Preface

The population is ageing, particularly in ‘developed’ nations. This, together with the lack of treatment options for conditions such as atrophic age-related macular degeneration, has resulted in a substantial increase in the number of visually impaired people requiring ‘vision care’. In addition, as our standard of living rises, there is an expectation that we will maintain a high quality of life into old age. These two factors continue to create an ever increasing demand on low vision rehabilitation services, especially those that involve multidisciplinary integrated care.

This book has been written by clinical and research experts in the fields of disease detection and management, primary and secondary optometric care, low vision optics and prescribing, counselling and rehabilitation. In writing this text we have attempted to disseminate the latest research findings in a digestible format for the clinician. The book is intended to be a comprehensive guide and up-to-date reference source. It is presented in an easy to access format, which should enable the front-line eye care professional to provide patients with sound, research-based, clinical care and rehabilitation. It is unique in presenting both the latest evidencebased knowledge and in covering the full gamut of issues relevant to comprehensive low vision rehabilitation.

In Section 1, low vision and its epidemiology are defined. The signs, symptoms and clinical management of the range of conditions that cause visual impairment in the three stages of life – childhood, working age and advancing years – are presented in

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detail. The measurement of visual function of the visually impaired is covered in Section 2, not just in terms of traditional measures such as visual acuity and contrast sensitivity, but importantly in considering the psychology of visual loss and functional visual measures such as quality of life. In Section 3, low vision aids, from simple hand magnifiers to electronic vision enhancement systems, are described from their optics to practical tips on prescribing. Last, but by no means least, rehabilitation strategies and techniques are discussed in Section 4, embracing the treatment of the visually impaired as a whole person. This book aims to be an essential read and reference text for all professionals involved in the care of the visually impaired, including ophthalmologists, optometrists, dispensing opticians, orthoptists, ophthalmic nurses, rehabilitation workers, occupational therapists, social workers, peer workers and psychologists, to name but a few. Although the book mentions, where appropriate, the situation in the UK, it also covers the worldwide status, and the contents should prove valuable to those wishing to push back the frontiers of the field, irrespective of location.

We hope that this book will be of use in routine eye care practice to enhance patient care from diagnosis to rehabilitation and, in particular, to optimise the quality of life of visually impaired people.

James S Wolffsohn

A Jonathan Jackson

Dedication

Collectively, we would wish to dedicate this book to those who have come along to see us as patients, or indeed as the parents or guardians of our ‘smaller’ patients, and who have placed their trust in us to help and advise on the optometric, medical and rehabilitative management of visual impairment. To our many visually impaired friends we would wish to express our genuine thanks for all that you have taught us over the years.

Jonathan, James, Giuliana and Owen

Acknowledgements

This text, which has been a labour of love over many years, could not have evolved to this point had it not been for the long suffering

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support of Carolyn, Rachel, Gordon and Pauline, our respective wives and husband. Their support, and sacrifice, is very much appreciated, as too is that of our children, Daniel, Lauren, Joshua, Peter, Laura and Adam. We would also wish to acknowledge the support of clinical colleagues at the Royal Victoria Hospital and, in particular, the secretarial support of Miss Elizabeth Elliman and Ms Amanda Macfarlane. Our thanks also go to the members of the Photographic Team at the RVH and QUB, Mr Mark Tierney, Mr David McCallum, Ms Stephanie O’Connor and Mr Vittorio Silvestri and to our many friends and colleagues from GDBA and RNIB who have assisted with many of the illustrations. Finally, we would wish to thank Ms Barbara Ryan for having reviewed the text and providing helpful suggestions concerning layout and content.

Prof AJ Jackson, Dr JS Wolffsohn, Dr G Silvestri, Mr OF Adams

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Editors

Dr Jonathan Jackson studied Ophthalmic Optics/Optometry at Glasgow College of Technology (UK), achieving a 1st class Honours Degree (1981). Upon completion of a pre-registration year at Moorfields Eye Hospital, London he obtained membership of the College of Optometrists and was awarded both the Scottish and Colebrook prizes (1982). After returning to Belfast to establish a hospital optometry department at the Royal Victo-

ria Hospital, he completed a PhD entitled ‘An Analysis of Corneal Endothelial Morphology under Normal and Traumatic Conditions’ at Queen’s University (1993). He is currently Principal Optometrist at the Royal Victoria Hospital and is Head of Professional Ophthalmic Services at the Northern Ireland Central Services Agency.

Professor Jackson holds an Honorary Senior Lectureship in the School of Biomedical Sciences/Centre for Vision Science, Queen’s University and a visiting Professorship at the Department of Optometry, University of Ulster, Coleraine. His research interests include visual disability and corneal physiology/contact lenses with particular emphasis on paediatrics and learning disability.

Professor Jackson has contributed to, as either principal or senior author, in excess of 60 peer reviewed scientific papers and has presented research findings at a broad range of national and international multidisciplinary meetings. The Belfast visual impairment team which he leads holds a large number of research grants from national and regional funders.

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Dr James Wolffsohn studied optometry at UMIST, Manchester, UK, achieving a 1st class degree. He qualified to practice independently following a pre-registration year at Moorfield’s Eye Hospital, London. Following this, James undertook a PhD on ‘the effects of visual imagery on the oculomotor system’ at Cardiff University and funded by British Aerospace. He then took up a clinical/ research position at the Victorian College of Optometry/University of Melbourne, Australia in 1997. In

2000, he returned to the UK and a lectureship at Aston University, being promoted to Senior Lecturer in 2002 and Reader in 2006. He is now Head of Optometry. James’ research and teaching interests mainly revolve around contact lenses, low vision and the measurement of accommodation, having published over 65 peer reviewed academic papers and given numerous international presentations. James is also the past President of the British Contact Lens Association.

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