How Does a Telehealth Appointment Work at the Low Vision Clinic? Dr. Shagas Explains

Are you curious what an appointment with Low Vision Optometrist, Dr. Anna Shagas, is like? For those who are interested and may be apprehensive about what a low vision telehealth appointment is like at the Low Vision Clinic – we’ve got you covered! Check out this video where Dr. Shagas goes over a few of the tasks you’ll be asked to do during your telehealth appointment. Along with a doctor’s referral, all you need is an internet connection!

Intro

My name is Dr. Shagas. I’m a low vision optometrist at the Lighthouse Low Vision Clinic in Seattle.

The low vision clinic focuses more on evaluation of functional vision and what can we do to help. Um, what kind of goals do you have? What is the, if you were to think, you know, day-to-day life, what is the area that you have most difficulty with? And then we figure out, you know, how to approach that and um, how to meet those goals.

Measuring Visual Acuity

So the first step here with this chart in particular is uh the patient will need to measure the length of this arrow in inches.

As you know, you know, when patients call in, um, they can call from their computer, they can call from a laptop, sometimes they call from an iPad or or their smartphone. And so for when they measure this length, this length of the arrow, it gives me an idea in terms of the size of the image that comes across when they’re looking at the screen.

So once I have this measurement, we can get started measure visual acuity one eye at a time. We also need a measurement from the eyes to the chart. Again, that helps me in terms of calculating magnification that is needed. And then we figure out, you know,

Measuring Magnification

where is it that letters become more difficult? Where do I hear that the that the patient’s starting to slow down when they read the letters? And that gives me an idea in terms of functional vision.

You know, usually when you see uh when you see your eye doctor, they say read the smallest line that you can see, and that’s not the case with with functional vision. You know, I want to make sure that I know what is comfortable vision and where is it that, you know, the patient is reading the chart and they’re reading it with some fluidity so that, you know, when you’re reading a newspaper, gosh, you know, you’re not you don’t want to read it one letter at a time.

And that’s what I’m what I’m listening for when I um when I’m seeing patients during during the visit like this.

Once um this part of the visit is complete, we also go through and look at a chart called the Amsler grid.

Amsler Grid

So this is an Amsler grid, and what it allows for me, um for me gives me some information in terms of what the patient is seeing and and where in the macular has their vision been affected by macular degeneration, for instance.

So I have them look right in the center of that grid and describe what they see in terms of the lines going up and down and side to side. Are there any distortions in those lines? If so, where are they?

Once we know and we can map out where those are located, we also figure out a way, you know, can we use um our peripheral vision to move those areas out of the way to help patients see better, um, when they are doing things like reading or watching television, you know, or even looking out the window. Kind of moving that area out of the way to get a better visual acuity there.

Devices

So, you know, once that initial visit is complete, we do send we talk about, you know, the different devices that um that are appropriate to meet those goals.

You know, is it a spectacle wearing magnifier or a handheld or a stand magnifier? Depending on what it is, we actually send those devices to the patient’s home.

You know, once we found devices that work well for the patient, they begin the training process with uh our occupational therapist Maya.

And you know when we were talking about forming the clinic and what was important, you know, training is really important.

Uh often, you know, patients come in and they say, gosh, look I got this this this telescope or this magnifier and it’s just sitting in my drawer because, you know, no one’s really taught me how to use it.

So it’s really important that we that we figure out what works best and that we do that training portion of it as well to make sure that the patients can incorporate it into their life and use it so it doesn’t end up in the drawer.

Here’s what to expect at your telehealth appointment at the Low Vision Clinic

The Low Vision Clinic focuses more on the evaluation of functional vision. Unlike a regular eye exam, a telehealth appointment at the Low Vision Clinic focuses on helping patients meet daily living goals. Dr. Shagas explains, “I ask them to tell me about the history of their eye health. What has brought them here to see us? Which goals do they have? What can we do to help? If they were to think about day-to-day life, what is the area that they have most difficulty with? And then we figure out how to approach that and how to meet those goals.”

“What’s nice about patients being in their own homes is that if we’re assessing a goal like reading a book, they can just pull it up and read it there during their appointment. That way I can listen and watch the way that they read. Often, there will be head movement or scanning that I can pick up on,” Dr. Shagas notes.

Next Steps After a Telehealth Appointment

During an appointment, Dr. Shagas will speak with patients about the different devices that may be appropriate to meet their goals. These devices range from handheld magnifiers, to CCTVs, to telescopes and more, and will often be sent to the patient’s home for them to test.

“Often I will send 2-3 different powers because we want to make sure that we get a good assessment for what works best for each patient, because different patients have different needs,” Dr. Shagas mentions.

Low vision care is all about trialing different things.

“Once they have that kit, we meet one more time when they have physical charts in their hands and we’ll work on it together. Then, we’re able to use those tools to figure out what works best.”

Once a patient has determined with devices work best for them in their daily life, they begin the training process with our occupational therapist.

Training is Essential

“When we were talking about forming a clinic. training was one thing that was really important,” shares Dr. Shagas.

“Often, patients come in and share about the tools they have sitting in their drawer because no one has taught them how to use it. It’s really important that we figure out what works best and incorporate training along with it to make sure that patients incorporate it into their lives.”

Once patients feel comfortable with a device, they’re able to start using it in their day to day life.

Privacy Is a Priority

Privacy was our #1 priority when we started thinking about telehealth in general. The current zoom that we use, the platform is called Zoom Healthcare. It is a HIPPA compliant service, so nothing is recorded. The meetings aren’t recorded or stored in the system, and there are extra encryptions that occur, so it is indeed safe when patients sign in for their appointment.

Alternatives to Video Appointments

“Some clients don’t feel comfortable meeting via telehealth,” Dr. Shagas notes. “We want to make sure they’re comfortable. They will have the option, when we reopen, that they can come in to the clinic, but we also have the option of connecting over a telephone call.”

When patients have concerns about reading charts online or about video calls, we are able to send a Telehealth Packet to their homes. A packet will include charts, as well as instructions on what to expect written in large, bold print.

Dr. Shagas explains, “Sometimes patients are more familiar with a telephone call than talking via an online video call, and it still works!”

Want More Information?

For more information about services, call (206) 436-2154 to speak to a representative or visit our Low Vision Services page to fill out a request or referral forms.

You may also be interested in these recent blog posts:

16 Tips for Communicating With People Who Have Vision Loss

99-Year-Old Uses Zoom to Meet With Doctor

6 free and low-cost ways to make your workplace accessible for someone who is blind or low vision

February 1st, 2021|COVID-19, Low Vision Awareness Month, Low Vision Services, Programs & Services, Seattle, Video|

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