According to the U.S. Census Bureau, there are nearly 7.5 million people living in the United States with visual impairments. Visual impairments can be classified many different ways, two of which are low-vision and legal blindness. Low-vision is commonly classified as best-corrected visual acuity of 20/40 or worse and legal blindness is defined as best-corrected visual acuity of 20/200 or worse in the better-seeing eye, or less than 20 degrees of visual field in the better eye. Moreover, the National Eye Institute projects that the number of people with visual impairments will double by 2050 due to an aging population.
The mission of the Lions Vision Research and Rehabilitation Center at Wilmer Eye Institute, Johns Hopkins Medicine is to improve everyday function in patients with vision loss that cannot be improved with eyeglasses, contact lenses, medication or surgery. In other words, Vision Rehabilitation is the clinic that teaches people life skills — either through enhancement with lenses and devices that will allow them to maximize their vision or alternatively through the use of nonvisual skills. Heather Connors, certified ophthalmic assistant and certified low-vision therapist, is the division’s sole ophthalmic technician. This is a story of her day.
I visited Connors on a recent Monday in September to learn more about her work. I arrived at the clinic shortly after 10am. Connors was unavailable. She was in the ocular immunology division to perform a visual field test on a patient of Belinda Weinberg, clinical assistant of ophthalmology, who was examining patients there on this day. On Mondays, not only does Connors perform diagnostic testing for Weinberg, but she also works alongside Judith Goldstein, associate professor and chief of the Lions Vision Research and Rehabilitation Center, and Kristen Shifflett, occupational therapist. When she isn’t performing diagnostic testing, Connors performs intakes and screens patients to obtain a detailed health and eye history.
By the time I arrived in the clinic, Connors had already seen three patients. When Connors returned to the clinic, a patient of Goldstein’s had arrived. For today’s visit, the patient wanted to learn how to maximize use of her iPhone by learning how to make it more accessible. For more than 30 minutes, I watched as Connors provided empathic care with patience and tact, while modifying settings and carefully reviewing the accessibility functions and answering all the patient’s questions.
According to Shifflett, Connors’ dedication to patient care does not go unnoticed. “Heather is indispensable. She is patient and will work with patients to get them what they need. She is a wealth of knowledge,” says Shifflett, who lauds Connors’ previous work as an optician and now as a certified low-vision therapist. “Heather is the Jill of all trades. She can fix eyeglasses, and she can help patients with accessibility.”
The next patient was an emergency add-on for Goldstein from the retina division. The retina specialist, upon examination, had noticed worsening of vision that was not present on previous exams. After the initial screening, Goldstein recommended the patient have a Goldmann visual field test. Unlike the automated Humphrey visual field test, a Goldmann visual field is a peripheral vision test in which the examiner manually moves the light from the periphery slowly into the central vision. Once the test is completed, results are plotted by hand.
Connors says there are many reasons why the clinic uses the Goldmann visual field test versus the Humphrey visual field test, including the ability to adjust the parameters of the test to accommodate the needs of patients with certain visual impairments.
Although visual field testing is painless, the patient was visibly nervous. However, Connors was able to quell any fears with kindness and warmth. She described the test in detail, and explained to the patient what the doctor was looking for and why.
Goldstein says Connors brings a combination of unique talents, skills and abilities to the vision rehabilitation service and the team.
“Her skills as an ophthalmic technician allow us to offer our patients specialized testing, which few technicians are skilled in administering, and she intakes patient histories with a functional orientation,” says Goldstein. “Her background as an optician enables her to communicate and advise patients regarding lenses and spectacles — something of utmost value to our patients and doctors. Heather’s certification as a low-vision therapist has added a level of value that routinely rounds out the patient experience as she teaches techniques and strategies to improve their everyday function.”
In addition to performing diagnostic testing, patient screening and intake, and providing patient education and rehabilitative services, Connors writes orders for glasses, quality checks eyeglasses in clinic and provides adjustments as necessary. She also works with Shifflett to produce patient information handouts and to order clinic equipment.
Connors graduated early from Salisbury University in 2005 with a general education degree. After graduation, she worked for eight years as an optician with her father, an optometrist. In 2015, Connors became a certified optician. After working with her dad, she managed an optical shop for a few years before joining the Wilmer family in 2017.
“It was an amazing move for me,” says Connors about the decision to join the Wilmer float pool. “I saw different specialties and different locations. I also learned that I love interacting with the patients. After a year, I found my home in the Lions Vision Research and Rehabilitation Center.”
In March 2018, shortly after joining the clinic full-time, Connors became a certified ophthalmic assistant. Two years later, she became a certified low-vision therapist — an achievement of which she’s proud.
“Our goal is always to help patients meet their individual needs, to stay independent and to help direct them to other services that may help,” says Connors. “It takes a village and multidisciplinary care, in and outside of Wilmer. I am honored to be part of this small village. Some days can be very emotional — happy or sad — but they are all days to do our best and help the patients.”
On Oct. 15, Connors spoke at Wilmer’s 24th Annual Tech Course, where she presented on the importance of vision rehabilitation services and how to interact with patients with limited vision. She even brought a Wilmer patient to talk about her experience as a someone living with vision impairment.
“Heather’s can-do attitude continually reminds us and our patients that there is always a way to problem solve, whether it be patient care, administrative or the logistical issues we encounter,” says Goldstein. “Her stellar organizational skills allow us to do what we do best — make every patient experience the best it can be.”