1 In the true sense of the word, "blindness" means NLP, although terms such as "legal blindness" - applied for legal, rather than medical, purposes - are still used in everyday practice.

• An increased risk of further injury [14]19

19 The risk of sustaining another injury (e.g., falling down the stairs) is greater if the person's vision is poor, especially if this occurred only recently; a vicious circle can also ensue since the eye can be reinjured during a fall.

• An impaired quality of life20

• Occasionally permanent physical disfigurement

To minimize the effects of these challenges, rehabilitation must aim at both maximizing the eye's remaining potential (low vision specialist21) and additional experts [20] such as psychologists, vocational advisers, occupational therapists, nurses, educators, mobility therapists, social workers. The ophthalmologist should be the initiator for the entire process and remain available for advice and leadership.22 A file on such patients should be kept so that if a new therapeutic option becomes available, the patient can be contacted.23

20 e.g., a diabetic patient may become unable to accurately draw and inject insulin without somebody's help

21 e.g., to develop and utilize to the maximum the function of a new macula; to use movement, rather than binocular parallax for stereopsis

22 Throughout the entire treatment/rehabilitation process, the ophthalmologist must emphasize the positives, not the negatives, to the patient. Focusing on what can be achieved, rather than on what was lost, improves patient attitude, cooperation, and outcome.

23 The author is forever indebted to Donald C. Fletcher, MD, San Francisco, Calif., for his invaluable contributions. Tables 1.7.5 and 1.7.6 are based on his previous works.

collect information on your eye injury cases, utilizing the standardized system (,

think of prevention, whether this concerns an individual case or a major societal risk factor consider initiating proper rehabilitation as soon as it becomes clear that vision cannot be restored in the injured eye

think that collection of epidemiological and clinical information on all your patients with serious eye injury is a waste of time: this is the basis for prevention and the improvement on current treatment approaches downplay the possibility of visual rehabilitation if an injured patient has poor vision; with proper techniques, the eye's functional capability can be increased substantially


Collecting epidemiological data on the occurrence of eye injuries allows identification of trends and societal risk factors. This information can then serve as the basis for designing and implementing preventive measures. Continuing data collection is necessary for the evaluation of the efficacy of the preventive measure. If the eye's functional capability remains seriously depressed despite all reasonable treatment efforts, the eye and person must be rehabilitated to utilize to the maximum the eye's remaining capabilities and help the person cope with the situation.


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