Monday, 5 December 2016

Low Vision

Low Vision

As an optometrist my main aim in our job is to protect clear vision. We do this not only by providing spectacles and contact lenses but by detecting preventable vision loss by eye disease. Unfortunately sometimes, regardless of early detection, these eye diseases lead to low vision.

Low vision is vision loss that can no longer be correct to a reasonable level with spectacles or contact lenses. Common conditions which lead to low vision are cataracts, age related macula degeneration, glaucoma as well as various other conditions.

"Sight loss affects people of all ages. As we get older we are increasingly likely to experience sight loss." (Access Economics, 2009)
In the UK: 
  • 1 in 5 people aged 75 and over are living with sight loss
  • 1 in 2 people aged 90 and over are living with sight loss
  • 63 per cent of people with sight loss are female, 37 per cent are male.
  • Estimated two million people in UK living with sight loss.

  • "The number of people in the UK with sight loss is set to increase dramatically. It is predicted that by 2050 the number of people with sight loss in the UK will double to nearly four million" (Access Economics, 2009) 

Without additional help using low vision aids people can struggle to read post, medicine bottles, watch TV and cook. Part of the low vision assessment is providing aids to help with such tasks but another key part is helpful tips on how to make the tasks easier.

The Community Low Vision Service

If you still have problems seeing clearly even with up to date spectacles you may have Low Vision. A low vision assessment can help to identify any problems you have and to suggest how to best utilise your vision. The most common example of this is using a magnifier to make small print bigger but there are other low vision aids and advice available.

The service is free of charge and the Low Vision aids are loaned to you for as long as they are useful. Normal spectacles may be needed to get the most out of your Low Vision aid but these are not provided on the scheme.

Accessing the Scheme

NHSoldThe Scheme is available for all patients registered to a GP in the North Tees or the South Tees area. To enter the scheme you will need to have had an up to date sight test in the last year. Your current optician or ophthalmologist will be able to tell you if you meet the requirements (6/18 or less in BE or N9 or less in BE) and they will be able to provide you with a referral into the scheme. In the North Tees area we can see any age category but in the South Tees area the scheme is limited to over 60s.

If your last sight test was longer than a year ago another sight test would be required with your optician before entering the scheme. If you do not have an opticians in the area we will happily do a sight test for you. Most patients can claim a NHS sight test but there may be a charge for certain patients.

You should bring the following to any low vision assessment:
  • your most recent spectacles
  • any magnifiers or low vision aids you have (even if you’re not using them)
  • The referral letter from your own optometrist
  • anything that can help assess your visual tasks at home, e.g. crosswords, books, newspapers etc.

OPTICAL MAGNIFIERS - available on the NHS

  • Stand Magnifiers
  • Hand Magnifiers
  • Pocket Magnifiers
  • Spectacle Mounted Magnifiers

Other BASIC AIDS - these can be purchased from the RNIB

  • Typoscopes
  • Reading Stands
  • Coloured Chopping Boards
  • Level Indicators
  • Talking Watches
  • Large Print Books
  • Audiobooks


Good lighting can have a massive impact on the ability to read, especially to someone with Low Vision. They are also very good for intricate hobbies such as model making and crafts.

We can provide a high powered LED lamp for £70.00 which has a touch sensitive dimming feature.


Unfortunately Electronic magnifiers are not available to NHS Low Vision patients. However, they can achieve up to 12x without distortion whilst still being able to be carried in a large pocket. These often give much better quality of vision than higher powered optical magnifiers that are provided by the NHS and are worth the extra investment.
ESCHENBACH Smartlux Digital - £500

Optelec Compact+HD - £390 

Mr Iain Mellis is a qualified Optometrists with a Professional Certificate in Low Vision, registered to do the NHS low vision scheme at both Mellis Eyecare practices.

If you would like to book in for a Low Vision Assessment please call:

01642 751048

North Ormesby
01642 225671

Or book online at:

A Guide to Occupational Lenses

 What are occupational lenses? 

Unfortunately our eyes weren't designed to read for any length of time and this gets increasingly difficult as we get older. After the age of 40 nearly everyone will need reading glasses. However, if we still want to function normally and read, use a computer,  whilst being able to peer up and see distance objects like clocks and people's faces, then we need a more advanced lens type. Varifocals were often used for this but they were designed before the internet age. They are great for driving or walking around shopping but as they have little intermediate correction they are not very good for computer use. Therefore, for today's digital world lens manufacturers have come up with "Occupational" or "Indoor" Lenses.

Occupational lenses are a type of varifocal lens that are designed to suit a specific task, such as working at a computer in an office environment.

Normal Reading Glasses
Traditional reading glasses are clear at our normal reading distance of approximately 40cm. However, in today's modern world we often have to read at arms length or further due to phones, tablets and computer screens. With a normal varifocal lens there are three useful parts in the lens, these being the distance part, the intermediate part and the near part, found in the top, middle and bottom of the lens respectively. Typically a normal varifocal lens is set up to favour distance vision and near vision, and the intermediate part of the lens is quite small. This can be a disadvantage for anyone who spends a lot of time at a computer screen as it restricts the position from which a screen can be viewed clearly, and means that the wearer must keep their head in one place.

To overcome this difficulty, the occupational lens, also known as an indoor lens and as a degressive lens, increases the size of the near and intermediate parts of the lens. To do this it usually sacrifices some or all of the distance prescription.

Add Power 60
The Hoya Add Power 60 is a degressive lens that sacrifices all of the distance prescription in order to get the best possible vision in the near portion of the lens out to a distance of sixty centimetres, which is a typical computer screen distance. This lens is ideal for a job that requires a lot of reading and computer screen work, but little else.

Tact 200
The Hoya Tact 200 and Tact 400, also sacrifice the full distance prescription to maximize the near and intermediate parts of the lens, but in this case they allow clear vision out to 2m and 4m respectively. The Tact 200 would be ideal for someone working at a computer in a smaller office area, and the Tact 400 might be used by someone working at a computer in a larger, open office.

 Great for wearing indoors 

Great for reading music
For those people who want the advantage of a degressive lens, but without completely sacrificing the distance part of the prescription, Hoya supply the Workstyle range in 200 and 400 versions. These are lenses that maximize the near portion of the lens and the intermediate portion of the lens out to either 2m or 4m, like the Tact lenses, but which also retain a small portion of the lens for the full distance prescription. This offers an excellent solution to the requirements of office work, but because the distance portion of the lens is smaller than the intermediate and near portion, these lenses should not be used for driving. However, many people find them great for hobbies such as reading music or sports such as golf and shooting.