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  • Smith's Low Vision Independence Measure 2020

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How to fill out the Smith's Low Vision Independence Measure online

The Smith's Low Vision Independence Measure is an essential tool designed to assess the difficulties individuals may face in daily activities due to low vision. This guide provides clear and supportive instructions on how to complete the measure online, ensuring users can accurately convey their experiences.

Follow the steps to complete the Smith's Low Vision Independence Measure online.

  1. Press the ‘Get Form’ button to access the Smith's Low Vision Independence Measure and open it in the designated editor.
  2. Review the Self Care section. For each activity listed, rate the difficulty level by selecting a number from 1 to 4 based on your experiences, where 4 means 'Not Difficult' and 1 means 'Unable'. Be sure to consider each activity independently and provide comments if needed.
  3. Proceed to the Food Preparation section. Similar to the previous section, respond to each activity regarding the ease of completion, again using the rating scale provided. Remember to document any specific thoughts in the comments section.
  4. Navigate to the Home Management section. Evaluate your ability to perform the listed tasks, and provide ratings as required. Use the comments area to elaborate on any particular challenges.
  5. Move on to the Communication section. Rate each activity based on your experiences and provide feedback in the comments section where applicable.
  6. Complete the Financial Management section using the same rating method. This section assesses your ability to manage financial tasks.
  7. Fill out the Leisure section, rating each listed activity according to the difficulty you experience.
  8. In the Shopping section, rate how difficult you find each task and use the comments section for any additional notes.
  9. For the Mobility section, assess your experiences related to mobility activities and include comments as necessary.
  10. At the end of the form, you can summarize your goals in the provided space. Don’t forget to add your therapist's signature if applicable.
  11. Finally, review all your responses, save your changes, and choose to download, print, or share the completed form as needed.

Complete your Smith's Low Vision Independence Measure online today to help identify your needs.

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The purpose of LVIM is to measure the amount of difficulty a patient, diagnosed with low vision, has in completing vision-dependent activities for daily living (ADLs) and instrumental activities for daily living (IADLs).

These often include: Visual acuity tests, where you read lines on a low vision eye chart. Visual field tests, which check for central or peripheral vision loss. Amsler grid test, where you look at a grid chart and check for wavy lines. Depth perception tests. Color vision tests.

Low vision aids (LVA) are devices intended to improve visual performance in patients with low vision. These devices improve academic, social, and skilled interaction and help uplift the daily experience.

The classification proposed by us is based on the national program for control of blindness' definition of normal vision (20/20 to 20/60), low vision (<20/60 to 20/200), economic blindness (<20/200 to 20/400) and social blindness (<20/400).

Visual acuity is scored as 0.1 logMAR for each line and 0.02 logMAR for each correctly read letter. Better visual acuity corresponds to a lower logMAR score. Depending on visual acuity, measurement can be performed by adjusting the distance between the patient and chart to 2 meters or even 1 meter.

20/500 to 20/1000, this is considered profound visual impairment or profound low vision. Less than 20/1000, this is considered near-total visual impairment or near-total low vision. No light perception, this is considered total visual impairment, or total blindness.

20/30 to 20/60, this is considered mild vision loss, or near-normal vision. 20/70 to 20/160, this is considered moderate visual impairment, or moderate low vision. 20/200 or worse, this is considered severe visual impairment, or severe low vision.

If someone has 20/70 visual acuity (meaning that they can only see something 20 feet away as well as something a person with normal vision can see from 70 feet away) or worse in their best eye even with corrective lenses, they have “low vision.” If they have 20/200 visual acuity in their best eye or worse, they are ...

The visual acuity test is used to determine the smallest letters you can read on a standardized chart (Snellen chart) or a card held 20 feet (6 meters) away. Special charts are used when testing at distances shorter than 20 feet (6 meters).

4 forms of visual impairment Central vision loss. The central part of the retina concentrates the cells responsible for visual acuity. ... Peripheral vision loss. In people with impaired peripheral vision, the visual field narrows. ... Blurry vision. ... Visual disorders following brain injuries.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232