Hypovision and visual rehabilitation
Hypovision is a term that describes a bilateral, irreversible functional impairment of vision that can negatively affect individual autonomy. This condition is often caused by the combined action of one or more pathologies affecting the visual apparatus. The most frequent causes of adult hypovision in the Western world are: maculopathies – including senile and myopic macular degeneration and hereditary maculopathy - hereditary degenerative disorders such as retinitis pigmentosa, diabetes, high myopia, and glaucomatous and ischemic neuropathy.
In Italy, a new legal classification of visual impairments has been introduced, which considers hypovision to occur when visual acuity is 3/10 or lower in the better eye, and blindness when visual acuity is 1/20 or lower in the better eye. Increasing life expectancies and new treatments for a wide range of pathologies have meant that the number of patients with visual impairments has increased, and thus visual impairments have become a social problem that affects a great number of subjects of various age classes. The importance and topicality of visual rehabilitation centres is based on social and epidemological considerations. Indeed, hypovision is a condition that affects more than one out of every 100 people. It has been estimated that 11 million people in Europe are affected by hypovision, with an additional one million who are blind. Between 60% and 80% of people with hypovision can be helped by vision aids: in Europe, this would mean between 6.6 and 8.8 million people.
It has also been proven that in most cases, the mere prescription of vision aids alone does not allow the patient to fully exploit their residual potential functionality. The primary rehabilitation goal for these patients is to preserve residual visual acuity and allow them to optimize their use in order to maintain autonomy in performing activities appropriate for their age, thus achieving a satisfactory quality of life. In other words, it is not just a matter of choosing the most suitable vision aid – in light of the type of pathology, residual vision, and the personal abilities of the patient (hobbies, reading, previous career). Most importantly, the patient must be taught to use a new retinal fixation in order to make the best of the prescribed vision aid. To this end, the rehabilitation programme may subject patients to microperimetic biofeedback sessions: rehabilitation through feedback takes place during a series of exercise sessions in which the patient, guided by visual and sonic stimuli, learns to recognize the new retinal fixation point (RFP) and stabilize it over time, thus improving their reading capability and making everyday activities safer and faster.
For several years now the Bietti Foundation has been running a Centre for Hypovision and Visual Rehabilitation, with a rehabilitation process that allows the patient to maximize their residual visual acuity. The centre uses standardized treatment protocols adapted to the needs of each individual patient, in order to provide the best functional results and, ultimately, an improved quality of life.