Low vision is both a subspeciality and a condition. Optometrists, Opticians and Ophthalmologists after their training may undergo further training in Low vision assessment and management. There are various classifications for low vision, this varies from country to country and even from state to state. It must however be noted that the work of a low vision specialist is very important as they aid individuals with reduced vision even in the presence of conventional lenses to be able to make use of their residual vision. People benefitting from low vision assessment must be motivated to make use of the residual vision and must again be willing to use the various aids that would be prescribed.
The World Health Organization classifies [1] [2] people with low vision as follows:
readings from left to right are in metres, feet and LogMAR values
Low vision visual acuity examinations are done using the LogMAR chart. The advantage that this presents with is that it allows for more accurate measures of the individual's vision to be recorded. Other tests done and their significance are as follows:
Peripheral vision, or indirect vision, is vision as it occurs outside the point of fixation, i.e. away from the center of gaze or, when viewed at large angles, in the "corner of one's eye". The vast majority of the area in the visual field is included in the notion of peripheral vision. "Far peripheral" vision refers to the area at the edges of the visual field, "mid-peripheral" vision refers to medium eccentricities, and "near-peripheral", sometimes referred to as "para-central" vision, exists adjacent to the center of gaze.
Amblyopia, also called lazy eye, is a disorder of sight in which the brain fails to fully process input from one eye and over time favors the other eye. It results in decreased vision in an eye that typically appears normal in other aspects. Amblyopia is the most common cause of decreased vision in a single eye among children and younger adults.
Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an animal's ability to recognize small details with precision. Visual acuity depends on optical and neural factors. Optical factors of the eye influence the sharpness of an image on its retina. Neural factors include the health and functioning of the retina, of the neural pathways to the brain, and of the interpretative faculty of the brain.
A Snellen chart is an eye chart that can be used to measure visual acuity. Snellen charts are named after the Dutch ophthalmologist Herman Snellen who developed the chart in 1862 as a measurement tool for the acuity formula developed by his professor Franciscus Cornelius Donders. Many ophthalmologists and vision scientists now use an improved chart known as the LogMAR chart.
An eye chart is a chart used to measure visual acuity comprising lines of optotypes in ranges of sizes. Optotypes are the letters or symbols shown on an eye chart. Eye charts are often used by health care professionals, such as optometrists, physicians and nurses, to screen persons for vision impairment. Ophthalmologists, physicians who specialize in the eye, also use eye charts to monitor the visual acuity of their patients in response to various therapies such as medications or surgery.
An eye examination, commonly known as an eye test, is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ophthalmologist, or an orthoptist. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care, especially since many eye diseases are asymptomatic.
In the study of visual perception, scotopic vision is the vision of the eye under low-light conditions. The term comes from the Greek skotos, meaning 'darkness', and -opia, meaning 'a condition of sight'. In the human eye, cone cells are nonfunctional in low visible light. Scotopic vision is produced exclusively through rod cells, which are most sensitive to wavelengths of around 498 nm and are insensitive to wavelengths longer than about 640 nm. Under scotopic conditions, light incident on the retina is not encoded in terms of the spectral power distribution. Higher visual perception occurs under scotopic vision as it does under photopic vision.
Visual or vision impairment is the partial or total inability of visual perception. In the absence of treatment such as corrective eyewear, assistive devices, and medical treatment, visual impairment may cause the individual difficulties with normal daily tasks, including reading and walking. The terms low vision and blindness are often used for levels of impairment which are difficult or impossible to correct and significantly impact daily life. In addition to the various permanent conditions, fleeting temporary vision impairment, amaurosis fugax, may occur, and may indicate serious medical problems.
The LEA Vision Test System is a series of pediatric vision tests designed specifically for children who do not know how to read the letters of the alphabet that are typically used in eye charts. There are numerous variants of the LEA test which can be used to assess the visual capabilities of near vision and distance vision, as well as several other aspects of occupational health, such as contrast sensitivity, visual field, color vision, visual adaptation, motion perception, and ocular function and accommodation (eye).
Metamorphopsia is a type of distorted vision in which a grid of straight lines appears wavy or partially blank. In addition, metamorphopsia can result in misperceptions of an object's size, shape, or distance to the viewer. People can first notice they suffer from the condition when looking at mini blinds in their home.
A visual field test is an eye examination that can detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as glaucoma, stroke, pituitary disease, brain tumours or other neurological deficits. Visual field testing can be performed clinically by keeping the subject's gaze fixed while presenting objects at various places within their visual field. Simple manual equipment can be used such as in the tangent screen test or the Amsler grid. When dedicated machinery is used it is called a perimeter.
Contrast is the difference in luminance or color that makes an object visible against a background of different luminance or color. The human visual system is more sensitive to contrast than to absolute luminance; thus, we can perceive the world similarly despite significant changes in illumination throughout the day or across different locations.
A logMAR chart is a chart consisting of rows of letters that is used by ophthalmologists, orthoptists, optometrists, and vision scientists to estimate visual acuity. The chart was developed at the National Vision Research Institute of Australia in 1976, and is designed to enable a more accurate estimate of acuity than do other charts. For this reason, the LogMAR chart is recommended, particularly in a research setting.
B1 is a medical-based Paralympic classification for blind sport. Athletes in this classification are totally or almost totally blind. It is used by a number of blind sports including blind tennis, para-alpine skiing, para-Nordic skiing, blind cricket, blind golf, five-a-side football, goalball and judo. Some other sports, including adaptive rowing, athletics and swimming, have equivalents to this class.
B2 is a medical based Paralympic classification for blind sport. Competitors in this classification have vision that falls between the B1 and B3 classes. The International Blind Sports Federation (IBSA) defines this classification as "visual acuity ranging from LogMAR 1.50 to 2.60 (inclusive) and/or visual field constricted to a diameter of less than 10 degrees." It is used by a number of blind sports including para-alpine skiing, para-Nordic skiing, blind cricket, blind golf, five-a-side football, goalball and judo. Some sports, including adaptive rowing, athletics and swimming, have equivalents to this class.
B3 is a medical based Paralympic classification for blind sport. Competitors in this classification have partial sight, with visual acuity from 2/60 to 6/60. It is used by a number of blind sports including para-alpine skiing, para-Nordic skiing, blind cricket, blind golf, five-a-side football, goalball and judo. Some other sports, including adaptive rowing, athletics and swimming, have equivalents to this class.
Humphrey field analyser (HFA) is a tool for measuring the human visual field that is commonly used by optometrists, orthoptists and ophthalmologists, particularly for detecting monocular visual field.
Louise Littig Sloan was an American ophthalmologist and vision scientist. She is credited for being a pioneer of the sub-division of clinical vision research, contributing more than 100 scientific articles in which she either authored or co-authored. Her most notable work was in the area of visual acuity testing where she developed and improved equipment. Sloan received her Ph.D. from Bryn Mawr College in experimental psychology. She spent a short period of time in both Bryn Mawr's experimental psychology program as well as the Department of Ophthalmology at Harvard Medical School. The majority of her career, however, was spent at Johns Hopkins Wilmer Eye Institute where she directed the Wilmer Laboratory of Physiological Optics for 44 years. In 1971, Sloan was the second woman awarded the prestigious Edgar D. Tillyer Award by Optica (formerly Optical Society for her many achievements in the field of vision.
The MNREAD acuity chart or Minnesota low vision reading chart is a text based chart used to measure near visual acuity in people with normal or low vision. It can also be used to measure maximum reading speed, critical print size and the reading accessibility index of a person. Digital and printed types of charts are available.
Near visual acuity or near vision is a measure of how clearly a person can see nearby small objects or letters. Visual acuity in general usually refers clarity of distance vision, and is measured using eye charts like Snellen chart, LogMAR chart etc. Near vision is usually measured and recorded using a printed hand-held card containing different sized paragraphs, words, letters or symbols. Jaeger chart, N notation reading chart and Snellen's near vision test are the commonly used charts for measuring and recording near visual acuity. Near vision testing is usually done after correcting visual acuity at a distance.