Manual and autofocus telescopes can focus from infinity to 12 inches. They are useful for distance, intermediate, and near tasks. Dr. Kinkade helps those with low vision in MA and nearby states use them for viewing signs and television, products on shelves, painting, card playing, and reading.
Low Vision Refraction
Many patients with low vision in CT and M and the surrounding region can be helped with a trial lens refraction allowing for eccentric viewing. Improvement may be seen regardless of the ocular diagnosis and level of entrance acuity. The worse seeing eye at presentation may become the better seeing eye after refraction. The balance lens eye should also be refracted. Ophthalmology 2010;117:1442-1446 (c) 2010 by the American Academy of Ophthalmology
Eccentric Viewing For Patients With Central Vision Loss
Most patients with a central scotoma adopt a preferred retinal locus (PRL) for eccentric viewing. Fixation stability and retinal location are not always optimal especially for reading with low vision aids.
For motivated patients, improved fixation stability and/or a more effective PRL location can be trained. Reading speed (MNRead test) and critical print size improves (often 2 lines on the ETDRS chart).
Gains in ocular motor control result in better visual performance and improve many activities of daily living (ADLs).
Patient Referrals
Surprisingly, my patients with low vision in CT and MA and throughout the Northeast (i.e., patients with functional vision impairments) can start before 20/50. Please consider referring your patients early when they can best adapt to spectacle-mounted magnification. If your patient's vision should decline in the future, stronger powers are more readily accepted when patients are already using these devices.
Please contact me by telephone or email regarding your patient's needs and concerns. Also encourage your patients or their family members to call my office. I will be happy to speak to them to determine if they are potential candidates for telescopic eyeglasses. Thank you for your interest. I know your patients will thank you. Randy Kinkade
When standard reading glasses or a +3.50 add no longer provide enough clarity for reading, your patient is a potential candidate for a telemicroscope. Telemicroscopes allow increased magnification with a relative longer reading distance than traditional single lens corrections. For motivated patients with mild to moderate visual impairments, our success rate is over 85%. Establishing realistic goals and managing patient expectations is fundamental to our high success rate.
For binocular patients, prism compensated reading glasses with proper illumination can be very effective. Functionally monocular patients benefit from single or doublet lens reading microscopes.
Corrective lenses for refractive error are incorporated into the eyepiece of the telescope and the carrier lens. Wide-angle telescopes have bigger objective lenses providing a larger exit pupil. There are Keplarian and Galilean telescope designs and both are afocal systems providing angular magnification.
Bioptic designs use miniature telescopes mounted superiorly, allowing for normal viewing centrally and inferiorly through the carrier lens. The carrier lens has the patients distance refractive error. The powers usually range in power from 1.7X - 3X. The telescopes can be focusable or non-focusable. The telescope is angled upward so that it will be in a straight-ahead position when the patient lowers their head to view through the telescope. The proper angle of inclination is one of the keys to patient success.
Driving with Bioptics
A trained driver used the central (non-telescopic) carrier portion for the vast majority of the time when driving. Scanning into the superiorly mounted telescope allows for a detail view of the road and signs up ahead. The driver uses the telescope just like their rear and side mirrors (i.e., glancing briefly and intermittently). Driving bioptics are spotting tools used for 1-2 seconds at a time.
