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Case History: The 3 Questions Rarely Asked

By David L. Armstrong, OD with Richard J. Shuldiner, OD, FAAO

Everyone wants to be able to live a full, independent life with no limits. People with low vision experience the frustration and limitations that come with impaired vision. They expect that their eye doctor will do everything possible to help them see the best that they are capable of. Unfortunately, they often leave the doctor’s office with no hope of seeing better. They know that their doctor is monitoring their eye condition, doing all that is possible to preserve vision and keep it from getting worse, but they may get the impression that the doctor does not understand how the vision loss impacts their life and makes living so much more difficult.

The key to helping a visually impaired person is understanding their daily struggles to function normally. I recommend asking them 3 questions. You may want to add them to your intake form. The patient’s answers will provide an appreciation of what their challenges are and what they would like help with. With that knowledge, you can make a plan to help them.

  • Question #1: How does your vision problem affect your daily activities?
  • Question #2: Has your vision problem caused you to give up any activities that are important to you?

The answers to these two questions will help you understand just how difficult ordinary daily activities have become the patient. You may find that they struggle to read or have given up on reading things that are important to them, like their Bible. They may tell you that they feel unsafe driving or have decided to stop altogether. If they’ve quit driving, they will tell you how depressing it is to be unable to run simple errands on their own. They may be hesitant to ask for help from family or friends who’ve volunteered to drive for them. Some are embarrassed that they can’t recognize a friend who waves to them.

If you provide low vision services in your practice this information will help you know what types of low vision glasses or other devices will be helpful. If you do not provide this service, I recommend that you ask the following question:

  • Question #3: Would you like me to refer you to a doctor who may be able to help you see better?

The patient will appreciate you caring enough to make the referral and you will have provided them with much-needed help. In the event that you are not aware of a low vision doctor, you or the patient should Google “low vision doctors”.

By adding these questions to your case history and/or your patient intake form, you will be surprised how much more your patients will appreciate your caring. In addition, you will be in compliance with the standard of care by referring to vision loss patients for low vision rehabilitation. The video below demonstrates the difference low vision care can make.

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