Occupational Profile/Case History

An informal questionnaire will gather information regarding the client’s vision and health status, history of receiving vision therapy, history of eye care treatments, to understand their prior level of function before their vision loss, and to assist in determining their current goals.

Veterans Affairs Low-Vision Visual Functioning Questionnaire (VA LV VFQ-48) is a questionnaire that is structured to ensure that an occupational therapist can gather relevant information during the evaluation that will assist in creating an accurate and effective plan of care. VA LV VFQ-48 is found to have valid and reliable measures to measure visual ability in low-vision clients with moderate to severe vision loss. This objective assessment can also be used to track functional improvement.

Suggested Questions to include during Occupational Profile Questionnaire:

“What happened? What brought you here today?”
“Do you remember when your vision problems started occurring?”
“How long have you had these problems?”
“What do you feel like your vision problems limit the most?”
“What are your daily struggles?”
“Have you seen an optometrist or ophthalmologist? Have you been properly diagnosed?”
“Do any of your family members have vision problems that you know of?”
“What is most difficult to see?”
“Can you see light? how about light shadows? People’s faces?”
“Do you wear glasses?”
“Have you received any vision therapy in the past? When? and describe it.”
“If you were to give me three goals that you would like to be able to achieve in the near future – what would they be?”

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