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    Challenges facing vision rehabilitation services


    In the United States, the only national, comprehensive vision rehabilitation service that includes full access to devices is the tiered, multidisciplinary service provided to military veterans.  Some refer to these Veteran Affairs services as the Cadillac of vision rehabilitation, according to Dr. Jackson.

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    Medicare and most U.S. insurers provide occupational therapy (OT) for beneficiaries with vision loss provided that the individuals have health-care coverage.

    “This OT service is an important and growing element of vision rehabilitation for Americans,” Dr. Jackson said. “The American Occupational Therapy Association is showing commitment to increasing the number of occupational therapists with specific vision training, and given that the majority of individuals with vision loss are elderly, the OT is well positioned and well trained to address vision and age-related issues in concert.”

    Both countries have national alternate-format audio libraries available for patients with vision loss or print disability.

    Each country has agencies, such as the Canadian National Institute for the Blind (CNIB), which is partially government funded and partially funded by charitable sources.

    There is a continuum of vision rehabilitation care in both countries, beginning with diagnosis and moving to visual function assessment, assessment for optical devices, and rehabilitation planning, and on to training and services such as orientation and mobility, and finally to numerous support services that make a difference for patients with visual loss.

    “The CNIB and the U.S. State societies primarily provide training and services, such as orientation and mobility and perhaps support services, but each of these national services lacks components of comprehensive vision rehabilitation that would support the full continuum of care,” she said.

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