A paradigm shift in the management and responsibilities of low vision clinicians in developed nations

Abstract: The role of the low vision clinician, in developed nations, has evolved from its earliest origins of essentially providing clinical care for the partially sighted in the 1930s, to that of being an integral part of the inter-disciplinary team by the 1970s. The past decade however has witnessed an expansion in the role of the low vision clinician in the management of the low vision patient. The new low vision clinical model that evolved has been influenced by the confluence of a host of major factors that appeared in a relatively short time. They include the release of the AREDS (the age-related eye disease study) findings in the Archives of Ophthalmology in October 2001, the introduction of the first new treatment of age-related macular degeneration in 25 years, photodynamic therapy (PDT), the powerful searching tool and home library afforded by the Internet, the greatly empowered patient and family, and the continuing reduction in patient consultation time by the retinal as well as other eye care specialists. Patients'' now seek out the advice from the low vision clinician about concerns as varied as the advisability of surgery (e.g. advisability of cataract surgery with a co-existing conditions such as age-related macular degeneration) to that of driving with vision loss. An historical perspective will provide some insight into the origin of the clinician''s role, preferred models of low vision, as well as the examination protocol. It will also provide a background for developing nations on how to include the traditional models of vision rehabilitation along with the added responsibilities that will be mandated for all those involved in the care of the partially sighted. [Copyright &y& Elsevier]