Visual impairment is included among the
10 most prevalent causes of disability in the
United States (National Eye Institute, 2004),
and occupational therapy is a profession that
specializes in reducing the impact of disabilities
and promoting the highest level of independence
and quality of life in children and adults with
all types of functional limitations. Occupational
therapists and occupational therapy assistants
are experts at analyzing the performance skills
and patterns necessary for people to engage in
their everyday activities and occupations. This
includes providing services to individuals with
low vision or visual impairments for the purpose
of optimizing the individual's performance of
meaningful everyday activities, thus reducing the
impact of the vision impairment. Occupational
therapy practitioners are knowledgeable about
multiple dimensions of disability such as the disease
process, body system function, psychosocial
factors, and comorbidities (for example,
diabetes or neurological disorders like stroke)
that might exist with vision problems. Their training
in activity analysis enables them to provide
screening to detect when functional deficits may
be due to visual dysfunction. They consult and
collaborate with physicians, optometrists, school
personnel, and other health care providers to
meet the needs of their clients and make referrals
as appropriate.
Adults with low vision may have difficulty
using their remaining vision efficiently and effectively
enough to complete needed activities and
may benefit from occupational therapy to enable
appropriate functioning. They experience difficulty
performing many basic activities of daily
living, including grooming, meal preparation,
financial management, driving, and shopping.
Their safety is often at risk: They report difficulty
using knives to chop and slice foods; difficulty
accurately monitoring and identifying medications;
difficulty accurately dialing emergency
telephone numbers such as 911; and difficulty
identifying spoiled foods, dials on stoves, and
water spilled on floors.
Occupational therapy recognizes that certain
activities may be possible for individuals with
low vision when compensatory strategies are
employed. Occupational therapy practitioners
adjust the task or environment for the individual's
particular needs and provide training or assistive
technology to assist the individual in accomplishing
tasks despite limitations created by the vision
loss. Based on the individual's capacity and
the demands of the environment, occupational
therapy practitioners can provide adaptations to
address low vision in the form of lighting; sensory
substitution, including audiotapes and special
talking devices; computer technology; special
writing materials; tactile markings; and other
environmental adaptations.
Occupational therapy for individuals
with low vision may be provided
in any setting, including
schools, skilled nursing or other
extended care facilities, rehabilitation
centers, specialty clinics,
and community based programs. Treatment
initially may be completed within a clinical
setting or educational environment to improve
performance skills, such as use of specialized
viewing techniques, or to try out various optical
and adaptive devices. Therapy is usually completed
in the person's home, community, or
school environment to ensure carryover into
the person's daily activities (AOTA, 2001).
