Clinical Low Vision Evaluation

By: Carmen Willings
teachingvisuallyimpaired.com
Updated June 14, 2025
A Clinical Low Vision Evaluation (CLVE) is a specialized assessment conducted by a Low Vision Specialist (usually an optometrist or ophthalmologist with low vision expertise). Unlike a standard eye exam, this evaluation focuses on maximizing the use of residual vision for functional tasks and provides actionable recommendations for increasing visual access across environments.

Purpose

The CLVE:
  • Assesses how a student uses vision in practical, everyday ways.
  • Determines if optical or non-optical low vision devices can improve functional vision.
  • Complements the Functional Vision Evaluation (FVE) and Learning Media Assessment (LMA) to guide literacy and educational planning.
  • Guides TVIs in determining appropriate training and support for device use.

Components of the Clinical Low Vision Evaluation

Case History
  • Medical and ocular history
  • Family observations about daily functioning
  • Information from the most recent eye reports
  • Home, school, and community independence levels
Ocular Health
  • Examination of eye structures
  • Review and clarification of visual diagnosis
  • Explanation of visual condition for family (when appropriate)
Visual Acuity Testing
  • Near and distance acuities tested
  • Each eye is tested individually and together
  • With and without corrective lenses
Visual Fields
  • Central and peripheral field assessment
  • Helps determine the functional impact of field loss
  • May support diagnosis of progressive conditions
Color Vision
  • Assesses ability to distinguish and identify colors
  • Informs strategies for using contrast effectively
Refraction & Lenses
  • Determines if visual acuity can be improved with an updated prescription
  • May recommend contact lenses for specific corneal or refractive issues
Binocular Vision & Oculomotor Skills
  • Evaluates the ability to use both eyes together (binocularity)
  • Examines tracking, scanning, fixation, and head positioning
  • Results affect device prescription and training plans
Contrast Sensitivity, Light Sensitivity, and Illumination Needs
  • Identifies needs related to glare, contrast, and lighting conditions
  • Helps guide environmental modifications and material presentation

Recommendations and Follow-Up

At the conclusion of the evaluation:
  • The Low Vision Specialist provides device recommendations (e.g., handheld magnifiers, monoculars, electronic magnification).
  • Some clinics offer loaner devices for trial.
  • A follow-up visit may be scheduled to assess benefit and make adjustments.
Possible Devices May Include:
  • Near magnifiers
  • Stand or dome magnifiers
  • Monoculars or telescopes
  • Video magnifiers (CCTV)
  • Tinted lenses or filters
  • Task lighting

​TVI's Role After a CLVE

  • Instruct the student on device use and care
  • Incorporate the findings into the IEP/504 Plan
  • Ensure classroom environments and materials align with specialist recommendations
  • Collaborate with the educational team to monitor success and usability of devices
  • Request follow-up if vision changes or device use declines

Suggested Questions to Ask the Low Vision Specialist

  • What is the cause of the student’s vision loss?
  • What are the student’s corrected visual acuities?
  • Is the condition stable or progressive?
  • Are there treatments or therapies available?
  • What training or tools can help the student use vision more effectively?
  • What follow-up or next steps do you recommend?

Guide to Selecting Optical Aids by the New York Lighthouse

Each symbol used in its Code relates the visual acuity range to the number of Diopters needed to read average print (8pt to 12pt)
Near Vision
Lighthouse Code
Diopters
Magnification
Focal Distance
20/40-20/60
A
3-6 D
Up to 1.5X
12-6 inches
20/70- 20/100
B
7-10 D
1.75X - 2.50X
6-4 inches
20/100- 20/200
C
10-20 D
2.5X - 4X
4 - 2.5 inches
20/200- 20/400
D
20-40 D
5X - 8X
2.5 - 1 inches
below 20/400
E
40-80 D
10X - 20X
0.5 inch or less
History of Visual Impairments
Professional Practice
Vision Professionals
Professionalism
Teacher Resources
Professional Publications
VI Book Resources
Family Resources
VI Referrals
Medical vision exams
visual diagnosis
fvlma
other evaluations