VA Maryland Health Care System
Fighting for Independence
Whether due to uncontrolled diabetes, age-related macular degeneration, glaucoma, or birth conditions, the number of people struggling with low vision is rising. “Although many with low vision impairment are over age 65,” said Dr. Olga Whitman, the low vision optometrist at the VA Maryland Health Care System, “vision loss or impairment has many causes and afflicts people of all ages.”
Just ask Richard Eller 73, and William “Les” Tweed, 55, two Veterans whose vision loss brought seismic changes to their lives, forcing them to forego many activities they took for granted, like driving.
Eller, an Air Force Veteran, enjoyed decent vision until two years ago when his central vision diminished due to glaucoma. As his vision faded, so did his independence—his ability to drive, to read, and to watch TV.
“We went to the Wilmer Eye Clinic at Hopkins, and only in passing did they ask if I were a Veteran. Once they learned I was a Veteran, they sent me to the VA. We had no idea that the VA could help us,” said Eller, whose wife helps him navigate the significantly reduced segment of the world he sees. “At my first appointment with Dr. Whitman at the VA Advanced Low Vision Clinic, I felt like a kid in a candy store,” said Eller. “After a thorough eye exam to determine my vision level and needs, she provided so many tools and devices to help with everyday activities. My new best friend is the CCTV/OCR machine.” (A CCTV / OCR combo machine is a closed-circuit television and optical character reader machine that allows people to magnify print to up to 60 times. When one gets visually fatigued, he or she can switch to the OCR part, which will read the text back to them.)
Tweed, a former Marine, echoes that sentiment, saying he found help and hope at the Advanced Low Vision Clinic, where he also learned that vision impairment did not have to slow his roll or lead to isolation and depression. For Tweed, whose vision diminished after a stroke at age 42, the Low Vision Clinic proved to be an answer to a prayer, and like Eller, he arrived not knowing all the services available to him as a Veteran.
“In my career, I was in a leadership position and mentored others. People don’t understand what it’s like to have low vision,” Tweed said, noting that vision impairment cost him a job he loved. “It can be depressing for a life changing thing to happen and to become dependent on others,” he said. But Tweed has remained positive, an attitude that sweetened after his first visit to the Advanced Low Vision Clinic, where he landed like Eller, as a result of a referral from the Wilmer Eye Institute.
“For years, my wife and I searched for help before we were referred by The Wilmer Eye Institute to Dr. Whitman at the VA Advanced Low Vision Clinic at the Loch Raven VA Medical Center. They actually called Dr. Whitman while we were there, and she called us back the next day with an appointment right away,” Tweed said. “After leaving the first VA appointment at the Low Vision Clinic, I felt hopeful for the first time in a long time. I was given so many advanced tools to use, including a specialty pair of reverse telescope glasses customized for me. I was the second person in the U.S. to have a pair quite like this.”
The Advanced Low Vision Clinic, which recently merged with VA Maryland Health Care System’s Blind Rehabilitation Services under one umbrella, operates at the Loch Raven VA Medical Center and offers a robust continuum of care focused on vision rehabilitation for optic conditions ranging from all levels of low vision to blindness. The Advanced Low Vision team includes the low vision optometrist, low vision rehab therapist, an orientation and mobility specialist and a vision impairment service team coordinator who work together to create a treatment plan to maximize a Veteran’s access to vision rehabilitation and related services, based on the patient’s needs and goals and recommendations from the clinical assessment.
“The vision rehab specialist, the mobility specialist, and I all perform assessments first, then form a plan of care based on a patient’s remaining or functional vision. We work with Veterans to address their goals,” said Whitman. “Some goals might include wanting to safely perform daily activities like bathing, shaving, meal preparation, cooking, medication management, dialing the phone, money identification, and vocational and leisurely pursuits.”
Individual Veterans have individual goals, whether it’s continuing to use power tools or continuing to work on a computer. Additionally, the program helps Veterans to use their remaining vision, training them to use the optical devices to read mail, newspapers, identify medication labels, faces and signs. The assessment may also include a home visit, after which the team can recommend changes to the Veterans’ home environments to maximize safety and independence with daily activities.
“If a Veteran’s goals exceed what we can teach and offer here, we offer a referral to the Blind Rehab Center Clinic at the VA Connecticut Health Care System for an intensive 6 to 10-week inpatient stay,” Whitman said.
For Eller, Tweed, and more than 600 Veterans struggling with vision impairment, the vision rehab team at the VA Maryland Health Care System provides hope with a roadmap and tools for independent living through quality, personalized care.