Low vision is a growing concern, especially as the population ages and conditions like age-related macular degeneration (AMD) become more prevalent. Many patients struggle with daily tasks as their vision deteriorates, often feeling lost and unsure of where to turn. This is where specialized low vision services can make a significant difference in their lives. Melissa Richard, OD, MS, of Spectrum Vision Care in Chalfont, Pennsylvania, has dedicated her career to helping these patients, using her expertise to improve their vision and quality of life.
EDUCATION AND PASSION
Dr. Richard’s journey into low vision care began during her time at the Pennsylvania College of Optometry (PCO). “PCO offered a master’s program in low vision rehabilitation that I could do alongside my OD degree,” she explains. “I started during my second year because I knew I wanted to specialize in something, and low vision was interesting to me since it combines seeing a lot of different pathology with helping people function better in their everyday lives.”
After graduating in 2006 with both her OD degree and a master’s in low vision rehabilitation, Dr. Richard didn’t immediately find a position in low vision. Instead, she gained experience in various practice settings, including a large ophthalmology practice, optometric private practice, commercial optometry and a hospital setting. It wasn’t until six years later that she found a part-time position doing low vision care exclusively. “Working there two days a week solidified my passion for low vision patients,” she says. “But I knew that wasn’t all I wanted to do. I enjoy the variety optometry provides.”
In 2016, Dr. Richard opened Spectrum Vision Care, with the goal of offering comprehensive care, low vision services and neuro-optometry, a specialty she developed after seeing many low vision patients. “Low vision helped grow my cold start practice,” she notes. “I got credentialed with all the medical plans in my area and networked with local retina specialists and ophthalmologists. These were some of my first patients and led to many other referrals.”
EARLIER INTERVENTION
One key aspect of Dr. Richard’s approach to low vision care is encouraging early intervention. “I wish ODs and MDs would refer more patients earlier in their disease state,” she says. “Getting a patient used to higher magnification or using handheld magnifiers is much easier if they still have some usable vision left, rather than waiting until they are count fingers or hand motion vision.”
She also emphasizes the importance of educating patients about their disease and managing expectations. “I wish fellow ODs and MDs would educate their patients on their disease and not tell them that referring them to a low vision specialist will solve their vision problems with a new pair of glasses.”
COLLABORATION AND EXPANSION
Dr. Richard values collaboration with other health care professionals, particularly occupational therapists (OTs). “I refer patients to the outpatient vision therapists in a few local hospital systems,” she shares. “I also have a home OT I refer patients to. She goes to their home, shows them how to use devices I prescribe and helps make their home more low vision-friendly.”
To expand low vision services, Dr. Richard encourages ODs to start by incorporating simple solutions like higher adds in bifocals or progressives and offering tints to help with low contrast situations. “Most patients need to be educated on lighting and working distance, but this can solve many of their issues,” she says. She also suggests reaching out to companies like Eschenbach for tools and resources to get started with low vision care.
SETTING THE STANDARD
Dr. Richard sets aside specific times in her schedule for low vision patients, ensuring they receive the attention and care they need. “Initial evaluations are scheduled for 1.5 hours. I always include refraction, fundus photos, electroretinogram and California Central Visual Field Test,” she explains. “These billable tests help make up for the 1.5 hours in my schedule, plus they help me educate the patient on their issue and why it may not be fixable with a pair of glasses.”
She also highlights the importance of staying informed about local low vision services and available resources, from devices to smartphone apps. “If you’re not going to offer low vision services yourself, make sure you have someone to refer your patients to,” Dr. Richard advises. “Retina specialists are not always aware of our services.”
Dr. Richard’s dedication to low vision care reflects her passion for improving patients’ lives. Through early intervention, collaboration and expanding low vision services, she has created a practice that not only helps patients see better but also empowers them to live fuller lives.
Read the results of a WO Pop-up Poll on offering low vision services.
