Interviews With:
Dr. Kyle Niemann, OD – Optometrist, Visual Eyes Optical
Megan Mackie – Community Events Coordinator, Outlook Enrichment
In the rush of daily life, it’s easy to overlook the small things, like visions. This sense is something many of us take for granted, until it begins to change.
In this blog, we share two unique perspectives on eye care: one from a patient and one from an optometrist. Their experiences together highlight the importance of routine eye exams and provide a deeper understanding of the diagnostic process from both sides of the exam room.
An Optometrist Shares What to Expect at an Eye Exam
When was the last time you had a comprehensive eye exam? Optometrists (OD) see hundreds of patients each year and recommend that everyone, whether blind, visually impaired, or without current vision concerns, receive a comprehensive exam annually. Why? Many eye diseases can progress silently, with little to no early symptoms, making regular checkups essential for protecting long-term eye health.
“Many of the traditional tests we perform during a regular comprehensive exam may need to be adapted to accommodate the level of visual impairment. One key difference between a low vision exam and a regular exam is how a refraction is performed. Visually impaired individuals may not notice subtle changes, so during the refraction, the doctor will need to determine the level at which the patient can detect a difference. The doctor will then arrive at glasses or contacts that may give you the most visual benefit,” explains Dr. Kyle
Vision loss exists on a spectrum. Some individuals are completely blind with no light perception, while others may be legally blind, have low vision, or simply need corrective lenses. In some cases, changes in vision may signal an underlying medical condition, such as diabetic retinopathy, macular degeneration, cataracts, or glaucoma, which are among the leading causes of vision impairment and blindness. Regardless of where someone falls on that spectrum, maintaining eye health is crucial for overall well-being.
Another critical component within the low vision exam is monitoring disease progression through several scans of the back part of the eye and optic nerve. These scans ensure that the disease is stable and not showing signs of rapid or dangerous changes. Patients may be referred to an ophthalmologist (OMD) for specialized treatment if their eye condition requires advanced care. In other instances, lifestyle adjustments may help slow the progression of vision loss, although a clear solution is not always present.
“Typically, a diagnosis is fairly straightforward with a simple update to the patient’s prescription. However, for patients with a visual impairment, the start of the conversation may be a bit different. One of the most important aspects of my approach is maintaining empathy for the patient. When dealing with sight-threatening diseases, it’s crucial to understand the patient’s situation and clearly explain the symptoms they may experience. I especially emphasize the importance of follow-up care to ensure stability of the disease and to prevent rapid progression. Many patients receive handouts, pamphlets, or are directed to a website for additional education. Outlook Enrichment has been a vital resource for patients struggling with daily activities, and it’s empowering to know there’s a place that can truly support and guide them,” shares Dr. Kyle.
A Patient’s Ongoing Journey with Diabetic Retinopathy
Growing up with diabetes, Megan Mackie was always aware that vision loss could be a potential complication. However, it wasn’t until she turned 28 that she noticed significant changes in her eyesight, which made it challenging to see at school and work. After failing an eye exam at the DMV, she realized it was time to visit an eye doctor.
“Initially, I could drive myself to the appointments. It all became routine: paperwork, then the waiting room. After being called back, I’d stop at a few machines for pictures of my eyes, receive dilation eye drops, wait in a dark room, and then proceed to the exam room. Repeating my eyesight status at every appointment became frustrating, and I was nervous about reading the eye chart because I could not accept that my eyesight was declining,” Megan explains.
At this point, she had been diagnosed with diabetic retinopathy and had already experienced a retinal detachment in the center of one eye. She noticed “floaters,” blobs of blood from the blood vessels in her eyes. Blood vessels continued to grow, blood flow worsened to her optic nerve, and she developed a severe case of band keratopathy.
“If this all sounds like a foreign language to you, it did to me, too. The details went in one ear and out the other,” Megan admits.
Initially, she felt hopeful. With various medical recommendations presented, the outcome seemed optimistic. But the following year, the retina in her “good” eye also detached. Her doctor scheduled surgery to attempt a reattachment, but there was little guidance beyond the medical side of things. No one explained how she would manage her daily life without vision, how to pay bills, access transportation, navigate Social Security and Medicaid, or continue working. In the beginning, Megan had to rely heavily on her family, who were facing the same uncertainties.
After several surgeries, Megan realized her vision had become even more limited than before. The treatments had taken a toll on her eyes, and there wasn’t anything more her doctor could do. The only option left was to manage her blood sugar and blood pressure, her best and only chance at preserving the little sight remaining.
At the time, Megan didn’t know anyone else who was blind, and everyday tasks quickly became overwhelming. She struggled to distinguish one eye drop bottle from another, draw up her insulin injections, and read or pay bills. She was scared to leave the house; the offers of help with transportation had ceased, and the idea of returning to work felt impossible.
“It wasn’t until I discovered the resources available for people with vision loss that I was able to rebuild my life physically, mentally, and financially slowly. At some point, I had to accept my vision loss journey. I realized I would be responsible for taking the necessary steps to move forward. The Nebraska Commission for the Blind and Visually Impaired (NCBVI) helped me learn cane travel, introduced me to public transportation, and supported me with job searching. Becoming employed at Outlook was a huge relief. I was able to get off state assistance, and they even had a resource advisor who could answer my Social Security questions with my best interests in mind. Looking back, had I been informed about resources available at the same time as my diagnosis, I could have started the recovery process sooner with more support,” she reflects.
Connecting Patients to Vision Loss Resources and Services
For someone who is blind or visually impaired, visiting the eye doctor requires extra planning. Patients must schedule transportation, navigate unfamiliar spaces, and fill out paperwork, all of which can take much longer than for the average patient. Many rely on adaptive technology, such as screen readers, closed-circuit televisions (CCTVs), or smartphone apps, to help complete these basic tasks.
Despite these challenges, the support patients receive often ends at the diagnosis. Patients like Megan are rarely given clear guidance on what comes next, and while that may not fall entirely on the doctor’s shoulders, even a small gesture of direction can make a meaningful difference. That’s where organizations like Outlook Enrichment come in.
Something as simple as a brochure or business card can provide valuable guidance for someone navigating a sudden loss of vision. These resources offer patients a tangible takeaway during a challenging time, serving as a starting point for their journey.
We act as a bridge between diagnosis and the next step of their journey, whether that means discovering adaptive technology, learning new life skills, regaining independence, or finding a community of individuals who truly understand their experiences.
As advocates for individuals with vision loss, we’re also working to educate eye care providers about this often-overlooked aspect of care. By collaborating with optometrists, ophthalmologists, and clinic staff, we aim to build stronger referral pathways and ensure patients are connected to the resources and support they need as early as possible.
Together, we can create a more informed, compassionate, and empowering continuum of care, one that doesn’t stop at diagnosis but supports every step that follows.
Vision loss is life-changing, but it doesn’t have to define your life. As we’ve seen through Megan’s story and Dr. Kyle’s insights, a diagnosis is only one step of the journey. What follows, access to resources, emotional support, and the ability to adapt, makes all the difference.
If you or someone you know is facing vision loss, remember that you’re not alone. Outlook Enrichment is here for you when you need us. Ready to take the next step? Get in touch with our team today.
