Monocular or Binocular Reading Spectacles

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Life After Low Vision Clinic
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What You Should Get From LVC

• Information to expect from a LVC
• Device(s) recommendations.
• Level of acuity achieved with use.
• Will lighting adaptations be necessary?
• Is the device used with one or both eyes?

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Why use LVC?

• Assures corrected refractive error.
• Has wide array of inventory to choose from.
• Allows trying before buying.
• May have suggestions for positioning.
• Often able to address why student is displaying
  specific visual behaviors.

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When should low vision aids be introduced?

• Will vary from student to student.
• When reading demands increase.
• When reading speed decreases.
• When observing physical discomfort.
• When formats of materials change.
• When child is not able to do what peers are doing.

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Near Vision Aids
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General Information about Reading Aids

• Wide variety available.
• May have built-in light source.
• Stronger power smaller field of view.
• Large print is overused. Appropriate
  magnification reduces or eliminates the need for
  LP.

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General Information about Reading Aids (cont.)

• Magnifiers need to be introduced at an early age.
• Most successful in cases where there is a desire
  for independence.
• Family support is critical.

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Reading Glasses

• Although children are capable of accommodating at
  near distances more easily than adults, they may
  benefit from reading glasses.
• Read for longer periods of time with less fatigue.

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Reading Glasses (cont.)

• The lenses themselves dont magnify the image.
  They change the focal distance and force the user
  to hold the material closer for relative distance
  magnification.
• If lower powers (up to 12 diopters or 3X) will
  give enough magnification, prisms may be given.

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Reading Glasses (cont.)

• Prisms allow wearer to use both eyes. This is
  often more comfortable and results in less
  nystagmus than using 1 eye.
• High plus lenses without prism are called
  microscopes. Only use 1 eye to read. May get
  competition from other eye so may be necessary to
  patch.

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Monocular or Binocular Reading Spectacles

• Disadvantages
• Requires a close working distance
• Arm fatigue can be a problem
• Induces head movement when reading

• Advantages
• Offers widest field of view
• Allows for hands-free use
• Inexpensive
• Inconspicuous

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Monocular or Binocular Reading Spectacles (cont.)

• Disadvantages
• Uncomfortable when worn for long periods of time.
• If not in the half-eyes style, user must remove
  glasses to see beyond end of nose.

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Handheld Stand Magnifiers

• Disadvantages
• Ties up the use of at least one hand
• Limits field of view
• Requires some degree of hand- eye coordination

• Advantages
• Useful for specific reading tasks
• Works well with eccentric fixation

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Handheld Stand Magnifiers (cont.)

• Advantages
• Highly portable
• Inexpensive
• Flexible
• Stand devices do not require a specific working
  distance

• Disadvantages
• Arm fatigue can be a problem

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Head Loupes

• Advantages
• The lenses can be moved in and out of position as
  they are needed
• Allow for hands- free use
• Inexpensive

• Disadvantages
• Cosmesis
• Requires a very close working distance

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Telemicroscopes

• Disadvantages
• May not be focusable
• Very conspicuous
• Can be very expensive
• Gives a very small field of view

• Advantages
• Can be set for any desired working distance
• Arm fatigue will not be a problem
• Allows for hands-free use

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Telemicroscopes (cont.)

• Disadvantages
• Can be heavy to wear
• Spectacle-mounted system requires additional head
  movement to compensate for small field

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Factors Involved in Successful Magnifier Use

• Exposure at a young age
• Desire for independence
• Student wanting to do what the other kids are
  doing
• Positive attitude
• Family support

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Factors Involved in Successful Magnifier Use
(cont.)

• Training in many environments.
• Availability.
• Coordination of efforts.
• Peers think devices are cool.

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Training for Magnifier Use

• Positioning of material and body
• Consider the use of reading stands, clipboards,
  3-ring binders, furniture.
• Stabilizing material
• Consider rubber bands, bull dog clips.
• If standing, brace material against body or on
  knee, if sitting.

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Training for Magnifier Use (cont.)

• Stabilizing the hand
• Use edge of hand or elbow to stabilize.

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Training for Magnifier Use (cont.)

• Adjusting the head to lens distance
• The closer student is to lens, the greater the
  field.
• Consider having student start by placing
  magnifier on material and slowly lift, to find
  focal distance.
• Have student hold magnifier and slowly bring in
  material until it is magnified.

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Training for Magnifier Use (cont.)

• Reading on a flat surface
• May need to use reading stand.
• Coordinating head, hand and eye movements
• Skills develop with practice, if not, system
  may not be suitable for student.

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Training for Magnifier Use (cont.)

• Reading in a variety of formats
• Gradually introduce materials in various print
  sizes (within the same document) or colored
  backgrounds or contrast changes or rounded
  objects such as can labels (stand magnifiers may
  not work here).
• HAVE APPROPRIATE ITEMS IN YOUR TRAINING KIT.

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Training for Magnifier Use (cont.)

• Tracking at reading speed
• Keep records of reading speeds with magnifiers.
  If student cant keep pace, may need to add
  modifications. Could be associated with eye
  condition.

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Training for Magnifier Use (cont.)

• Stamina
• Comes with practice. Avoid too much too soon,
  as may cause headaches. Dont be afraid to assign
  homework. Goal is for student to complete work
  in same amount of time as sighted peers. May
  need to adjust depending on other disabilities.

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Training for Magnifier Use (cont.)

• Viewing non-print materials
• This is the fun part -- use cool things like
  rocks, jewelry, coins, butterflies, leaves, etc.

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Training for Magnifier Use (cont.)

• Selecting the Magnifier for the Task
• Students need to develop a sense of when a
  certain magnifier will be better than another
  type. Should be armed with at least two kinds in
  school/home and in community. Once power has
  been determined, it isnt difficult to try other
  styles of the same power.

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Tasks for Magnifier Use

• Rock hunt
• Looking at fingerprints
• Board games
• Reading comics
• Building with Legos
• Looking at school yearbook
• Reading CD packages
• Collecting

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• The End (but really just the beginning).