Low Vision

Summer Date: June 8-9, 2012 (Louisville-KSB)

Eye Clinic Forms and Information

Needed Before Eye Clinic

Clinical Low Vision Referral Form

Pediatric Medical History Questionnaire

Preparing Students for Clincial Low Vision Examination

Kentucky Instructional and Diagnostic Services Permission Form

TVI Notes Sheet for Low Vision Clinic

The Doctor is In: Taking Options in School (article)

Clinical Low Vision Evaluations at the Kentucky School for the Blind 2011-12

Director of Outreach for Statewide Services Meg Stone will be coordinating the clinical low vision evaluations that will occur throughout the 2011-12 school year at KSB.  She will be collaborating with Jenny Wood , OD, FAAO, to provide this valuable service.  As Dr. Wood will be traveling from Texas for the clinics, they will occur over a two to three day period. The first two day clinic will be Friday-Saturday, October 7-8.

Purpose of the Clinical Low Vision Evaluation

The primary purpose of a clinical low vision evaluation is to determine whether an individual with low vision can benefit from optical and nonoptical devices, as well as adaptive techniques, to enhance visual functioning.  Because this type of evaluation should be an adjunct to the care a student receives from their primary eye care provider, it should not be used to as a means to update eye reports or replace routine eye examinations.  The clinical low vision evaluation differs from the examination of the primary eye care specialist by:

• Beginning with a comprehensive, goal-oriented case history
• Using special charts and materials for assessment of near and distance visual acuity not routinely used in general eye examinations
• Going beyond the pre scription of standard spectacles to pre scribe optical, nonoptical, and/or nonvisual devices to help individuals meet specific visual needs
• Including the gathering of information about the individual’s functional use of vision

Procedures for making referral for a clinical low vision evaluation at KSB:

1. All referrals for clinical evaluations at KSB should be directed to Meg Stone, Director of Statewide Support Services. Before beginning any official documentation with an ARC, review referring information with Ms. Stone to establish that this is an appropriate referral at this time.
2. Before the clinic appointment can be scheduled and confirmed , submit a Low Vision Clinic Referral Form along with the following to Ms. Stone:

• Copy of signed evaluation plan form from the ARC indicating a clinical low vision evaluation
• A copy of the current Functional Vision Learning Media Assessment
• Copy of current medical information from the primary eye care provider (Dr. Wood requires medical information to be within one year)

3. Upon receiving the necessary forms, the appointment

   will be scheduled and an additional packet will be sent to the parents and cc’d by email to the teacher.  This packet will include:

If you have any questions or need further information, please contact Meg Stone or call 502-897-1583, ext. 219 or fax 502-897-8737.