Let’s try again. We want to help a patient return to immersive, pleasurable reading, which means we need to get them reading at a fast-fluent reading speed.
Previously, I asked ‘could it be as simple as giving them a stronger magnifier?’ — meaning a magnifier strong enough to shift the print from its origin not just into the Visual Volume, but further, all the way into the patient’s Optimal Visual Volume.
The answer isn’t no. But it’s not yes either — it’s maybe. It also depends on whether the magnifier they use has a speed limit that allows fast-fluent reading. And as we saw, the stronger the magnification, the fewer high-speed options we have.
The revolution under way at present is the increasing prevalence of smartphones and tablets, which patients often have and are familiar with using before they even develop vision impairment. That skill can then be utilised to turn those devices into quite low vision aids. Added to that is the demographic shift towards a new generation of vision-impaired patients who are less intimidated by technology than the generation who came before them.
Other Factors Limit LVA Suitability
So, is that it? Choose a stronger magnifier, but make sure it’s a fast one?
Not quite. We also need to consider the rest of the patient:
- What if the patient has only one hand/arm? Suddenly there are a whole bunch of LVAs which would be fine in theory, but in practice they’re useless. Could you make them work with a special stand? Or would it be better to use a completely different magnifier?
- What if the patient needs an electronic magnifier, but they can’t afford one? Or they are intimidated by anything high-tech?
- What if they read fine with a low-magnification illuminated stand lamp, but their hand has too much arthritis to hold it? Or a magnifier lamp works well, but their arms don’t have enough strength or range-of-movement to position it properly? Or if their fingers aren’t strong enough to work the switch?
- What if the patient really could read really well with a small portable CCTV, but they have short-term memory loss and find it hard to pick up new skills?
- What if the patient could do brilliantly with any of a variety of aids, but what they really want is for you to give them those fabled ‘stronger glasses’ that will restore their sight to them without all the compromises that magnifiers entail?
That’s our final challenge — the patient, and their broader circumstances.
But once you’re through that — all of that — and you’ve still got a match…
… well then, you’re a legend, and you’ve changed your patient’s world.
I don’t give up on them though. I usually schedule them to come in for a review in a year. Quite often I find at that stage they have evolved psychologically, to the point where they are ready to accept help.
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