Features

Two well-respected clinicians in the visual impairment field, Professor Jonathan Jackson and Dr James Wolffsohn, edit the recently published Low Vision Manual.

The list of contributing authors is also impressive, including a chapter by the late Janet Silver, possibly one of her last contributions to the profession and visual impairment field.

The book is a comprehensive reference source for anyone interested or currently working in the field of visual impairment. It covers the relevant theory as well as useful practical information and it is gratifying to note a compelling section on rehabilitation written by a appropriate professional.

The chapters are arranged with handy practical advice highlighted in easy-to-read sections. These sections ensure the practitioner can access functional information quickly, while the scholar can read the associated theory. A number of appropriate illustrations, in colour and black and white, are useful both for diagnosis, identification and teaching others - including patients.

Definitions

The book is divided into four clearly defined sections. The first examines the definition of low vision and epidemiology. National and international statistics and definitions are included. Unfortunately the latest data on UK blind and partially sighted registrations were released following publication of this book so the UK statistical data is outdated.

Three chapters look at visual impairment in the young, the working population and the elderly. It is pleasant to see some of the less common, but still seen in practice, conditions included. A relatively new low-vision practitioner may find this is a useful source. An interesting piece of advice, with reference to examining the young is 'if in doubt, believe the mother and either re-examine or refer'.

Hospital treatment of conditions is also mentioned, including some of the more recent therapies for 'wet' AMD. However this information, like all others, will soon become out of date in this rapidly developing area. This section also includes suggestions for management of the different groups of patients.

Emotional concerns

The second section looks at low-vision assessment and measurement of visual function. There is a good opening on the psychological aspects of vision loss. Though, as a profession, we are not trained psychologists, the emotional aspects of sight loss cannot be ignored.

Understanding our patients a little better, may actually aid us in achieving an improved end result. The fact that this chapter is included before the more clinical testing that optometrists normally associate with a low-vision assessment is an indication that it is imperative to address the emotional status of the patient, as a priority.

This chapter ends with a small section dealing with the psychology of the practitioner and how to deal with failure, something all low-vision practitioners encounter at some point and for some this may be difficult to deal with.

There are many reference sources which detail how a low-vision assessment should be structured. The information is practically based, with real-life advice, along with relevant theory and explanation of tests. A good range of different test methods include the less commonly used such as the Melbourne Edge Test and Brightness Acuity Test.

Professor Jackson has also added a chapter on assessment of functional vision and quality of life. Those working in low vision will appreciate this topic is very much 'in vogue' at the moment.

Optics of LVAs

The third section considers the optics of low-vision aids. It also contains some useful practical tips on how to prescribe and use a variety of different aids. This includes real-life advice on how to demonstrate them to patients. While looking at the most common types of aids, hand magnifiers, stand magnifiers etc, the book also examines some of the lesser-used aids such as the Redi-fit. For the optically minded students and practitioners the book naturally explains the optics involved. There is also a good section on electronic aids.

A low-vision book would not be complete without mentioning non-optical solutions. A chapter is dedicated to this area, again with some highlighted useful practical advice.

Rehabilitation

The fourth and final section examines rehabilitation. This is a timely inclusion following the recent launch of the Low Vision Standards, commissioned by the Department of Health. Rehabilitation is an area that traditionally was not taught to optometrists, but is now becoming part of the academic curriculum and is a very important part of dealing with vision loss. This section covers low-vision therapy, functional visual loss and includes useful information on the current multi-disciplinary approach to service delivery.

This book is a welcome addition to any optometrist's library. It is useful for undergraduates, pre-registration graduates, low-vision specialists and in fact any optometrist. It may also be a useful reference tool for rehabilitation workers, social workers, occupational therapists and anyone working within the visual impairment field. With the increasingly ageing population it will be virtually impossible for any practising optometrist to avoid seeing a visually impaired patient. ●

Low Vision Manual, paperback, 448 pages, ISBN-13: 978-0-7506-1815-1

ISBN-10: 0-7506-1815-9

Imprint: Butterworth-Heinemann

● Joy Myint is senior adviser to the RNIB

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