Low Vision Rehabilitation Helps The Legally Blind To See Again

Many patients classified as blind today actually have some sight remaining and, thanks to developments in the field of rehabilitative vision, also known as low vision, they can be helped to make good use of it.

Anyone with reduced vision is visually impaired, and can have problems functioning, ranging from minor to severe difficulty. There are two general classifications of low vision in use today:

o partially sighted – visual acuity that with conventional prescription lenses is still between 20/70 and 20/200 (a person with 20/70 eyesight must be 20 feet away to see clearly an object that a person with 20/20 eyesight can see clearly from 70 feet away);

o legal blindness – visual acuity that cannot be corrected to better than 20/200 with conventional lenses and/or the patient has a restricted field of vision less that 20 degrees wide. (Note that some definitions of “partially sighted” include the legally blind.)

Low vision impairments take many forms and exist in varying degrees. It is important to understand that the visual acuity alone is not a good predictor of the degree of the problem a person is having. Someone with relatively good acuity (e.g., 20/40) can be having a very hard time functioning, while someone with worse acuity (e.g., 20/200) might not be having any real problems doing the things that they want to do.

The common types of low vision are:

Loss of Central Vision – the center of the person’s view is blurred or blocked, but side (peripheral) vision remains intact. This makes it difficult to read or recognize faces and most details in the distance. Mobility, however, is usually unaffected because side vision remains intact.

Loss of Side Vision – typified by an inability to distinguish anything to one side or both sides, or anything directly above and/or below eye level. Central vision remains, however, making it possible to see what is directly ahead. Typically, loss of side vision affects mobility and slows reading speed because the person sees only a few words at a time. Sometimes referred to as “tunnel vision.”

Blurred Vision – objects both near and far appear out of focus, even with the best conventional spectacle correction possible and even when the target is very large.

Generalized Haze – the sensation of a film or glare that may extend over the entire viewing field and may produce various patterns or areas of relatively severe vision loss.

Extreme Light Sensitivity – exists when standard levels of illumination overwhelm the visual system, producing a washed out image and glare disability. People with extreme light sensitivity may actually suffer pain or discomfort from relatively normal levels of illumination.

Night Blindness – inability to see outside at night under starlight or moonlight, or in dimly lighted interior areas such as movie theaters or restaurants.

Doctors of Optometry who specialize in low vision care are skilled in the examination, treatment and management of patients with visual impairments not fully treatable by medical, surgical or conventional eyewear or contact lenses. Each type of low vision problem requires a different therapeutic approach. A thorough examination by an optometrist, which will also include tests to determine the patient’s current vision status, may also include a vision rehabilitation program to enhance remaining vision skills.

The low vision specialist will ask for a complete personal and family general health and eye health history. In addition, the optometrist will discuss the functional problems with the patient, including such things as reading, functioning in the kitchen, glare problems, travel vision, the workplace, television viewing, school requirements, and hobbies and interests.

Preliminary tests may include assessment of ocular functions such as depth perception, color vision, contrast sensitivity, and curvature of the front of the eye. Measurements will be taken of the person’s visual acuity using special low vision test charts, which include a larger range of letters to more accurately determine a starting point for gauging low vision. Visual fields are usually evaluated, and each eye will be examined.
The optometrist may prescribe various treatment options, including low vision devices, as well as assist the person with identifying other resources for vision and lifestyle rehabilitation.

There is a wide variety of optical devices and adaptive products available to help people with low vision live and/or work more productively and safely. Most people can be helped with one or more of them. Unfortunately, only about 20-25 percent of those who could benefit have been seen by a low vision specialist and had treatment options, including low vision devices, prescribed specifically for them. The more commonly prescribed devices are:

o Spectacle-mounted magnifiers – A magnifying lens is mounted in the individual’s spectacles or on a special headband. This allows use of both hands to complete the close-up task, such as reading.

o Spectacle-mounted telescopes – These miniature telescopes are useful for seeing longer distances, such as across the room to watch television, and can also be modified for near (reading) tasks.

o Hand-held and stand magnifiers – Serve as supplementary aids. They are convenient for reading such things as price tags, labels, and instrument dials. Both types can be equipped with lights.

o Electro-optical aids – Closed-circuit television (also called CCTVs) enlarge reading material on a video screen. Some are portable, while some can be connected to a computer. The user can adjust the image brightness, size, contrast and background illumination.

In addition, there are numerous other products to assist those with low vision, such as large-type books, magazines, and newspapers, books-on-tape, talking wristwatches, self-threading needles, and more.

If you, or someone you love, suffers from low vision, your optometric low vision specialist can provide the help and resources needed to gain back the independence and freedom that once seemed lost. People with low vision can be taught a variety of techniques to perform daily activities with what vision remains. There are government and private programs that offer educational and vocational counseling, occupational therapy, rehabilitation training, and more.

Experts agree that low vision does not have to diminish the quality of life. As of October, 1999, both the American Optometric Association and the American Academy of Ophthalmology have called for Medicare coverage of low vision rehabilitation services. As changes occur in Medicare policies and coverage, we will update this site to provide you with the latest information.

Is Being Visually Impaired the Same as Being Legally Blind?

Years ago, my school division sent me in Southern Ontario to follow a course that would prepare me to teach Braille to one of my future students. While studying over there, I did not only learn so much more than Braille but I also met two friends that were legally blind. One was using a white cane and large print while the other was blessed by the precious assistance of a guide-dog.

That is when my knowledge became not only practical but also part of my everyday life with them during my stay there. Believe me, I did not only learn about reading and writing Braille but also how to guide, play, prepare activities, explore and experience everyday tasks and activities like someone that either was born or became legally blind.

What is the difference between being visually impaired and legally blind?
Well, being visually impaired means that your vision is either affected by visual problems such as having no peripheral vision, having very low eyesight while it is superior to 5% or having problems seeing in certain areas of your vision such as in front, in spots, not seeing in 3-D or in color, etc.

What does “legally blind” means? All that it means is that your vision is 5% and less or that your visual impairments are so severe that the percentage of actual vision also fits in this category.

One thing that I soon discovered was that despite poor eyesight, it is amazing to see how acute other senses become with time. My friends made me pay attention to all the information that other senses give you but unfortunately as most people rely so much on visual cues, we tend to be oblivious to details and information that we come to take for granted.

My friends also explained to me how to describe an activity without forgetting important steps, how to guide someone effectively, how to act with and around a guide-dog and so much more.

As time went by, I also learned the emotional ups and downs associated with facing the difficulties related to gradually becoming legally blind, how to become independent and not depend on solely on others. And finally, dealing with the mourning involved with the loss of sight and the fact that they will never be able to enjoy fully the beauty of a sunset, butterflies and other visual treasures that we take for granted.

The most important lessons that I actually learned during this course is the fact that not only people should learn to appreciate the countless benefits of sight but also how to appreciate and live in visually impaired and legally blind people’s shoes by using a blindfold or specially designed goggles.

7 Tips For Adjusting to Legal Blindness in the Family

When my husband was declared legally blind in 1988, we immediately began searching out ways to cope and organize our home. His attitude has always been “it could be something worse.” His positive approach to his disability has been an inspiration to us all. He has always had fun and laughed often — and he has continued in that same spirit.

Here are a few quick tips for you:

1. The knobs and drawer pulls on your kitchen cabinets should be significantly darker or lighter than the cabinets themselves. Repaint the hardware until your legally blind family member can easily make that distinction.

2. Discard all socks and start over. Buy one color of socks and buy about 7 pair of that one color. Do not purchase other colors of socks. You want your family member to be as self-sufficient as possible. Same color socks will help — no matching required.

3. Buy printed or striped tops and solid pants or skirts. Coordinate all clothing so that no matter which item is chosen, it will match any other top or bottom. This is very simple with men. We buy navy and khaki pants. My husband has golf shirts of all colors. And all will match the navy and khaki, so he is able to dress himself and always looks coordinated.

4. Purchase “bubbles” to use on the remote control, microwave and telephone. These clear plastic bubbles are very inexpensive and are available from merchants who specialize in items to assist the handicapped. The bubbles are self-sticking. Simply add bubbles to areas your patient deems convenient.

5. You will also want to paint stairways in bright colors, especially the edges of stair steps. A strip of reflective tape might be helpful also. As with any of these ideas, you will need to adjust them to your patient’s particular visual acuity.

6. It is best not to rearrange furniture. However, if moving furniture becomes necessary, be sure your legally blind family member knows exactly what has been moved.

7. When serving food, inform the patient of the location of the food by use of a clock face. For example, “Your chicken is at 2:00 and your beans are at 5:00.” After a few weeks, you will automatically do this quickly and quietly.

Tips For Legally Blind Folks

For legally blind individuals, it is very necessary to cope and organize their houses in a proper way. In order to help those blind people gain normal life or minimize the potential inconvenience, many efforts can be made associated with everything in daily life. This article provides some of the useful tips which can be utilized to make legally blind folks happy with life.

One helpful tip is to paint stairways in bright colors, especially the edges of stair steps. Climbing upstairs can be dangerous for legal blind people because they may fail to see an additional step. By painting the steps, they can perceive them more easily. It is also helpful to use a strip of reflective tape.

Furniture in a house should not be rearranged if there is a member who is legally blind. Few things can be done towards furniture. Since family members all have been accustomed to the positions of different furniture, rearrangement may cause a legally blind member to suffer difficulty in recognizing the moved furniture. In an extreme case, other members are responsible for telling the blind member about exactly what has been moved.

For legally blind individuals, it is necessary to discard all socks they used before getting blindness. They can buy 7 pairs of one color of socks. Remember to get colored socks in a single color. This way eliminates matching when they want to put on their socks.

Even clothes require special consideration. Legally blind folks should coordinate all clothing so that matching them requires little effort. In general, they need to buy printed or stripped tops and solid pants or skirts. Navy and khaki pants are the right choice because they can easily match all colors of shirts.

They can still use “bubbles” on the remove control, microwave and telephone. Made of plastic, these self-sticking bubbles are available from merchants selling items which assist the handicapped. These bubbles can be set in any areas they want.