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Low Vision

The Problem

Low vision occurs when vision is significantly reduced, but has some functionality (as opposed to blindness). Low vision cannot be corrected or improved with glasses, contact lenses or surgery. The main causes of low vision are age-related macular degeneration and glaucoma. Diabetic retinopathy is also becoming an important cause of low vision.

While the causes of low vision are primarily age-related, it also occurs in young people. In middle to high-income countries, low vision is often caused by hereditary or congenital conditions while in low-income countries it may be the result of vitamin A deficiency, measles, cataract and harmful traditional practices. Low vision affects a person’s quality of life in a variety of ways involving visual, functional, psychological, social and economic factors.

Global Impact

Nearly 246 million people in the world have low vision, with 63 percent age 50 or older. Low vision services are accessed by a mere 5 to 10 percent of those with the condition, leaving the majority to face obstacles similar to those who are blind. The disparity is a result of service, client and health professional issues:

  • Service-related barriers: delayed referral of patients, poor coordination and integration of interdisciplinary services and limited promotion of low vision services.
  • Client-related barriers: lack of seeking care because they misunderstand their condition, are unaware of the benefits of low vision services or they have limited mobility or financial means.
  • Professional-related barriers: heavy focus on the medical aspects of their patient’s vision problems causing low referral rate for low vision rehabilitation as part of their normal treatment regimens.

Treatment

Rehabilitation and the use of adaptive devices can help those with low vision use their remaining vision and maintain quality of life. Comprehensive low vision services include clinical rehabilitation services and the use of adaptive technologies. Low vision services are delivered through three main models of care:

  • Primary—vision screening, referral to low vision services, advice on environmental modification and non-optical interventions and use of simple low vision devices conducted at community-based centers.
  • Secondary—diagnosis and treatment, assessment of low vision, refraction, prescription of optical and non-optical devices, training in visual skills and use of devices conducted by ophthalmologist or optometrist.
  • Tertiary—diagnosis and treatment, assessment of low vision, refraction, prescription of high-power and complex optical, non-optical and electronic devices, training in visual skills and use of devices and referral and consultation with other professionals conducted by specialized multidisciplinary low vision care teams.

SightFirst’s Work

While low vision is a new program area for SightFirst, Lions have long been involved in various low vision efforts. The Core 4 Low Vision program, adopted in 1999, awarded 19 grants totaling US$3.2 million. These projects—which included the establishment or expansion of low vision centers—took place in Australia, Dominican Republic, MD300 Taiwan and the United States.

In addition, the Lions/WHO Project for the Elimination of Avoidable Childhood Blindness includes a component to purchase equipment and provide training for low vision services offered at 34 needs-based pediatric Lions eye care centers.

Under the SightFirst program, low vision services are critical to the development of comprehensive eye care systems, and LCIF seeks to strengthen those services. The first low vision grant approved under the SightFirst program will focus on developing a three-tier low vision rehabilitation system in Shenzhen, China.

Funding Priorities

The priorities for low vision projects are:

  • Projects should strengthen secondary and tertiary level eye care institutions with the addition of low vision services for adults and children. This may include provision of equipment and low vision devices, training of personnel, development of outreach and awareness efforts, monitoring and evaluation.
  • Projects may support occasional regional training seminars for specialized low vision services.
  • Projects should expand existing low vision services, especially innovative projects focused on outreach to new populations.

In general, SightFirst projects must focus on the major causes of blindness on national or large regional levels. These projects reach populations who are underserved or who have limited or no access to eye health care services. The program funds high-quality, sustainable projects that deliver eye care services, develop infrastructure, train personnel and/or provide rehabilitation and education in underserved communities.

 

Find more information, including the SightFirst grant application, disease-specific questionnaires and long-range policy papers.

To learn more about the low vision statistics found on this page, please visit the following:
World Health Organization: Prevention of Blindness and Visual Impairment
Centre for Eye Research Australia: Focus on Low Vision

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