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Low Vision Center helps patients lead more active, independent lives

For Jeff Bohman, the difference in his life seems like night and day.

An autoimmune disorder called Sjögren’s syndrome was causing Bohman’s vision to worsen, and the change made him feel isolated. But now, months after visiting the University of Minnesota’s Low Vision Center, he finds he can once again do many of the things he’s always enjoyed.

Occupational therapist Mary Ruff teaches Joan Dombowski how ot read the newspaper using a big-screen viewing aid at the University of Minnesota's Low Vision Center.

“It’s hard to have dreams and make plans when your eyesight keeps getting worse,” says Bohman, who is 39 years old. “Visiting this center opened up a whole new world for me.”

Dave Oxley’s experience at the center was similarly helpful. By providing him with subtle lighting changes, a wide spectrum of colored lenses, and a variety of other helpful tools, the Low Vision Center has made daily tasks easier.

An IT manager at a large law firm, Oxley, age 39, was diagnosed with a rare genetic condition called cone dystrophy eight years ago. Cone dystrophy is characterized by deteriorating central vision and a deteriorating perception of color. Oxley needs high contrast to see his computer at work or to read for pleasure at home, and he requires many pairs of glasses for different settings and conditions.

“The coping strategies I’d developed on my own weren’t working any more, which is why I went to the Low Vision Center,” Oxley says. “We found out that my eyes are very sensitive to certain spectrums of light, so bright lights and bright sunlight can make me very uncomfortable.

“People often think that working with low vision is all about size, but getting the right color mix is what made a big difference to me. Once your vision starts to get worse, you no longer have a very good idea of what normal vision is. But when things are put under lights and you’re given the help you need, you can remember again.”

Tailored treatment

Located inside the ophthalmology clinic in the University of Minnesota’s Phillips-Wangensteen Building, the Low Vision Center provides services to patients who have decreased vision that cannot be corrected with ordinary glasses or with medical or surgical procedures.

Mary Ruff is the center’s occupational therapist. Her job, she explains, is to help patients with “the occupation of life,” which means helping them find ways to modify the things they do in their everyday lives. “Identifying resources can be a huge barrier for people, particularly when they have compromised vision in the first place,” Ruff says. “We can help with that.”

Working under the direction of a physician, Ruff collaborates with a team of people who specialize in low vision, including medical director Mary Lawrence, M.D., M.P.H., and three specially trained ophthalmic technicians. Lawrence works with referring physicians to enhance patient care.

Daily tasks such as paying the bills can be difficult for people with compromised vision. Here, occupational therapist Mary Ruff helps Joan Dombrowski with large-print checks and a large-print check register.

After her colleagues measure a patient’s eyesight and determine if a new prescription for his or her eyeglasses would be helpful, Ruff helps the patient identify the activities that are most challenging and asks about any specific goals in the home, at work, or in the community. Ruff sometimes makes home and workplace visits, as well, depending on the patient’s needs. “The patient and I develop a treatment plan together,” she says. “Everyone has different goals, so the strategy has to be tailored to the individual.”

For example, a stove and refrigerator in the Low Vision Center’s kitchen area allows Ruff and her patients to work on cooking or homemaking goals. The center also offers low-vision technology and optical devices for reading, writing, and other daily living goals for patients to try out.

After identifying helpful devices in the clinic, Ruff finds it’s often best to let people test the devices at home to make sure they work well in their own environments and meet their long-term needs.

A new outlook

While the center serves many seniors with macular degeneration, patients with a wide variety of conditions—some as young as five years old—have received help with their visual challenges. Regardless of patients’ age or circumstances, the first thing Ruff asks is what they like to do.

For example, Ruff and Oxley concentrated on cooking, in addition to his work-related responsibilities. At the Low Vision Center, Oxley has learned about special cooking tools, including specially marked measuring cups and spoons and a talking thermometer that lets him know when meat is fully cooked.

Before he worked with Ruff, Bohman says he had no idea what tools were available to help him see better. “She asked me about the kinds of things I like to do, and then she showed me things that might help, like large keyboards, special computer programs, magnifiers, and all kinds of other things I’d never heard of,” Bohman says. “I’m in a wheelchair, so she took that into consideration when showing me these devices, too.”

Statistics show that there’s a five- to seven-year gap between a senior receiving a diagnosis of vision loss and receiving some kind of rehabilitation. “I like to think we’re closing that gap and not leaving people floundering for such a long, sad while,” Ruff says. “It doesn’t take a lot of visits or a lot of time to make a big impact on somebody’s life and on their ability to continue to do those things they care about. I tell people that we maybe can’t fix your vision, but we can help you live with it more happily and more productively.”

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