The future of vision correction through the use of contact lenses opens vast new areas of progress for the aging as well as for the

young.

PARTIAL VISION AND OPTICAL AIDS

The degree of visual acuity in the past was the basis of the three classifications of sight. In the normal range was anyone whose vision checked out at 20/70 or better (the first figure represents the distance in feet at which a line of letters on an eye chart is read, while the second figure represents the distance at which it should be read by a person with "normal" vision). In the second group, called "sub-normal", were those with vision 20/200 or better and less than 20/70. The third was composed of those with vision less than 20/200, and this was called "blindness".

Although this arbitrary classification served a useful purpose in problems relative to vision, a more reasonable approach is one based on the positive aspects of vision. This indicates how much a patient can see in contrast to his loss, rather than vice versa. It is acknowledged and agreed that from "above normal vision" to "blindness", there is an entire range of vision possibilities. Any vision, no matter how much below normal, is an advantage, especially if it can be corrected to provide more useful sight. The preferred term of classification of deficient visual acuity might be "partial vision", rather than "sub-normal vision" or "blindness".

Practically everyone with vision desires to use the eyes in perception. And with modern techniques, it is the rule, rather than the exception, that partial vision can be improved with optical aids. This is a great boon to the senior citizen, for as he gets older, more and more of his self sufficiency is dependent on vision. Most of the ability to use the knowledge and adeptness gained from a lifetime of experience is controlled by the eyes .... even though in their uncorrected state they might offer only partial vision.

From a legal standpoint, the difference between "blindness" and "vision" is strictly an arbitrary one based on the presence

or absence of useful vision. The fallacy of identifying limited vision as "blindness" becomes more evident when the following fact is considered Only 25 per cent of the "total blind" people have no perception to light, while the remaining 75 per cent have varying degrees of useful vision, from the bare minimum capable only of giving guidance, to sufficient amounts to allow reading. Many of the senior individuals heretofore classified as "blind" have found that what vision they do have can often be mobilized and made more efficient through the use of various optical aids developed by research in optometry. It is for this reason that the diseases and anomolies that cause impaired vision are of deep concern to the modern optometrist.

One of the problems to be coped with by the ophthalmic professions is the "shock" that occurs when an aging person learns that his vision has become impaired. Much of this is due to a lack of understanding or lack of information as to the tremendous strides that have been made in correction and aid.

In perception, those with impaired vision (especially those requiring optical aids) find a problem in habituation and automazation .... getting used to the new visual demands, so to speak. It is a matter of changing one's habits in order to use new "vision". This is especially difficult in reading and writing where so much is based on making use of "visual cues" (scanning and tip-off words). Until the individual learns to use his optical aid and automatically "see" without requiring conscious analyzation and interpretation, vision is restricted.

Another major problem for the partially-seeing individual is an inadequate rate of perception for meaningful comprehension in reading. It is not at all uncommon to have the rate of perception reduced to individual letters. And since effective reading requires recognition of a group of letters as a word, a group of words as a phrase, a group of phrases as a sentence, and a group of sentences as a paragraph, those with partial vision find reduced ability a difficult handicap, until proper and effective optical correction. is made.

Mobility, the capacity of facility for movement is another essen

tial function that creates a problem for the visually handicapped. Mobility has two components: mental orientation and physical locomotion. Lowenfeld (1950) defined mental locomotion as the "ability of an individual to recognize his surroundings and their temporal or spatial relation to himself", and locomotion as "the movement of an organism from place to place by means of its organic mechanism". Both are essential.

One of the greatest handicaps to the aging person is the loss of mobility. It is considered by many as the most severe single effect of the loss of sight, and creates conflict and frustration. But although good vision is desirable for mobility, it is not always necessary. Even limited sight, skillfully used, maintains orientation and mobility. As a general rule, if visual acuity is better than 20/400, there is little restriction of mobility.

Magnification makes it possible to correct or increase the resolving power of the eye by increasing the size of the retinal image. This is the basis of most compensating lenses. For example, if the best visual acuity of an individual is 20/80, the relationship makes necessary a magnification of 4-times if the individual is to see normally. Correction can be made in only three ways: by decreasing the distance of the object from the eye, by increasing the size of the object (as enlarging the print in a book), and by angular magnification through the use of one or more lenses in front of the eye.

A COMMUNITY RESPONSIBILITY

With the trend moving toward a population of older people in our society, it is only natural that aging has become a community responsibility, as well as an opportunity.

There has been a growing interest in the older citizens, in hundreds of communities throughout the United States. This in turn has been transformed into activity designed to cope with the challenge of aging.

All of our fifty states have now established commissions or committees on aging. Scores of conferences have been held, and geriatric organizations and meetings are becoming more prominent.

The American Optometric Association and many individual optometrists are deeply active, for good vision is a deterrent to many of the worst handicaps of age.

Because optometry's interest is so keen and its function so important in alleviating problems of the senior citizen, it is only natural that many community projects are spear-headed by local optometric societies. Among those that have proved

successful are:

Community Clinics For The Partially Sighted

Community vision screenings are conducted at cost to patients. This is a valuable community project because it enables aged individuals who have reduced or limited incomes, because of their physical limitations, to get good vision care.

Many of these clinics are conducted in cooperation with the public health department, service clubs, and other organizations. Vision clinic programs can be arranged in most communities upon request.

Senior Citizen Plan For The Indigent Aged

This is a community project in which citizen's groups and local optometrists cooperate for the welfare of the community's indigent aged. The citizen's groups contribute ophthalmic material, while the optometrists contribute their time. This is a very valuable combination that can benefit a large number of otherwise neglected senior citizens.

Eye Care Programs For Homes For The Aged

As the title suggests, this program is designed specifically to benefit aged individuals in nursing homes, and shut-ins. This is particularly valuable in smaller communities and smaller homes where regular staff optometrists are not retained.

Where this program operates, local optometric societies provide a panel of local optometrists, who are made available to provide visual screening services for the homes. They also offer consultation as to methods of

improvement of lighting conditions, general environment, types of printed material to be provided for reading, and other services helpful to comforting and aiding the partially sighted or blind aged patient.

Public Information

One of the major problems facing any profession is education of the general public to facilities that are available. The more specialized the profession, the greater the problem. It has been found that the general public is usually several years behind in receiving correct information concerning vision care. Often the information is misconstrued or misinterpreted. There are times, too, where the public believes baseless information from an unreliable source, often nothing more than opinion or superstition.

To counteract the lack of reliable information, the American Optometric Association, through its Committee on Vision Care of the Aging, has established a special panel program available for meetings, radio, and television. Available to service clubs and citizen groups, as well as through the broadcasting media, the program presents information in an interesting and easy to understand manner.

Many optometric societies are also active in providing exhibits for meetings and programs sponsored by various senior citizens' organizations, hobby clubs, county and state fair boards, and other groups interested in the care of the aged.

Material and equipment, such as telescopic spectacles, glaucoma screening devices, books and articles on vision care, vision aids for the partially seeing adult, and specialized and unusual types of lens corrections, are shown. This affords the community an opportunity to see a wide variety of the latest ophthalmic devices.

The programs listed above are currently being used in various communities throughout the United States. Unfortunately, a lack