By Alexandra Copeland, OD, FAAO, of Innovative Eye Care in Kalamazoo, Michigan
Low vision services are often overlooked when an optometrist
thinks about adding a specialty to her office.
Practitioners often shy away from this area because
they think it requires knowledge of complex optics or too
much time and investment without enough profit. Both
are untrue. Low vision services can be a great addition to
A lot of optometrists’
only experience with
low vision patients was
in optometry school.
They associate low vision
with two-hour exams
and think there’s no way
they can fit that into
their schedule. However,
remember that completing
a routine eye exam
in school likely took
nearly an hour as well.
Doctors now see patients
in half that time or less.
This can be the same for
low vision patients. Low
vision patients do tend to
run on the elderly side.
Blocking an hour for the initial exam will provide enough
time to complete all exam elements and discuss any
patient questions. These hour blocks can help fill a new
practice or associate’s schedule.
Low vision evaluations should be billed as medical office visits. A lot of time is spent on
education and counseling on things
like the ocular condition’s effect on the
visual system and different low vision
services and devices available. Billing
a low vision exam based on face-to-face time instead of
exam elements completed allows the practitioner to be
for her time. Medical
insurances do not offer
benefits for low vision
devices like handheld
and electronic magnifiers.
Selling these devices
creates an additional
office revenue stream.
A small investment
in low vision devices can
still have a big impact
as doctors build their
low vision patient base.
I would suggest starting
out with one binocular
distance telescope, a few
and stand magnifiers and
a couple pairs of fit-over filters. It’s great to have an electronic
magnifier in office, but these products are a bigger
investment. If you don’t have the extra funds, reach out to
company reps to see if they are willing to loan you a device
Optometrists can apply basic refractive principles to
solve a lot of low vision patients’ needs. Many visually
impaired patients complain about trouble reading. For
patients with mild to moderate impairment (best corrected
vision about 20/40-20/80), a stronger add can resolve this
issue. Optometrists should be familiar with the strongest
add power available in their progressive lens of choice.
Recommending switching to a lined bifocal or single
vision reading lens for extended near tasks to give a larger
field can also make a big different for these patients. These
suggestions require no additional equipment or further
optical knowledge. An in-office eyeglasses purchase also
adds to office revenue.
As the U.S. population ages, the need for low vision
services is only increasing. The National Institutes of Health
estimates the number of Americans with visual impairment
will nearly double from 2010 to 2050 to reach more than 8
million. An optometrist’s inherent knowledge of optics and
ocular disease makes her the ideal candidate to provide low
vision services to this growing population.