About
Teachers of the visually impaired, doing the work the doctors handed over.
Solutions in Low Vision is a program of Advocates for Blind Citizens. Everyone who built it came out of a classroom or a clinic rather than a boardroom, and that shapes what we do and who we train.
Where this started
July 2023, at an international optometry convention.
Optometrists in the room said plainly that vision therapy was not working well enough for children who struggle to read, and that it might be time to let it go. What followed was the idea the reading program is built on: let the teachers of the visually impaired become teachers of vision.
What we do
Two programs, one underlying idea.
How a person’s eyes are aimed decides what they can do. That is true of a five year old learning to read and of an eighty year old learning their way around a room again. Both problems are found by a screening that takes minutes, and both are missed almost everywhere.
Reading, for children
Children whose eyes travel right to left, or outward from the center, flip letters and get labeled learning disabled. The predictor is visible in a screening a school already runs, and the correction is a habit: look left, read right.
Color screening, for all ages
A 27 plate screening that finds the roughly 1 in 12 boys the classroom is quietly failing, and the color loss in older adults that hides pressure sores, jaundice and the edges of a step.
Why the older adult work exists
The need is growing faster than the services are.
As baby boomers age, more people leave hospital needing support than the system was built to carry. These are the numbers that shaped this side of the program.
What goes wrong
Patients with low vision leave hospital and do worse.
None of the following is inevitable. All of it is more likely when nobody on the care team has been trained to notice what a patient can no longer see.
Falls and fractures
An increased risk of falls and fractures, which makes admission to a hospital or nursing home more likely, along with disability and premature death.
Depression
Older adults with low vision are 31% more likely to suffer the effects of depression.
Medication errors
Difficulty identifying medications leads to drug related errors. Medicines have become the fifth leading cause of death among seniors. Forty percent of seniors take five or more prescription drugs a week and 12% take more than ten.
Daily living
Difficulty bathing, dressing and moving around the house. Roughly 1.8 million older Americans who are not living in nursing homes report some difficulty with these tasks.
Every figure on this page comes from published research. The studies are listed, with their limitations, on the bibliography page.
The legislation behind the programs
The IMPACT Act changed how post-acute care is measured.
The Improving Medicare Post-Acute Care Transformation Act passed in 2014 and changed how nursing homes and home health agencies have their performance measured. The Centers for Medicare and Medicaid Services now rate post-acute providers so that patients can compare outcomes, and mobility was added to that ratings system.
Mobility means the support a person needs to navigate their own environment, whether that involves a walker, other equipment, or simply being able to see the edge of a step. Patients who cannot see contrast are the ones who pull those ratings down, and they are also the ones most easily helped. Solutions in Low Vision provides the training and support that post-acute providers need as more of their patients age into this.
Who we are
A non-profit program, run by educators.
Solutions in Low Vision is sponsored by Advocates for Blind Citizens. The team spans four time zones and has worked with over 200 hospitals to improve access to post-acute services. We partner with local Lions Clubs, school nurses, teachers, pediatricians, primary care and post-acute providers, eye doctors and parents.