Skip to Content

Clinical Services

  • Evaluation of low vision.
  • Evaluation and prescription of optical and non-optical low vision devices.
  • Training in the use of low vision devices.
  • Information and referral services.
  • Patient support group.
  • Legal blindness determination.
  • Determination of driving suitability.
  • Evaluation of electronic and computer low vision devices
  • Closed-circuit television and computer training.

Referrals and Referral Criteria

  • Referrals may come from the following:
    • Outside optometrists.
    • Outside ophthalmologists.
    • Outside physicians.
    • Outside agencies, e.g., Department of Rehabilitation, HMO’s, schools.
    • Family or friends.
    • Internal optometrists.
    • Internal ophthalmologists.

Exam Procedures for Low Vision Patients

  • Appointments are 9:00 A.M., 10:30 A.M. and 2:00 P.M.
  • May require two visits to complete the evaluation.
  • Low vision evaluation includes:
    • Intake questions (case history) with doctor, students, and rehabilitation personnel present.
    • Measurement of distance acuity with current spectacles.
    • Retinoscopy and trial frame subjective refraction with best corrected visual acuity measurements.
    • Near visual acuity using text or word reading charts.
    • Predict equivalent viewing distance required to attain goal print size.
    • Measure contrast sensitivity.
    • Visual fields.
    • Binocular vision testing as needed.
    • Color vision testing as needed.
    • Evaluation of patient’s ability to use low vision devices.
    • Evaluation of electronic magnifying devices.
    • Evaluation of non-optical low vision devices.
    • Counseling with our rehabilitation specialist.
    • Evaluation of electronic and computer aids as needed.
    • Anterior and posterior segment evaluation, as needed.
    • Prescribing, dispensing, or recommendations for low vision devices.
    • Report to the source of the referral.

Low Vision Devices

  • Evaluation of patient’s ability to use low vision devices:
    • Patients are instructed on the use of each type of low vision device.
    • Trials are conducted with hand-held and stand magnifiers.
    • High-add spectacles, single vision or bifocal are evaluated.
    • Electronic magnifying and computer systems are evaluated.
    • Telescopes for distance tasks, including bioptic telescopes, are considered.
    • Rehabilitation specialists demonstrate non-optical low vision devices.
  • Ordering and Dispensing:
    • Once approved, devices are ordered if not currently in stock.
    • If the Department of Rehabilitation is providing coverage for the devices, prior authorization must be obtained before any devices may be dispensed.
    • Dispensing visits are scheduled at 10:30, 11:00, 11:30, 2:30, 3:00 and 3:30 P.M. Patients are trained on the use of the device, how to replace batteries, and how to replace light bulbs.
    • Batteries are included with those devices requiring them.

Guidelines for Billing

  • Billing the Department of Rehabilitation for Low Vision Services:
    • Include the proper code from the International Classification of Disease, ninth revision, Clinical Modification (ICD-9-CM).
    • Department of Rehabilitation prior authorization must be obtained for all devices prior to dispensing.
    • Codes for low vision devices include:
      • V2600 for hand-held and other non-spectacle mounted devices (including tints and stand magnifiers).
      • V2610 for single lens spectacle mounted low vision aids (including high add spectacles, prism half- or full-eyes, microscopics, Optivisors and spectacle mounted loupes).
      • V2615 for telescopic and other compound lens systems, such as distance vision telescopes, near vision telescopes, and compound microscopic lens systems (including hand-held or spectacle mounted distance or near telescopes).
        • The report should include an opinion as to the cause of the low vision, best corrected distance and near acuities, acuities with low vision aids (when appropriate), a description of the aid dispensed or recommended (include the manufacturer’s name of the device, the catalog code number, and the wholesale and retail costs).
    • Medi-Care and HMO’s do not reimburse for devices.
    • All records must include reports in order for the records to be considered complete.

Patient Reports

  • All patients have a report generated.
  • Reports are sent to the source of the referral.
  • If there is no referral source the original of the report is kept in the file.
  • Reports contain the following information:
    • Brief ocular and medical history.
    • The patient’s chief reason for seeking low vision care.
    • Measurement of the refractive error with best corrected acuity.
    • Measurements of near acuity.
    • Contrast sensitivity, visual field, and if applicable, color vision results.
    • Anterior and posterior segment findings (when applicable).
    • Recommendations concerning driving.
    • Legal blindness determination.
    • Recommendations for optical and non-optical devices.

Educational Objectives

  • Prerequisites for Low Vision Clinic – the student must be able to:
    • Pass Optometry 251 – Low Vision.
    • Perform a low vision case history.
    • Perform a trial frame refraction.
    • Perform a trial lens refraction over patient’s correction.
    • Perform retinoscopy with trial lenses.
    • Perform radical retinoscopy.
    • Measure low vision distance acuities.
    • Measure low vision reading acuities.
    • Determine magnification needs for distance and near.
    • Assess a patient’s ability to use distance and near devices.
    • Select and prescribe distance and near low vision devices.
    • Assess illumination needs.
    • Understand the uses of non-magnifying optical devices such as prisms and reversed telescopes.
    • Train patients in the use of low vision aids.
    • Verify optical properties of low vision aids.
    • Assess patient performance with video magnifiers and train patients in their use.
    • Communicate, both verbally and through written reports, with other health care and rehabilitation professionals.
    • Present patient chart review and case during seminars.
  • Faculty Responsibilities:
    • Clinical Faculty are the providers in low vision. Students are secondary providers (observing).
    • Provide training in low vision techniques through demonstration, seminars, and critique of student performance.
      • Over time, allow students to assume a greater role in patient care and prescribing of aids.
    • Review examination records and letters.
    • Oversee computer data entry for accuracy and completeness.

Forms

  • Exam
  • Medicare consent to pay non-covered services
  • Billing
  • Checklist
  • Chronological record
  • Order
  • Consent for exchange of information
  • Legal blindness