What is Vision Rehabilitation and Who are the Professionals?

After or in conjunction with treatment by the optometrist or ophthalmologist, there is more help available that is of the most practical kind.

Vision Rehabilitation refers to the services that restore independence after vision loss.  It does not mean that the vision itself is rehabilitated, but rather the person with vision loss receives the services and training that bring independence and maintain quality of life.  People who are blind receive these services as well as those who have some usable vision — which most people do.

Vision Rehabilitation services are provided by several different specialized professionals.  It takes a team of professionals with their specialized knowledge and the support of family and peers to help most people with vision loss regain their sense of self and the skills needed to live independently.

Who Are The Vision Rehabilitation Professionals?

A more accurate description of these professionals would be to say they are experts on blindness.  They know what the appropriate response should be when vision loss occurs.

These professionals have post-graduate degrees in vision rehabilitation and must complete an intensive internship.  National certification is available but not all choose to go through the certification process.

• Vision Rehabilitation Therapist (VRT)/Certified Vision Rehabilitation Therapist (CVRT)

• Low Vision Therapist (LVT)/Certified Low Vision Therapist (CLVT)

• Orientation and Mobility Specialist (OMS)/Certified Orientation and Mobility Specialist (COMS)

The Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) offers certification.

All three professions have knowledge of:

1. Medical Aspects of Vision Loss

• Basic anatomy of the eye.
• Functional implications caused by different eye diseases and disorders.
• Medical, surgical, and optical treatments.
• Assessment of whether visual, non-visual or a combination of strategies is needed to achieve the goals for independence.

2. Psychosocial Implications of Vision Loss

• Stages of adjustment to vision loss and strategies needed to assist people with vision loss (either from birth or later in life) and their families.
• Positive self-advocacy techniques.

3. Teaching and Learning Strategies

• How to perform a functional assessment and design and implement a sequential training program appropriate to the age, abilities, and goals of the person with vision loss.
• Ways to adapt the instructional process when the person has additional physical or health issues such as hearing loss, deaf-blindness, cognitive impairment, age-related issues, etc.
• When to use interdisciplinary teamwork and case management practices: the vision rehabilitation professionals will refer to other health professionals as needed to ensure holistic treatment for their client.

For a complete description of each please refer to ACVREP.

Low Vision Therapist

A Low Vision Therapist performs a functional vision assessment to assess acuity, visual fields, contrast sensitivity, and visual perceptual and visual motor functioning.

• Instructs how to make the most efficient use of residual vision, based on the results of the function vision assessment.
• Teaches an individual how to use their optical devices, adaptive technology, and other special equipment and how to integrate them into their daily activities.
• Instructs an individual to use techniques for all activities of daily living: reading, cooking, organizing, cleaning and grooming with appropriate adaptations.
• Helps determine the need for modifications in the environment (home, work, or school).

When the person’s visual ability is severely compromised, a Low Vision Therapist will refer to a Vision Rehabilitation Therapist for additional services.

Vision Rehabilitation Therapist

A Vision Rehabilitation Therapist’s expertise encompasses that of the Low Vision Therapist with the addition of special skills and knowledge, such as braille to teach adaptive independent living skills to people with no useable vision.

Orientation and Mobility Specialist

Teaches a person with vision loss how to travel independently both indoors and outdoors. Training is one-on-one. It usually, but not always includes instruction on how to use a white cane (called a “mobility cane”).

• Training teaches how to focus on and interpret sensory information in the environment (for example, the slope of a sidewalk, sound of a traffic surge, the smell of a nearby cafeteria) to assist in maintaining orientation as they travel to their destination.
• Any residual vision is incorporated in to safe travel techniques and strategies as well as use of optical devices and a variety of technological devices designed to facilitate safe and efficient travel.

Optometrists, Ophthalmologists and Low Vision Specialists

Optometrist (Doctor of Optometry O.D.)

Optometrists are the first line of detection and defense for eye diseases and disorders.  They conduct eye examinations, diagnose eye diseases and disorders, and prescribe corrective lenses.  They will often see additional training to become specialists in a specific area such as neuro-optometry or geriatric eye care.

Ophthalmologist (Doctor of Medicine, M.D., or Doctor of Osteopathy, D.O.)

Ophthalmologists are physicians who specialize in the medical and surgical care of the eyes.  They can provide the full range of care from prescribing glasses to performing surgery.  Often they will specialize in a specific area of eye medicine and become, for example, a retinal specialist.

Low Vision Specialist

Both optometrists and ophthalmologists may choose to specialize in the unique needs of low vision patients.  Low Vision Therapists are often found working closely with Low Vision Specialists.