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Deborah Kogler helps a patient at her store.

How To Better Serve Low Vision Patients

Patients with low vision often have many special needs that may require you to re-think the way you practice.

Whether you serve only a handful of low vision patients, or specialize in this subset, there are important considerations that need to be taken when dealing with this group of clientele. Due to their vision problems, these patients have many struggles in their daily lives. But the eye doctor’s office should be a place where they feel comfortable.

Deborah Kogler, LDO, ABOC, NCLE, has taken this mantra to a whole new level by creating a space that is completely catered to low vision patients. She says she wanted her practice to feel “warm and fuzzy” and not at all like a doctor’s office. Kogler is a low vision specialist and the owner of Magnifiers & More, Inc., which is the only brick and mortar store of its kind in the Midwest area. Here, people can come in and actually try and compare a wide selection of devices to find one that best fits their needs. For patients who are used to ordering from a catalog, the ability to experiment with various devices is welcomed. 

“I use the analogy of comparing low vision devices to shoes,” says Kogler. “Everyone wears a different size, likes a different style, and has different needs. We allow patients to try out the devices like they’d try on shoes. And if they bring it home and it doesn’t work, we have a return policy so they can bring it back.” 

But many patients don’t need to return their devices because what’s also unique about Kogler’s office is that it was designed to look and feel like home. This way when patients try out the devices, they can actually get a sense of what they’ll be like once they take them out of the office. “We have a kitchen table, a lounge chair, a desk, and even a little kitchenette with some countertops and cupboards,” explains Kogler. “These are things that patients would normally encounter in their everyday life so that when they’re testing out the products, they can get a true sense of what they’ll be like at home. We encourage them to emulate the same tasks they’d do around their house. So if they’re sitting at our desk, they should practice putting their coffee cup down where they’d normally set it.” 

Kogler says she also took the layout of the space into consideration when planning for her practice. “We have 1,800 square feet, 1,500 of which is dedicated to showroom space,” she says. “I did not want a typical set up with dispenser tables. We kept things open and I took into consideration that a lot of my clients are seniors and use walkers or wheelchairs so everything is ADA accessible. I also used a color scheme throughout the office that would show off the contrast—delineating different areas. The main colors are black, white, and yellow, which are the colors that are easiest for the visually impaired to see.” 

Good lighting is also key. In addition to having plenty of overhead lights installed, Kogler’s practice also makes use of a lot of natural light. “Having a lot of daylight come through the windows can even help in showing patients how glare products work,” she says.

When the Minor Details Count

Though low vision is a specialty to Kogler and every single aspect of her practice is focused on better serving this clientele, anyone can make important changes that would make a big difference to low vision patients. Even if you only see a handful of low vision patients, making them more comfortable is not only responsible, but is good business. Paula Nicola, MD, of the practice Seal Lawrence & Nicola in Chattanooga, Tenn., says that over the years she’s learned a lot of ways that she can make the practice more accessible to low vision patients—even though only around five percent of her clients meet that criteria. 

“The first thing we always do is make sure they don’t have any transportation issues,” she says. “When you’re dealing with low vision clients, they can’t always drive themselves. If a patient has missed an appointment, we think it’s important to find out why. There are state agencies that can help them and we can aid them in getting that information.” 

Nicola says that catering to low vision patients is often just common sense. Things like making sure there aren’t obstacles in the hallway and that the waiting room is easy to navigate seem minor, but make a big difference. She says it’s also important to pay attention to the parking lot. “We have a ramp for people to come down, making it accessible not only for those who are visually impaired, but have other disabilities as well,” she says. “We also have a bright yellow line on the steps so that you can see the edge easily.”

In addition, Nicola says that communication is also important when working with low vision patients. “Once they come to check-in, they might need assistance getting to their seat,” she explains. “You may need to tell them where the seat is, or even physically help them sit down. So making sure your staff communicates well with these patients is also critical.”

Similarly, these patients often need help being led down the hallway and getting situated in the exam room. And when the exam is over, Nicola says the doctor can’t just walk out and leave them. “You can’t just say, ‘See you next time,’ and leave the room like you might with another patient,” she explains. “That patient might not be able to find their way out of the room and back to the check-out area. It’s important to have a technician assist them to the front when it’s time to get checked out.” 

Nicola adds that the practice allows Seeing Eye dogs to accompany patients throughout the office as well. At Kogler’s practice, her Golden Retriever, Murphy, who is also a trained service dog, is part of the practice and has become a sort of mascot. “He greets people as they come in,” she says. “We call him the CEO—the canine executive officer.” Kogler also puts out a quarterly newsletter which includes a dedicated page in which Murphy always ‘writes’ something. “We sometimes get more calls about Murphy’s page than the rest of the letter,” she laughs. 

In addition to the newsletter, Kogler also caters to low vision clients through her website. In fact, she even uses extra large typeface and specific colors that make her webpage easier to read. She also uses large print for appointment cards. These are all small details, but they make a huge difference in the long run.

You can start small to better serve your own low vision patients by making minor changes like lighting or reorganizing your waiting area if it’s difficult to navigate. Or you can even make sure your staff takes the extra steps to help patients to and from their seats or with any other special needs. Kogler admits that working with low vision patients can take time and heart. But it’s important to realize how frustrating it can be for these patients to do even the simplest daily tasks. Putting yourself in their shoes is critical for understanding. 

“Sometimes better serving these patients means something very simple, but it’s easy to get stuck in a certain way of doing things,” says Kogler. “I think we need more places like [my practice] throughout the country. I do a lot of consulting and have helped set other businesses up. It may not be a dedicated low vision practice, just a mini low vision clinic within a larger practice, but special considerations still need to be made. If you’re dealing with low vision patients at all, it’s important to know what they need.” 

Lindsey Getz

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