VA Blind Rehabilitation Services (BRS)

Blind Rehabilitation Service provides care coordination, assessments and therapeutic instruction to help Veterans and active duty Service members reclaim the confidence and skills needed to lead an independent, fulfilling life after vision loss.

Blind Rehabilitation Service (BRS) at James A. Haley Veteran’s Hospital includes several clinics. To learn more about each clinic use the links below. 

Visual Impairment Services Team (VIST) Coordinator

Visual Impairment Services Team (VIST) Coordinator

The VIST Coordinator is often the entry point into the BRS Continuum of Care for visually impaired Veterans and serves as a lifetime care manager for Veterans who are enrolled in BRS. 

The VIST Coordinator helps organize a program of services for eligible Veterans and their families. Such services focus on improving the Veteran’s quality of life and may include inpatient, outpatient, or community referrals for: 

• Vision-enhancing devices and technologies and training in how to use them. 
• Training in new visual skills to help with everyday tasks such as reading, writing, cooking, medication management, locating and reading signs.
• Sensory training that helps make use of other senses, like hearing or touch.
• Orientation & Mobility training that helps improve safety and confidence navigating the world with vision loss. 
• Strategies for restoring communication through writing or use of assistive technology. 
• Counseling and support groups to help with adjustment to vision loss. 
• Family training to educate the Veteran’s support system on how to assist during the adjustment process. 

The VIST Coordinator evaluates Veterans for these services and more during the initial appointment for enrollment in the VIST program. After enrollment, follow up will be provided annually, or at a frequency recommended by the VIST Coordinator. 

Who is eligible for services? 

To enroll in the VIST program, a Veteran must be:

1. Eligible for VA health benefits (or active duty service members) and 
2. Diagnosed as legally blind (as diagnosed by an Optometrist or Ophthalmologist) 

Additionally, some Veterans with vision loss may qualify based on functional deficits and other disabilities, as determined by the VIST. 

What is “legal blindness”? 

Legal Blindness is a measurement based on acuity (clarity of vision) and/or visual field (lateral and vertical). The maximum lateral field of view is almost 180 degrees and the maximum vertical is about 135 degrees. To qualify as Legally Blind, a person must have at least one of the following: 

• A visual acuity of 20/200 or worse in the best eye using the best corrective lenses. 
• A visual field of 20 degrees or less.

Legal blindness exists on a spectrum and serves as an indication that a Veteran may benefit from additional support from Blind Rehabilitation Services. Most Veterans enrolled in the VIST program have some amount of remaining vision. 

Inpatient Blind Rehabilitation Centers

If deemed an appropriate part of the VIST treatment plan, a Veteran may be referred to one of the VA’s inpatient Blind Rehabilitation Centers (BRCs). 

A BRC provides inpatient, intensive interdisciplinary rehabilitation programs to Veterans with visual impairment within a VA medical facility support system.

BRC residential settings maximize the opportunity for peer-to-peer interactions, which help Veterans strive to achieve their best level of independence and envision a positive future. 

Veterans receive a comprehensive individualized treatment plan based on their expressed goals and unique needs. Therapeutic instruction is provided on a one-on-one basis or group setting. Length of BRC program will vary depending on the Veteran’s treatment plan. 

Family members, included as members of the treatment team, are provided with education and training that allows them to understand visual impairment and provide support for goal achievement. 

LOCATIONS 
American Lake, WA 
Augusta, GA 
Biloxi, MS 
Birmingham, AL 
Cleveland, OH 
Hines, IL 
Long Beach, CA 
Palo Alto, CA 
San Juan, PR 
Tucson, AZ 
Waco, TX 
West Haven, CT 
West Palm Beach, FL

Questions 

For more information on Blind Rehabilitation Services or to find out if you qualify for the VIST program, please contact the VIST Coordinators at James A. Haley Veteran’s Hospital. 

Heather Couch, COMS, VIST Coordinator


William Wilson, M.A., VIST Coordinator
 

Blind Rehabilitation Outpatient Specialist (BROS) 

Blind Rehabilitation Outpatient Specialists (BROS)

The treatment plan developed by the Veteran and VIST Coordinator may include outpatient services delivered by the Blind Rehab Outpatient Specialist (BROS). The BROS provides assessments and therapeutic instruction within a variety of settings, which may include the Veteran’s home. Services provided by the BROS:

• Goal development and individualized treatment planning. 
• Assessment and instruction to increase awareness of the environment and improve safety. 
• Provide therapeutic instruction on how to maximize remaining vision to complete tasks, such as accessing printed material, financial management and food prep/kitchen safety. 
• Training on how to use assistive technology to address functional deficits as a result of visual impairment.

Advanced Low Vision & Low Vision Therapy (ALVC)

Advanced Low Vision & Low Vision Therapy

What is Low Vision? Low vision is defined as a condition in which there is significant loss of vision uncorrectable by conventional means (eyeglasses, contact lenses, medicines, or surgery) that negatively impacts patient safety or impairs or restricts one or more activities of daily living.

What is a Low Vision exam? A standard ophthalmic exam includes both a vision test and an assessment of eye health; medications may be prescribed. A low vision exam focuses on how vision loss affects daily life and enhancement of remaining vision. Magnifiers and other low vision aids are trialed during the low vision exam. 

Services may include, but not limited to: 

• Low vision optometry exam and functional vision evaluation.
• Assessment and therapeutic instruction on how to maximize remaining vision to complete tasks such as accessing printed material, financial management and food prep/kitchen safety.
• Training on how to use assistive technology to address functional deficits as a result of visual impairment.
• Assessment and instruction to increase awareness of the environment and safety. 

Orientation & Mobility (O&M) 

Orientation & Mobility (O&M)

Vision loss can have significant impact on not only safety, but also confidence. Orientation & Mobility is hands on, functional training that can teach a Veteran how to use remaining senses to navigate a variety of environments and situations.  Orientation can be defined as knowing where you are, where you want to go, and how you’re going to get there – this can be a challenge when sight is limited. Mobility refers to the ability to move through the environment in a low risk and efficient manner. O&M provides Veterans with skills and tools to reduce risk and increase efficiency for travel inside and outside the home.

Common concerns O&M can address: 

• Loss of confidence and independence 
• Bumping into people, furniture, or doorways 
• Tripping over items on the ground, such as parking curbs
• Ability to navigate stairs, curbs, ramps
• Loss of transportation 
• Getting turned around in familiar or unfamiliar areas 
• Difficulty crossing various types of intersections
• Training for a Veteran’s partner, family, or caregiver, such as Human Guide technique