Blind Rehabilitation Services Outpatient Clinics
The VA Blind Rehabilitation Service model of care encompasses an array of rehabilitative services, extending from the patient’s home to the local VA care facility, and to regional low vision clinics and lodger and inpatient training programs. Blind rehabilitation services may be provided through a variety of programs:
Intermediate and Advanced Low Vision Clinics
When basic low-vision services available at VA eye clinics are no longer sufficient for veterans with low vision, intermediate and advanced low vision clinics provide clinical examinations, a full spectrum of vision-enhancing devices, and specialized training in visual perceptual and visual motor skills. Eye care specialists and Blind Rehabilitation Specialists work together in interdisciplinary teams to assure that Veterans and active duty Service Members with low vision are provided with technology and techniques to enhance their remaining sight and facilitate their independence.
Each patient attending the program receives a comprehensive eye examination by a low vision eye care specialist, and a thorough visual skills assessment.
The Intermediate Low Vision Clinics focus on effective use of remaining vision through the development and use of visual motor and visual perceptual skills. Assessment and instruction with special optical and electronic devices is provided. Ergonomic equipment such as special lighting and positioning devices are provided to assist Veterans in using vision effectively. Therapy may employ the use of visual and ergonomic equipment and new visual skills to address routine daily tasks such as reading, writing, managing medications, cooking, locating and reading signs.
In the Advanced Low Vision Clinics, patients are also provided with orientation and mobility training. Principles of independent travel are taught using the long white cane, when appropriate, to enhance the user’s safety and independence. Maximum use of any remaining vision to assist travel is evaluated, and in many cases low vision devices are provided and made an integral part of mobility training. Sensory training classes teach the Veteran how to more effectively use remaining senses, particularly hearing, as an aid in travel. In addition, exercises in mental mapping serve to enhance the Veteran’s orientation while traveling through different kinds of environments. Orientation and mobility instruction in relatively simple routes to increasingly complex routes builds confidence in the ability to travel independently.
Vision Impairment Services in Outpatient Rehabilitation (VISOR) Programs
These programs provide short-term (about 2 weeks) blind and vision rehabilitation. They provide comfortable overnight accommodations for Veterans and active duty Service Members who are visually impaired and require lodging. Those who attend VISOR must be able to perform basic activities of daily living independently, including the ability to self-medicate.
In addition to the low vision and orientation and mobility services already described, VISOR also provides training in communication, activities of daily living and computer use.
Communication instruction is designed to enhance and restore abilities in written and spoken communication. Strategies and tools for communication are offered, such as typing, handwriting, telling time, management of financial records, Braille, recording devices and other electronic equipment. These skills help the Veteran to maintain effective communication with others, and keep up with current events, correspondence and personal files.
Patients learn strategies to accomplish tasks ranging from routine (e.g., telling time, making a cup of coffee) to complex activities (e.g., arranging an entire wardrobe, shopping, kitchen organization, preparing complete meals). The emphasis is on learning by doing; techniques and methods are taught and then integrated into the individual’s daily routine. By the completion of the program the Veterans should be capable of handling daily living tasks with complete or greatly enhanced independence.
The computer equipment issued by VA is state-of-the-art technology with all necessary peripherals and accessible hardware/software to meet the patient’s identified needs. Computer training may include an adaptive needs assessment, recommendation of appropriate computer equipment, training on recommended equipment, issuance of equipment upon successful completion of training, and follow-up technical support as required. Individualized training may further include instruction on accessible hardware/software, computer literacy, familiarization to computer keyboard, fundamentals of disk operating systems and fundamentals of word processing, internet access and email.