• Outpatient Low Vision and Blind Rehabilitation Services for Veterans and Active Duty Service Members (OVRS)

  Outpatient low vision and blind rehabilitation services in the VA’s continuum of care for veterans and active duty service members with low vision or blindness provide an individualized rehabilitation program aimed toward achieving skills acquisition, adjustment to their condition, and community integration. This is accomplished through a full-service continuum established in each Veteran Integrated Service Network (VISN) through the Veterans Health Administration (VHA) system, by contract with qualified providers from the private sector, or a combination of both.

  Outpatient low vision and blind rehabilitation services begin with a comprehensive evaluation of visual functioning and an evaluation that identifies impediments to activities of daily living, health care, home and living activities, educational pursuits, vocational pursuits or volunteerism, and family and community involvement. A comprehensive rehabilitation plan is developed through an interdisciplinary process to incorporate the person’s expressed goals as well as identified needs as assessed by professional staff members and available VISN and local community resources. Persons served are referred to the appropriate level of care based on their evaluation results. See Appendix E. in the standards manual for a flowchart for referrals for veterans and active duty service members who have low vision or who are blind.

  Veterans and active duty service members who have developed blindness or low vision may also acquire co-morbidities that may create additional disability. These disabilities may result from a complex interaction of medical conditions, related morbidities, and environmental factors that affect patients and caregivers. Rehabilitation services are designed to address the complex nature of disabilities and must be interdisciplinary. Their development requires the creative energy of multiple disciplines working in a synergistic manner. For example, rehabilitative interventions such as magnifiers that target poor visual acuity may improve visual performance; however, everyday function may not be enhanced if appropriate environmental or assistive technologies such as good lighting, visual skills training, and ergonomic support are not available to complement the visual performance improvements. Similarly, improved visual function may not improve overall everyday function and quality of life if veterans also have medical conditions that affect their ability to function. An interdisciplinary approach to developing optimal rehabilitative interventions for this population is critical. Such interventions may include assistive technologies, environmental modifications, skills training, caregiver education, and various combinations of these strategies.

  The following programs are available for accreditation under Outpatient Low Vision and Blind Rehabilitation Services for Veterans and Active Duty Service Members:

  • Intermediate Low Vision Clinics (OVRS:IC)
  • Advanced Ambulatory Low Vision Clinics (OVRS:AC)
  • Advanced Hoptel Outpatient Blind Rehabilitation Clinics (Visual Impairment Services Outpatient Rehabilitation {VISOR} Programs) (OVRS:AH)

• Advanced Ambulatory Low Vision Clinics

  This program provides an emphasis on training in the use of vision skills and vision enhancement for performance of activities of daily living (ADL). Emphasis is placed on training in the use of assistive technology to enhance a person’s travel and mobility-related activities, with a strong emphasis on safe traveling.

  Services include an emphasis on development of visual as well as other sensory and tactile compensatory strategies, communication modalities (such as basic Braille for labeling), and ergonomic considerations. Core components include enhanced use of assistive technology and skills training for ADL; instruction in orientation and mobility; and service agreements with audiology, physical medicine and rehabilitation, social work, and other social or psychosocial services as appropriate.

  Veterans and active duty service members who are referred to advanced ambulatory low vision clinics are identified as having needs that could not be met in an intermediate low vision clinic setting and are assessed to need advanced training on travel and mobility-related activities and skills, resulting in safe travel. As compared to the services provided in an intermediate low vision clinic, this program emphasizes use of enhanced specialty devices and provides more in-depth training to achieve the desired goals and outcomes. This requires greater planning and interdisciplinary team effort to assess and teach compensatory strategies, use of alternative techniques, and/or utilization of other senses. Alternate modalities such as auditory and tactile techniques are explored when they may be more safe or efficient. This program provides enhanced services and supports for ergonomics and environmental modifications.

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