The Low vision service at the Singapore National Eye Centre was first set up in the early 2000s; and now has a team of 5 optometrists. These optometrists play an important role in helping patients with visual loss secondary to advanced glaucoma, diabetic retinopathy, inherited ocular disorders, high myopia and age-related macular degeneration. Their cliental age range from young children to octogenarians. The aim of the low-vision optometrist is to help our patients function better at school, at their jobs or daily activities, and improving their overall quality of life.
Hi Kai Ting, what training do you need to be a low-vision optometrist?Low Vision is part of the Optometry School curriculum. Hence, SNEC Optometrists who specialize in Low Vision care would undergo on the job training to complement knowledge gained from Optometry School. Two of our team members went to the University of California, Berkeley and Duke Eye Center, North Carolina for the Health Manpower Development Plan (HMDP) training to gain more insights about setting up low vision services, vision rehabilitation and multidisciplinary low vision care.
What are the sorts of patients do our low vision clinic see?The majority (>80%) of the patients are aged 50 years old and above. The causes of visual impairment can be due to congenital, hereditary or acquired eye conditions with the top 3 being Glaucoma, Age Related Macular Degeneration (AMD) and Diabetic Retinopathy.
What are the common functional issues that low vision people have?A person with low vision has reduced visual acuity, restricted visual field and / or reduced in contrast sensitivity clinically.
Common functional concerns include difficulty in reading, recognizing people, traveling around independently, carrying out daily household chores etc.
Image: normal vision versus low vision
Have there been cases where you felt gratified that you have helped?Yes. I get fulfilment as there are many patients in whom I can actually do something which helps them. One of the most memorable cases was one middle aged woman who had been having ‘counting fingers’ vision for the longest time and was referred to the low vision service for vision rehabilitation. I examined her and discovered that she had very high myopia and she never wore spectacle before. As soon as I put on the trial frame with my refraction results, she whooped in amazement. That was her first time seeing the biggest letter, E on the chart.
Another satisfying case was a 7-year-old girl whose mother reported was struggling with her school work and who disliked attending school. After assessing her vision, I realised that she was having problems with her near vision. Hence, I prescribed her dome magnifier to aid with her reading. When I reviewed the girl again a few weeks later, the mother was delighted that a simple magnifier actually helped her daughter to gain the interest in her school work. Her child now looked forward to attending school!
Image: Dome Magnifier
Are there also cases where you feel there are not much you could do?Unfortunately, yes, there are frustrating cases as well. Some patients are in a denial stage and unable to accept their conditions. These patients tend to reject all form of assistance to help them make good use of their remaining good vision to cope with their daily living.
What do you think is necessary to make our service better?Yes, of course! As the saying goes “There’s always room for improvement”. It is definitely important to make our service better and keep abreast with the latest vision rehabilitation methods. This will greatly benefit our current and future low vision population.
For more information, watch this video on Day in the life of a Low Vision Optometrist:
Internet access required
Sim Kai Ting
Optometry Service, Allied Health Professional Department
Singapore National Eye Centre
EyeSight main page.
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