The low vision support system is a general term for a mechanism that connects medical care, welfare, education, employment, and information support for people with residual visual impairment. When treatment alone does not resolve difficulties in daily life, support that utilizes remaining visual function and connections to social resources become important 2).
The Japan Ophthalmologists Association states that for people who have developed low vision, in order to continue daily life and plan for the future, it is necessary to provide daily living training, skill acquisition, and employment support in parallel with disease treatment 2).
It is a template for a regional collaboration leaflet used to introduce consultation services so that low vision patients can receive appropriate guidance and training according to their concerns 1). It is used as an entry point from ophthalmology to regional support organizations.
Consultation services
Medical: Low vision clinics, ophthalmology medical institutions.
Community support: Vision impairment centers, disability independence support centers, special needs schools, etc.
Coordination pathway: Smart Site is used to organize consultation contacts 1).
Devices
Representative examples: Magnifying reading devices, information and communication support devices.
Concept: Eligibility varies depending on the type and severity of disability and household situation 5).
Procedures: In many cases, prior application before purchase is required 5).
Information support
Reading support: Braille books, audio books, DAISY.
Human support: In-person reading aloud, consultation support.
Facility examples: Libraries, braille libraries, light centers, etc. 3)4)6).
The support systems can be broadly categorized as follows.
| Support | Representative example | Example consultation contact |
|---|---|---|
| Community coordination | Smart Site | Ophthalmology |
| Assistive devices | Magnifying reading devices | Local government |
| Information support | Braille and DAISY | Libraries, etc. |
Before consulting about support systems, organizing the following can be helpful.
According to Yokohama City’s guidance, daily living aids are provided under a system that supplies “equipment necessary for smoothly carrying out daily life,” with a standard 10% copayment and requiring prior application 5). An example of information and communication support aids is the video magnifier 5).
According to Yokohama City’s information support guide, all 18 municipal libraries offer lending of audio and braille materials as well as face-to-face reading services, and the Central Library also provides online face-to-face reading 4). Additionally, there is postage exemption for braille mail, and braille, audio, and DAISY versions of public relations materials are available 4).
The Braille Library Room at Osaka City Hayakawa Welfare Hall produces and lends braille and audio books, offers face-to-face reading, reading consultations, and can obtain materials from braille libraries nationwide 6). Lending is free, and as it is handled as fourth-class mail, round-trip postage is free 6).
The Ministry of Health, Labour and Welfare’s reading support photo report introduces that braille libraries nationwide produce and lend braille and audio-transcribed books, and that Sapie is an information provision network for braille and DAISY data 3).
The local government’s daily living aids counter is often the first point of contact 5). It is easier to proceed if you can consult with an ophthalmology or low vision clinic about the actual suitability and necessity.
A realistic flow is as follows.
| Step | Content | Contact Point |
|---|---|---|
| 1 | Organize concerns | Patient/Family |
| 2 | Ophthalmology consultation | Ophthalmology |
| 3 | Community referral | Smart Site, etc. |
| 4 | Apply for services | Local government |
| 5 | Ongoing support | Welfare/Education, etc. |
The Japan Ophthalmological Society has positioned simple low vision care that all ophthalmologists can provide in daily practice, i.e., quick low vision care, as the next goal following the development of Smart Site 2). The idea of connecting from ophthalmology to support is important.
There is support available. According to the Osaka City Braille Library guide, people without a certificate or those who have difficulty using print can also consult 6). On the other hand, some systems such as daily living aids require a certificate or grade as a condition 5).
According to materials from the Japan Ophthalmological Society, a Low Vision Network Study Group was established in 2011, and by 2021, the creation of Smart Site leaflets was completed in all 47 prefectures 2). Currently, they are also used for welfare collaboration across prefectural borders 2).
The same materials position low vision care as part of primary eye care and emphasize the importance of connecting patients who are anxious because treatment is not progressing as expected to support at an early stage 2).
In addition, the Smart Site related information page shows how to use it by listing consultable facilities such as local low vision clinics, visual impairment centers, special support schools, and disability independence support centers, and giving them to patients 1).
Low vision support systems mix nationwide common concepts and regionally different practices.
It is not the same. Although the concept of support is common, specific contact points, distribution materials, benefit items, and facility names differ by region 1)5). It is necessary to check the regional version of Smart Site or local government guides.
