Closing the gap: Duke builds a first-of-its-kind vision rehabilitation training pipeline

Vision loss can have a profound impact on independence, but professionals best positioned to help— like occupational therapists — have historically received little formal training in vision disorders.  The gap has created a critically small workforce at a time when an aging population is driving an urgent need for greater vision rehabilitation services.   

As age-related eye diseases such macular degeneration, glaucoma, and diabetic retinopathy become more common, the need for vision rehabilitation services is expected to dramatically increase.  With only about 450 Certified Low Vision Therapists (CLVTs) in practice nationwide, the need is immense, particularly for states like North Carolina with a large influx of retirees.

Duke School of Medicine is tackling the challenge with an innovative partnership between Duke Eye Center and the Duke Occupational Therapy Doctorate (OTD) program, a first-of-its-kind educational pipeline designed to train the next generation of vision rehabilitation specialists.

A New Educational Model

The program includes a graduate certificate in vision rehabilitation for occupational therapy students. Beginning in August 2026, it adds a vision rehabilitation fellowship for an advanced year of interdisciplinary clinical training, scholarship, and leadership development — making Duke the only institution in the country to offer both.

Together, the certificate and fellowship create a comprehensive training pathway unlike any other in the nation. Program leaders hope the model will help transform vision rehabilitation into a component of comprehensive eye care for occupational therapy students.

Diane B. Whitaker, OD, chief of Duke Eye Center's Division of Visual and Rehabilitation Performance, is unambiguous on the point: occupational therapists are the gold standard for assessing how physical and cognitive challenges affect a patient's ability to live independently. "That's what they do," she said.

Whitaker adds that an estimated 15 million adults over 65 will need vision rehabilitation in the next two decades, while countless others can also benefit. "They're already seeing patients with falls, hand injuries, stroke recovery, and other daily living challenges,” she said. “We've known for decades that this was an educational problem. What's innovative is that we're finally building an educational model designed to solve it."

Duke is bringing vision rehabilitation directly into occupational therapy education. Developed collaboratively by Duke Eye Center clinicians and Duke's OTD program, the graduate certificate in vision rehabilitation is built around nationally recognized competencies and extensive hands-on clinical experience.

The program requires students to complete at least 350 hours of supervised clinical training with patients as part of the fieldwork and capstone experiences for students in the certificate program. Graduates are immediately eligible to sit for the CLVT examination.

Students learn how vision loss affects mobility, cognition, safety, and quality of life. They also gain expertise in assistive technology, environmental modifications, lighting interventions, adaptive equipment, and rehabilitation strategies that help patients remain independent.

"It's not just learning it — it's doing it," said Omar Mohiuddin, OTR/L, CLVT, a low vision occupational therapist at Duke Eye Center who works with trainees and patients. "Students are immersed in patient-centered care, working alongside mentors, physicians, and rehabilitation specialists in real clinical environments."

"We are also seeing a record number of applicants for the certificate program. This year, more than one-third of our OTD class applied to participate,” said Tomeico Faison, OTD, OTR/L, director of the OTD Division’s Innovation in Professional Pathways program. “This level of interest reflects both the growing need for vision rehabilitation services and students' desire to develop expertise in an area where highly trained practitioners are urgently needed."

Patient-Centric Care

Much of the program's innovation lies in the environment where students train, an interdisciplinary setting that mirrors the realities of patient care. Students are embedded within Duke Eye Center, working alongside ophthalmologists, optometrists, occupational therapists, social workers, and rehabilitation specialists.

A patient may see multiple providers during a single visit, while clinicians collaborate in real time to address challenges ranging from driving safety and mobility concerns to assistive devices and emotional adjustment to vision loss. Ophthalmologists frequently stop by the rehabilitation clinic for informal consultations, creating opportunities for immediate collaboration and learning, a practice that Whitaker has coined “curbside consults.”

"Vision impacts every facet of life," Mohiuddin said. "Ultimately, we're addressing quality of life, independence, dignity, and the ability to participate in meaningful activities."

For students, the experience has opened unexpected career paths and revealed opportunities to address longstanding gaps in care.

Students Finding Purpose

Brian Gonzalez Granados, OTD, OTR/L, a member of the 2026 OTD cohort completing the vision rehabilitation certificate, said the clinical experience strengthened his confidence while highlighting disparities he observed growing up.

"This is a good option for me to provide back to the community I grew up in," he said.

After graduation, Gonzalez Granados plans to provide home-based low vision services in Durham County, with a particular focus on expanding access for Spanish-speaking patients.

For graduate Joshua Lucas, OTD, OTR/L, CLVS, a low vision specialist, the field became personal after watching a close family member struggle with glaucoma. Lucas plans to practice at Cape Fear Valley Health and hopes to eventually establish a low vision rehabilitation practice serving rural communities.

"I always wanted to work in a more rural area that doesn't have these services," Lucas said. "The certificate program allows you to restore people's hope in life, and in themselves, and in the things that they want to do, need to do, and have to do."

Lucas believes demand for these skills will only continue to grow. "You will have a skill set that is not only needed now, but will be in high demand for the future, and you will help many, many people," he said.