“Low Vision in practice is a lot different than what you probably learned in school,” advises Dr. Henry Greene.  “In school we learned it’s not Low Vision, it’s Slow Vision,” he jokes, but he’s dedicated his career in optometry to practicing this specialty and teaching others to rethink what their preconceptions about how a low vision practice is run in the real world. In his experience, Low Vision is easy to do, it’s a great way to separate yourself from other providers, and it’s a rewarding way to build life long relationships with patients and feel a sense of purpose in your career.

Dr. Henry Greene graduated optometry school in 1974 from the Pennsylvania College of Optometry. After graduation he moved back to his home state of New York but was having a hard time standing out and attracting patients in a saturated optometric landscape. Adopting a specialty focus on Low Vision was the niche that really separated him and launched his successful practice and career. His passion for this profession led him to found Ocutech, an optometric low vision device company that creates leading edge telescopic and digital vision enhancement technology.

How to Get Started with a Low Vision Specialty

In school, instructors are tasked with teaching all of the possible work up and treatment options in a short amount of clinic time. Just like your routine primary care exams probably look a lot different in real life practice than they did when you were a third year student in optometry school, in real life you will take a more straightforward goal specific approach to Low Vision exams. Dr. Greene simplifies the exam by explaining you have only 3 possible goals to target: improve distance, midrange, or near activities. Most doctors will use the same handful of devices for all of their patients so once you know your tools, you can quickly implement them for the right patient needs.

“You can’t learn low vision from a text book,” Dr. Greene advises. The first step to setting up a practice should be to find someone to mentor you. Watch how they perform their exams, how they schedule their patients, and how they manage their patients’ expectations and outcomes. There are also several conferences held each year that are great learning events. He recommends attending the Envision Conference at UAB in March and at Western University in October.

Another great resource for getting started are low vision device companies. Dr. Greene shares that there’s an enormous demand for more Low Vision specialists. At Ocutech they field calls all of the time from patients searching desperately for a Low Vision provider in their area. If you know you want to practice Low Vision but aren’t sure where to set up your practice, you can even call Ocutech to get an idea of the locations around the country that are most in need!

Performing the Exam

The exam should start with taking a careful patient history and asking patients about their specific desires or goals.  When you perform a Low Vision exam, you already know the patient’s medical diagnosis, so this exam focuses on solving patient goals. Are they wanting to address distance (driving, TV watching), midrange (computer), or near (playing cards, reading)?

Distance

Dr. Greene explains there are only 3 ways we can improve distance vision for our patients.

Refraction: It is RARE that a better refraction will make a difference for a Low Vision patient – they wouldn’t be in your chair if this is the case.

Move closer. If your patient can’t see at 10 feet, then have them move closer to 5 feet – that’s 2 x magnification for free. Sometimes it’s as simple as educating a patient where they should sit in relation to their television screen.  But sometimes you can’t move close enough to see so...