 The Lowdown on Low Vision
By Kathy Zelaya, M.A., Sp.Ed.,
C.O.M.S
Legally Blind?
Legally blind is the term used to describe
individuals with the best corrected visual acuity of 20/200 or less, or restricted fields
to 20 degrees. This is a measurement used by agencies and service providers to qualify
potential clients for special programs and services. It is estimated that 90 percent of
people who are legally blind have usable remaining vision...and they find themselves in an
unusual situation.
Partially Sighted...
The word "blind" in the term legally
blind says very little about the person's ability to "see". This is a special
group with very special needs and unique difficulties. Most of us believe that people are
"blind" or not blind... they either "see" or "see nothing".
For example, when a partially-sighted individual
goes shopping and needs assistance with price tags or reading labels, the public deals
with them as if they were illiterate. They are very often treated with disrespect, pushed
aside by other shoppers and store personnel.
Individuals with partial vision see better at
sometimes than others. Some people experience severe vision loss in areas of strong
sunlight and often walk into displays or objects along the sidewalk. Other pedestrians
frequently assume they are drunk.
To assist people with partial vision to be safe,
Orientation and Mobility Specialist provide training and a white cane. When they use a
white cane, they are accused of "faking" blindness.
Even their friends and families have difficulty
understanding the idea of partial sight. They complain that their friends are able to see
better than reported because they "get around so well" and can a "pin on a
carpet". They are accused of using blindness as a ploy for sympathy.
The History of Low Vision...
Until recently, individuals with low vision were
trained as if they were totally blind. Children were sent to "blind schools" and
were blindfolded during activities in order to "save their vision". They were
taught to walk with a cane, using the same techniques as a totally blind person, keeping
their eyes straight ahead.
The story today is quite different. With the
appropriate vision-enhancement devices and proper mobility training, individuals with
partial sight now have easier access to the world around them and opportunities for
greater independence than ever before.
The Low Vision Specialist...
Here is an unfortunate fact. The ophthalmologist
and family optometrist do not normally provide referrals to a low vision specialist. They
only tell their patients that lenses can no longer improve their vision and send them
home.
Much to our dismay, it is often much later that
the consumer discovers that there is someone to help them. Unfortunately, the ocular
muscles have become accustomed to lack of use, making adapting to any new devices
significantly more difficult.
Each eye condition is unique and the way each
person is effected is unique, so any "off the rack" purchases should be avoided.
The low vision specialist has the expertise of prescribing vision-enhancing devices and
allows the necessary time to test them.
Many offices have a "loaner" program
where you can take them home to use in your daily life. If not, we recommend consulting
another doctor, as the equipment can be quite costly. Be aware that many optometrists say
they have the experience and equipment to provide low vision services. Unfortunately, they
do not and ultimately short-change the patient.
When making the appointment, be sure to verify
that the doctor does indeed have the training in this specialty. Don't be embarrassed to
ask the doctor's field of specialty and background. IT'S YOUR DIME!
Also, be sure to inquire about training with the
device(s). Instruction in their use should be included, as part of the service and
specially trained office staff should be available to provide that training. Instruction
for indoor devices should be conducted indoors, and instruction for outdoor devices should
be conducted outside.
We have found that frequently the outdoors
training is omitted. Viewing a blackboard or buildings while standing at a window is a
good introduction to the use of adaptive visual aids. However, try searching for addresses
with cars whizzing by and try to imagine how a bus appears coming at you full speed
through a telescope!
It is not possible to duplicate these situation
indoors, and the lack of training is the reason many people ultimately fail at learning to
use the low vision aids. If the office does not provide training to use the device then
ask for referrals to one who does. Or, insist that outdoor training is included,
preferably by an O&M Specialist or low vision therapist with expertise in this area.
Remember, its YOUR dime!
Tips for Using Low Vision Aids...
With rare exceptions, the new user must go through
an "adjustment period" when learning to use an adaptive aid. After just a few
minutes, they may begin to feel nervous, anxious, fatigued and/or nauseated. Often, the
consumer may complain of a severe headache lasting several hours.
Unfortunately, it is the point in which the device
is often tossed into a drawer...never to be used again. It is necessary to understand that
the ocular muscles, like all muscles, require time to "learn" and
"adapt" to the new demands being made on them. They will react in the beginning
by making us uncomfortable. Like all new fitness programs, build endurance and tolerance
by starting slowly, limiting use to a few minutes. Don't be hasty in giving up before
you've had a real chance to develop some visual stamina.
With the correct prescription, and enough time,
experience and practice, these devices can greatly enhance the lives of the people who use
them. Many people are able to see family photographs again, read mail and take care of
their own paperwork. The proper device can enable the user to read street signs, check
addresses, look at merchandise in store windows and look far down the sidewalk for
obstacles. Use of these devices makes their lives safer and more efficient. Moreover, it
helps them to be more independent!
So remember, before purchasing any adaptive
equipment and devices, we cannot emphasize how very important it is to obtain a low vision
evaluation, by a low vision specialist.
The author is a certified orientation and
mobility specialist (C.O.M.S.) with 12 years experience teaching adults who are visually
impaired. She specializes in working with victims of stroke, traumatic brain injury and
non-blindness related learning disabilities.
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