2 low vision-focused O.D.s share just how they establish visual goals with patients for a better outcome
What do low vision patients want? To see as well as they did before.
Though that’s not possible, their desire underscores the critical importance of establishing visual goals with them.
How to do that is exactly what we asked two low vision practitioners: Janelle Brown, O.D., who practices at Pontiac Family Eye Care in Pontiac, IL, and Tom Porter, O.D., director of Low Vision Services at the Saint Louis University School of Medicine’s Department of Ophthalmology.
Here’s a look, step by step, at how they set and act upon visual goals with patients.
Contact. “We begin the process with the initial phone contact,” explains Dr. Porter. “I developed a script to prequalify patients and want them to understand specific visual goals. I request that each patient come up with specific things they want to do that they are currently unable to accomplish.”
Call. “A tech calls the patient the night before to confirm the appointment,” he adds. “They go over the things I mentioned above, and we again remind them of the visual goals.”
IN THE EXAM
Focus. “A successful low vision exam is, in fact, centered around the patient’s goals and needs,” says Dr. Brown.
Repeat. She adds, “We ask them about goals. Then, throughout the exam, I use their own exact wording, when possible, to advise them how devices can be used.”
Testing. “Techs work up patients with basic, preliminary testing,” explains Dr. Porter. “The visual goals are reviewed, and each goal is written on a 3-by-5 card. Then the patient is asked to pick which goal would be most important, and so on down the line.”
Review. “This means that when I meet the patient,” continues Dr. Porter, “I already know the level of vision, what the goals are, and which devices they have tried in the past.”
Considerations. “I break down visual goals by the duration of the task,” explains Dr. Porter. “Reading a menu versus a book, for example. I further consider the working distance of the task. Finally, whether the patient has any physical issues that would influence the best device.”
Transition. “Let’s say the patient has three goals, and reading the mail is the primary one,” explains Dr. Porter. “When we make a determination, I set the device on top of the 3-by-5 card and move on to goal No. 2, etc. When I finish, the aids are lined up in order of priority and my tech then comes in and works with the patient on the devices.”
Conclusion. “Discuss vision frustrations, expectations, and limitations in the present, and anticipate future needs,” stresses Dr. Brown. “Patients will cope better if they know what challenges may present in the near future.”