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Congressional Briefing Stresses Growing Need for Low Vision
Rehabilitation Services

Featured speaker Michael Fischer, O.D., F.A.A.O. (Northport Veterans Affairs Medical Center)
Featured speaker Michael Fischer, O.D., F.A.A.O. (Northport Veterans Affairs
Medical Center)
On July 14, Lighthouse International and its vision community partners hosted a standing room-only Congressional Briefing entitled Low Vision and Vision Rehabilitation: A Growing Need. Lighthouse President and CEO Mark Ackermann set the stage by reviewing the demography of the aging population and the concomitant increased risk of vision impairment. Congressman Gene Green (D-TX), a co-Chair of the Congressional Vision Caucus, provided a welcome and emphasized the importance of the early recognition of vision issues.

The featured speaker was Michael Fischer, O.D., F.A.A.O., who is the Chief of Optometry Service at the Northport Veterans Affairs (VA) Medical Center (Long Island, New York) and a consulting low vision clinician at Lighthouse. He previously served as Chief of Low Vision Services at Lighthouse and spoke in his capacity as a Lighthouse consultant, not as a VA representative. He explained that the VA Medical Centers located throughout the United States conduct extensive low vision rehabilitation services for veterans and, within the private sector, low vision rehabilitation services are provided by agencies (such as Lighthouse), Low Vision Clinics at Colleges of Optometry, and by independent practitioners, such as ophthalmologists and optometrists.

Dr. Fischer described low vision as a loss of visual function that cannot be corrected by standard glasses, contact lenses, medications or surgery and that may result from an inherited eye disease, an acquired condition, trauma, or some other problem that damages the visual system. He discussed in detail the four main causes of low vision in adults—age-related macular degeneration (AMD), diabetic retinopathy, glaucoma and cataracts. According to the National Eye Institute (NEI) within the National Institutes of Health (NIH), about 35 million Americans currently experience one of these disease conditions, and that number will grow to 50 million by 2020. As a result of the aging population, the need for low vision rehabilitation services is growing exponentially.

In the low vision rehabilitation process, a patient will first have a low vision examination to determine the level of visual function (e.g., extent of visual field, visual acuity, contrast sensitivity), and then a rehabilitation plan will be developed to meet that individualís lifestyle goals, such as maintaining the independent living skills of reading and mobility within the home and the community. The plan includes training by an Occupational Therapist (OT) or a Vision Rehabilitation Therapist (VRT) on the use of organization within the home, lighting, markings, and assistive devices to support independent activities. It may also include the participation of other vision rehabilitation professionals, such as orientation and mobility specialists, low vision therapists, and social workers for counseling.

Dr. Fischer explained that, although the Medicare program covers portions of the low vision exam and OT services, it does not cover the VRTís services or those for orientation and mobility, except in a six-site Demonstration Program currently being conducted by the Centers for Medicare and Medicaid Services (CMS) which has had limited success due to design flaws at its inception. He announced that Lighthouse recently convened a group of stakeholders in the vision community to explore legislative options for reimbursement of the specialized vision rehabilitation professionals, including a new Demonstration Program that improves upon the current program that expires in 2011 or the creation of a dedicated benefit for vision rehabilitation. Dr. Fischer concluded by stating that, "With the appropriate rehabilitation, most people can perform the needed daily living tasks independently, but greater access to vision rehabilitation services is needed."

Dr. Fischerís comments were echoed in concluding remarks by Cong. John Boozman, O.D., (R-AK), who said that adequate reimbursement for vision rehabilitation services up-front could save Medicare costs downstream. Cong. Boozman is member of the Congressional Vision Caucus.

Lighthouse was joined by the following co-sponsors in hosting this event:
Alliance for Eye and Vision Research (AEVR)
American Foundation for the Blind (AFB)
American Occupational Therapy Association (AOTA)
American Optometric Association (AOA)
Association for Research in Vision and Ophthalmology (ARVO)
Envision
Prevent Blindness America (PBA)
VisionServe Alliance

Lighthouse President and CEO Mark Ackermann introduces Cong. Gene Green (D-TX), a co-Chair of the Congressional Vision Caucus, who provided a welcome to attendees
Lighthouse President and CEO Mark Ackermann introduces Cong. Gene Green (D-TX), a co-Chair of the Congressional Vision Caucus, who provided a
welcome to attendees
Cong. John Boozman, O.D.  (R-AK), a Vision Caucus member, provided concluding remarks
Cong. John Boozman, O.D. (R-AK), a Vision Caucus member, provided
concluding remarks
Lester Marks (left) and Cynthia Stuen, Ph.D. (right) from Lighthouse International with Roxann Mayros (center) of VisionServe Alliance, a briefing co-sponso
Lester Marks (left) and Cynthia Stuen, Ph.D. (right) from Lighthouse International with Roxann Mayros (center) of VisionServe Alliance, a briefing co-sponsor
NAEVRís David Epstein (right) with Tom Zampieri (left) of the Blinded Veterans Association, which has been a strong supporter for the expansion of VA Blind Rehabilitation Programs
NAEVRís David Epstein (right) with Tom Zampieri (left) of the Blinded Veterans Association, which has been a strong supporter for the expansion of VA Blind Rehabilitation Programs