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Vision rehabilitation (often called vision rehab) is a term for a medical rehabilitation to improve vision or low vision. In other words, it is the process of restoring functional ability and improving quality of life and independence in an individual who has lost visual function through illness or injury. Most visual rehabilitation services are focused on low vision, which is a visual impairment that cannot be corrected by regular eyeglasses, contact lenses, medication, or surgery. Low vision interferes with the ability to perform everyday activities. Visual impairment is caused by factors including brain damage, vision loss, and others. Of the vision rehabilitation techniques available, most center on neurological and physical approaches.
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Definition of rehabilitation
Rehabilitation is derived from the Latin word habilitas, which means "to make able again". Rehabilitation helps patients achieve physical, social, emotional, spiritual independence and quality of life. Rehabilitation does not undo or reverse the cause of damage; it seeks to promote function and independence through adaptation. Individuals can seek rehabilitation in different domains, such as motor rehabilitation after a stroke or physical rehabilitation after a car accident.
Definition of low vision
Low vision is a condition where a level of vision is 20/70 or worse and it cannot be fully recovered with medical treatment, surgery, or conventional glasses.
Approximately 14 million Americans suffer from low vision. The prevalence of low vision increases from 1% at age 65 to 4% at age 79, and increases dramatically to 17% after age 80. In addition, the prevalence of low vision is increasing, and depression is becoming a common issue for individuals with low vision.
Low vision is different from blindness in that people with low vision have some useful sight. However, those people often have a hard time accomplishing daily tasks as their vision deteriorates (such as reading, cooking, driving, recognizing people's faces, and discerning color).
Diseases that cause low vision and associated disabilities of each disease
Low vision can be caused by many diseases. Though low vision mainly influences the elderly, it can appear at any stage of life. Most people develop low vision as a result of eye conditions and diseases such as macular degeneration, diabetic retinopathy, glaucoma, cataracts, retinitis pigmentosa, and stroke.
Clinical studies and treatments
Since rehabilitation is becoming increasingly adopted, many researchers conduct studies pertaining to vision rehabilitation. There are many treatments for patients to choose from including training sessions, therapies, and surgeries. Most physical approaches focus on helping people by changing the environment or acquiring skills to survive in difficult situations. Neurological approaches focus on treatments that will slow the process of degradation or improve visual acuity. Psychological consulting sometimes is used because vision impairment can lead to depression.
Neurological approach
There are many treatments and therapies to slow degradation of vision loss or improve the vision using neurological approaches. Studies have found that low vision can be restored to good vision. In some cases, vision cannot be restored to normal levels but progressive visual loss can be stopped through interventions.
Chemical treatments
In general, chemical treatments are designed to slow the process of vision loss. Some research is done with neuroprotective treatment that will slow the progression of vision loss. Despite other approaches existing, neuroprotective treatments seem to be most common among all chemical treatments.
Gene therapy
Gene therapy uses DNA as a delivery system to treat visual impairments. In this approach, DNA is modified through a viral vector, and then cells related to vision cease translating faulty proteins. Gene therapy seems to be the most prominent field that might be able to restore vision through therapy. However, there are some problems with gene therapy which can lead to severe conditions such as death.
Physical approach
For physical approaches to vision rehabilitation, most of the training is focused on ways to make environments easier to deal with for those with low vision. Occupational therapy is commonly suggested for these patients. Also, there are devices that help patients achieve higher standards of living. These include video magnifiers, peripheral prism glasses, transcranial direct current stimulation (tDCS), closed-circuit television (CCTV), RFID devices, electronic badges with emergency alert systems, virtual sound systems, and smart wheelchairs.
Mobility training
Mobility training improves the ability for patients with visual impairment to live independently by training patients to become more mobile. For low vision patients, there are multiple mobility training methods and devices available including the 3D sound virtual reality system, talking braille, and RFID floors.
The 3D sound virtual reality system transforms sounds into locations and maps the environment. This system alerts patients to avoid possible dangers. The talking braille is a device that helps low vision patients to read braille by detecting light and transmitting this information through Bluetooth technology. RFID floors are GPS-like navigation systems which help patients to detect building interiors, which ultimately allow them to detour around obstacles.
Home skills training
Home skills training allows patients to improve communication skills, self-care skills, cognitive skills, socialization skills, vocational training, psychological testing, and education. One study indicates that multicomponent group interventions for older adults with low vision as an effective approach related to home training. The multicomponent group interventions include learning new knowledge or skills each week, having multiple sessions to allow participants to apply learned knowledge or skills in their living environment, and building relationships with their health care providers. The most important factor in this intervention is support from family, which includes assistance with changes in lifestyles, financial concerns, and future planning.