Home
Forms Library
Low vision assessment pdf

Low vision independence measure 2026

low vision assessment pdf Preview on Page 1

See details

4.8 out of 5

22 votes

The document presents the Smith’s Low Vision Independence Measure (LVIM), a tool designed to assess the difficulty individuals with low vision experience in performing daily activities across various domains such as self-care, food preparation, home management, communication, financial management, leisure, shopping, and mobility. It includes a rating system for participants to evaluate their difficulties in these activities, aiming to identify areas where support may be needed to enhance independence.

Here's how it works

01. Edit your low vision assessment pdf online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out low vision independence measure with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Low Vision Independence Measure in the editor.
Begin by reviewing the 'Self Care' section. For each activity listed, rate your difficulty level from 4 (Not Difficult) to 1 (Unable), or select 'n/a' if not applicable.
Proceed to the 'Food Preparation' section. Again, assess each task and provide your rating based on your experience.
Continue through the sections: 'Home Management', 'Communication', 'Financial Management', and 'Leisure'. Fill in your ratings thoughtfully for each activity.
In the 'Shopping' and 'Mobility' sections, repeat the rating process. Ensure you capture your experiences accurately.
Finally, use the comments fields provided throughout the form to elaborate on any specific challenges or insights related to each section.

Start using our platform today for free to complete your Low Vision Independence Measure effortlessly!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the functional assessment of low vision?

Low vision when a person has a visual acuity of 20/70 or lower. Their vision cant be improved, even with glasses or contact lenses. Legally blind when a person has vision of 20/200 or lower. If visual aids such as glasses can correct a persons vision to better than 20/200, they arent considered legally blind.

How to measure low vision?

Distance visual acuity should be measured with a pinhole to assess possible refractive error. A multiple pinhole is preferable for people with low vision. Ideally, near vision should be tested using passages of print (in the LogMAR format) but if not possible, letters, numbers or symbols can be used.

How do you test for low vision?

Your doctor can check for low vision as part of a dilated eye exam. The exam is simple and painless. Your doctor will ask you to read letters that are up close and far away, and will check whether you can see things in the center and at the edges of your vision.

What is the range for low vision?

The World Health Organization defines low vision as visual acuity between 20/70 and 20/400, with the best possible correction, or a visual field of 20 degrees or less.

What qualifies as low vision disability?

The functional vision assessment (FVA) is for children with low vision. It is an assessment of how a child uses their vision in everyday life, so it is usually not done with children who are totally blind or have light perception only.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

What is the standard for low vision?

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.

Low vision independence measure 2026

Here's how it works

How to use or fill out low vision independence measure with our platform

Complete this form in 5 minutes or less

Got questions?

What is the functional assessment of low vision?

How to measure low vision?

How do you test for low vision?

What is the range for low vision?

What qualifies as low vision disability?

Security and compliance

Complete this form in 5 minutes or less

People also ask

What is the standard for low vision?

Related links

Try more PDF tools