Vision Questions…and Answers

I answer a lot of questions. Many start with “I have this patient…” and the patient has some visual complaint. “…and what can I do to help.” It is great to see therapists recognizing the role vision is playing in function but our education has not prepared us to address visual complaints.

When one sends me a questions, I will frequently ask some questions myself.

  • My first question always involves the eye doctor.
    • Have they seen an eye doctor?
      • Was it a complete, comprehensive eye exam with dilation?
    • What did the eye doctor diagnose?
      • Do you understand the diagnosis?
      • What interventions are supported by evidence for the diagnosis?
      • What is the functional effect of the diagnosis?
  • Then comes my questions about vision correction
    • Glasses? Single vision, multi focal? Contacts? Cataract surgery?
    • How old is their current glasses?
  • What is their vision history?

Understand the Vision Diagnosis

We learn a lot about so many diagnoses in school, but spend very little time learning about vision related diagnosis. Maybe a bit about some low vision diagnoses, but not even the basics of myopia or amblyopia. These are common conditions with functional implications.

It is also our responsibility to understand the evidence-based treatment for the conditions. With some conditions we can help through interventions, with others, compensation is appropriate. Only by understanding the diagnosis and knowing the evidence can we provide the appropriate interventions. The eye doctor may also have recommendations for interventions that should be followed.

I spend a lot of time at PubMed searching for the latest research on vision topics.

Send them to the Doc!!

We must think of vision complaints just as we do other complaints our patients share with us. If a patient complains of shoulder pain, we may look at range of motion and strength, but we will refer them to an orthopedist for complete assessment. We need to be doing the same thing for vision complaints.