Vision rehabilitation services for low vision therapy

What is low vision rehabilitation? 

Low vision rehabilitation includes a specialized eye exam, therapy, training and other services that help people who have low vision. Specialists teach them skills to help them maintain their quality of life and have greater independence. They can also teach them to use optical assistive devices. 

If you have low vision, it means your vision cannot be fully corrected with glasses or contacts. But those with low vision are not necessarily considered blind — their vision can sometimes be improved with a variety of visual aids. 

Low vision can consist of central or peripheral vision loss. It can also include general blurry vision or trouble seeing at night. Sometimes low vision is due to issues with glare or reduced ability to see contrast. It may also be due to a reduced visual field. Low vision rehabilitation can give people ways to cope with low vision and make the most of their remaining vision. 

What to expect during low vision therapy and training 

Low vision rehabilitation will not be able to improve your measured visual acuity. However, the therapy and training skills you learn will greatly improve your quality of life and help you to have more independence. 

In addition to eye doctors who specialize in low vision rehabilitation, there are three types of trained specialists who work with people who have low vision:

• Low vision therapists

• Vision rehabilitation therapists

• Orientation and mobility specialists

Each specialist provides different services and training, depending on your needs and goals. 

Initial evaluation and assessment

Most low vision evaluations begin by seeing an eye doctor who has specialty training in vision rehabilitation. This doctor will perform a functional assessment of your vision. It will tell them how much or how little you are able to use your vision for everyday functioning. This type of exam includes tests that are not usually part of routine eye exams, such as:

• Visual acuity testing using a specialized chart

• Contrast sensitivity testing

• Glare assessment

• Depth perception

• Color vision testing

• Trial frame refraction

The eye doctor will make recommendations to your therapist(s) based on the results of these tests. They may also recommend that you have a comprehensive eye exam. This kind of exam assesses the overall health of your eyes.

LEARN MORE about low vision eye exams

After your vision assessment, you'll meet with a specialist to discuss therapy options. They will ask you about your day-to-day activities, vision goals and other needs. These details, combined with the vision assessment, let them determine the best therapy program for your specific case.

Training sessions

Training sessions with your therapists will be about one to two hours long. You can expect to have sessions twice a week for about six weeks. The therapists will teach you a variety of skills and techniques to help you achieve your vision goals. These skills often include computer use as well as independent living skills, such as: 

• Self-care techniques, including ways to apply make-up and tips for shaving.

• Techniques to help sort laundry, measure laundry detergent and iron your clothes.

• Ways to find recreational activities that can be adapted for people with low vision.

• Tips for traveling and moving about indoors in a safe way.

Vocational rehabilitation may be provided if you are working or plan on looking for a job. This can include assessments to test your skills for employment. It may also include help with job training, changing jobs and finding jobs. 

Your therapists may also recommend adjustment counseling. This type of counseling can provide guidance for both you and your family members. Counseling sessions may be one on one or in a group setting.

Vision rehabilitation therapists (VRT)

Vision rehabilitation therapists (VRTs) work with people who have low vision or are blind to be more self-sufficient. They are often the first type of therapist people work with during low vision rehabilitation. 

VRTs use occupational therapy tactics to teach people adaptive independent living skills. These skills fall under a variety of categories.

• Communication skills – These skills include learning how to read Braille and utilizing large print. VRTs can also help with handwriting and with using other assistive communication technology. 

• Personal management – VRTs can teach different grooming techniques. Recommendations may also include the development of organizational systems for labeling medication and clothes. This allows for easier identification.

• Home management – Tips and skills for the home can include alphabetizing spices and putting a pot on the stove before turning it on. VRTs can also teach skills for easier record keeping, budgeting and how to keep your home safe.

• Time management – These skills include telling time and how to keep track of appointments. They also include ways to organize phone numbers and addresses.

• Recreation – VRTs can assist in helping you to still enjoy your favorite activities. These can include everything from card games and crossword puzzles to a variety of recreational sports. 

Depending on your degree of vision loss, modifications to your environment may be necessary. Your VRT can help determine the best ways to modify your home for daily tasks. They will focus on four main areas:

• Your need for more lighting or brighter lights.

• Your level of contrast sensitivity. 

• Your level of issues with glare. 

• Your ability to distinguish objects from their backgrounds. 

VRTs help people in many places, like hospitals, schools, nursing homes and rehabilitation centers. They even work in people’s homes. 

To become a vision rehabilitation therapist, you must have at least a bachelor’s degree. Some employers also require a master’s degree or a certificate from a university program. 

To become a certified vision rehabilitation therapist (CVRT), you need to pass the Certified Vision Rehabilitation Therapist exam. It is administered by the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP). 

Orientation and mobility (O&M) specialists

Orientation and mobility (O&M) specialists assist people who are blind or who have low vision in safely moving about inside and outside their homes. 

O&M specialists work with people of all ages, from infants to older adults. They teach people a variety of techniques, such as:

• How to use your other senses to help determine location.

• How to use a support cane or a probing cane.

• How to safely cross the street. 

• How to use landmarks to help with directions.

• How to walk with a guide.

• How to use public transportation.

• How to figure out where you are if you become lost. 

Orientation and mobility training is one of the required steps before a person can get a guide dog. These canines can be very helpful mobility aids for people with low vision. They are trained to help their owners travel and move about safely. Many states offer free guide dog programs and services that provide mobility assistance. 

O&M specialists work as a team with low vision doctors and other therapists to monitor your progress. They typically meet with people one on one within the community and at rehabilitation centers. They also work in nursing homes, schools and hospitals. 

To become an orientation and mobility specialist, you must have a bachelor’s degree and be certified in O&M. In some cases, a master’s degree is also required. You need to pass the Certified Orientation and Mobility Specialist exam to become certified. This exam is also administered by the ACVREP. 

Low vision therapists (LVT)

Low vision therapists (LVTs) focus on helping people utilize their remaining vision. Their main task is to determine the best devices for people with low vision and teach them how to use them. LVTs take the following visual challenges into consideration when recommending different devices:

• How much magnification you need to see more clearly. 

• If you might need different types of lighting to brighten a room or do specific tasks.

• Whether you are affected by glare.

Your LVT will help you find the best low vision devices for your specific needs and goals. Low vision devices can be optical or non-optical. They are useful for activities like reading and using a computer and even for household tasks. 

Optical devices include:

• Spectacle-mounted magnifiers – These are also known as microscopes. They are magnifying lenses that can be attached to a pair of glasses or a visor-like headband. They make close-up objects look bigger.

• Spectacle-mounted telescopes – A small telescope is attached to each lens on a pair of eyeglasses. These are useful for seeing things that are far away, but they can also be used for seeing close up. 

• Handheld telescopes – These telescopes can be used for looking at something in the distance as well as close up. 

• Handheld magnifiers – These magnifiers help with reading small amounts of text, such as menus or price tags. They can also have a built-in light. 

• Stand magnifiers – These magnifiers are useful for when you will be reading for a longer period of time, as you do not need to hold them. They can also have a built-in light. 

• Electronic video magnifying systems – These are also called closed-circuit television (CCTV) systems. These systems project a magnified image through a video camera onto a monitor.

READ MORE about low vision magnification devices

There are also a variety of non-optical devices that can be very helpful. They include:

• Reading stands to prop up books. 

• Adjustable lighting like a flexible-arm lamp.

• Colored acetate sheets, which can help with contrast while reading. 

• Locator dots that adhere to items to help feel for things like the setting on a dial.

• Typoscopes, which help with focusing on one line on a page at a time.

• Assistive technology for computers and smartphones, including screen readers and enlargement software programs. 

Low vision therapists can also show people how to use helpful smartphone and computer applications. They can also make suggestions for environmental modifications. 

LVTs often work in tandem with the patient’s optometrist or ophthalmologist through an eye care clinic. They may go to a person’s home or work at a rehabilitation center. They may also work at a hospital, a home for the visually impaired or a school. 

To become a certified low vision therapist (CLVT), you must have a bachelor’s degree. You must also pass the CLVT exam that is given by the Academy for Certification of Vision and Education Professionals. 

Cost of low vision rehabilitation services

Each state is different in what they consider enough vision loss to be eligible for government assistance. Depending on eligibility, you can get certain devices and services for free from state or non-profit organizations. 

Others may be billed to Medicare or other health insurance. However, it is possible that you may need to pay for some devices or services out of pocket. 

Talk to your eye doctor about how much these devices and services cost in your area. They may also be able to point you toward other resources for the visually impaired. If they don't specialize in low vision, you can also ask them to refer you to a low vision eye doctor.

Page published on Wednesday, September 27, 2023

Page updated on Tuesday, October 3, 2023

Medically reviewed on Wednesday, September 13, 2023