80 pounds due to her lack of mobility and inability to perform many daily tasks that we take for granted. For her, this has resulted in reduced physical functioning and impaired activities of daily living (ADLs), instrumental activities of daily living (IADLs) and safety in moving around in the environment.
Affected ADLs include dressing, bathing, eating, transferring and toileting. Affected IADLs include more complex, but essential, daily tasks such as preparing meals, taking medications, using the telephone, self-health monitoring, using devices such as glucometers and administering wound care.
In this case, rehabilitative care involves working with her optometrist and/or ophthalmologist. In my practice, it also involves referral to occupational therapy, physical therapy, orientation and mobility, behavioral health, various ophthalmic personnel and a patient coordinator to ensure all mutual goals for a productive life, overall well being and safety concerns are addressed.
If you are experiencing a loss of vision due to stroke or diabetes, ask your doctor for referral to low vision rehabilitation professionals to improve your personal safety and maintain your independence. Good luck and best wishes.
