Occupational Therapy at the Eye Doctor?

Rachel Partner, OTD, OTR/L, CLVT

Individuals with low vision conditions such as macular degeneration, glaucoma, or diabetic retinopathy don’t expect to interact with an occupational therapist at the optometrist’s office, whether they come in for an annual appointment or a low vision consultation. But this isn’t the case at Restore Eye Care & Eye Gym! What is occupational therapy? And how does it relate to low vision and an optometric practice?

Occupational therapy is a client-centered healthcare profession that assists individuals across their lifespan to independently engage in functional, meaningful daily activities, or “occupations,” to their maximal potential. In other words, occupational therapists help clients to do the things they want to do in daily life as safely and independently as possible. Although occupational therapists typically work in settings such as nursing homes, hospitals, and personal residences, working as part of an optometric practice to address low vision has become an emerging area for occupational therapists over the past decade.

Vision is the primary sense though which people obtain information about and interact with the environment. So, if vision is impaired, even the slightest bit, an individual can have trouble effectively participating in daily life. An unobserved step might cause a fall. Difficulty seeing the oven temperature control could result in an undercooked apple pie. Having trouble focusing on the newspaper could disrupt reading the stats from the weekend sports games.

Thus, a collaborative relationship between an optometry practice and an occupational therapist can be beneficial. While the optometrist is able to assess the eye’s health and monitor the progression of low vision conditions, an occupational therapist can focus on aspects related to daily functional performance. Occupational therapists work with clients who have low vision in the following ways:

• Teach clients how to use their remaining vision to complete activities using eccentric viewing techniques, adaptive equipment education/training, and lighting, glare, and contrast sensitivity strategies;
• Modify and/or adapt activities using compensatory strategies, organizational techniques, and/or environmental modifications such as placing marker dots on common household appliance controls or using motion-sensor lights;
• Educate clients on available resources such as public transportation options, low vision devices, support groups, and other low vision professionals;
• Create a safe home environment to prevent falls/injury; and
• Facilitate active problem-solving and critical thinking skills for future use.

In addition to addressing the vision-related components, occupational therapists can determine if other factors like arthritis, muscle weakness, decreased range of motion, decreased activity tolerance/endurance, and/or reduced coordination are interfering with occupational engagement. This is done by analyzing the activity, the person, and the situation and modifying the components accordingly. For example, a client with macular degeneration and arthritis might have trouble grasping a handheld magnifier to read because the handle is too small. However, a stand magnifier could create a more successful reading experience for that same individual because the device has a larger handle and can rest on the reading material.

To receive occupational therapy services, a prescription from a physician or eye care professional is required. The occupational therapist completes an evaluation, which involves an interview to establish the client’s baseline and prior levels of performance as well as creating the goals he or she wants to work toward. Throughout the intervention sessions, the client is assessed for any changes in performance, whether they are improvements or declines, and the plan of care is adjusted. A client is discharged from occupational therapy service when either the goals have been met, progress is no longer being made, or further services are declined. While the ultimate goal of low vision occupational therapy is to improve clients’ occupational performance, any increase in function or perceived quality of life is worthwhile as well, especially if it is meaningful to the individual. Because occupational therapists are licensed, many insurance companies recognize them as healthcare professionals and will cover services that are provided. So, call Restore Eye Care & Eye Gym or stop by to learn more about how occupational therapy can help optimize daily activity performance!