Rééducation orthoptique basse vision : Indications et buts dans les pathologies maculaires - Le point de vue de l'Ophtalmologiste

Despite major therapeutic advances during the last decade, age-related macular degenration (AMD) and other maculopathies remain the leading indication for low vision rehabilitation (LVR). LVR includes all means to improve the patient ability to compensate for visual loss and to use peripheral vision more effectively for daily living tasks. It is often essential to reduce the impact of the disease on the quality of life of affected patients. In order to achieve optimal results, ophthalmologists must choose the correct timing for LVR based on the history of the disease and its evolution, on the remaining visual capacities but also on the overall general health status, psychological makeup and coping ability of each patient. Therefore, detailed patient and family interview in order to assess the impact of vision loss on reading, activities of daily living, and psychosocial well-being is required. Patients must be carefully educated about potential benefits and limits of rehabilitation. In addition to optical (telescopes, hand held or fixed magnifiers) and electronic magnifiers, technological advances have provided new tools for LVR such as e-book readers, tablets and smartphones with a wide-range of apps (including text-to-speech functionality) allowing to improve illumination, increase contrast and reduce glare. Ophthalmologists are responsible for coordinating LVR with specialized orthoptists and providing education and support for the patient and his family. They also must continue to provide other ophthalmic care whenever needed while monitoring the evolution of the maculopathy and of other ophthalmic diseases (such as cataract, glaucoma…) throughout LVR.