LOW VISION

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This section  will help people  with vision loss and their families and friends better understand low  vision. It describes how to get help and live more safely and  independently.   This information was obtained from the NEI website  www.nei.nih.gov.

What is low vision?  

Low vision means that even with regular  glasses, contact lenses, medicine, or surgery, people find everyday  tasks difficult to do. Reading the mail, shopping, cooking, seeing the  TV, and writing can seem challenging.

Millions of Americans lose some of their vision every year. Irreversible vision loss is most common among people over age 65.

Is losing vision just part of getting older?  

No. Some normal changes in our eyes and vision occur as we get older. However, these changes usually don't lead to low vision.

Most people develop low vision because  of eye diseases and health conditions like macular degeneration,  cataract, glaucoma, and diabetes. A few people develop vision loss after  eye injuries or from birth defects. While vision that's lost usually  cannot be restored, many people can make the most of the vision they  have.

Your eye care professional can tell the difference between normal changes in the aging eye and those caused by eye diseases.

How do I know if I have low vision?  

There are many signs that can signal vision loss. For example, even with your regular glasses, do you have difficulty:

  • Recognizing faces of friends and relatives?  
  • Doing things that require you to see well up close, like reading, cooking, sewing, or fixing things around the house?  
  • Picking out and matching the color of your clothes?  
  • Doing things at work or home because lights seem dimmer than they used to?  
  • Reading street and bus signs or the names of stores? 

Vision changes like these could be  early warning signs of eye disease. Usually, the earlier your problem is  diagnosed, the better the chance of successful treatment and keeping  your remaining vision.

How do I know when to get an eye exam?  

Regular dilated eye exams should be  part of your routine health care. However, if you believe your vision  has recently changed, you should see your eye care professional as soon  as possible.

Meet Mary, Jim, Crystal, and Mike  

By making better use of their remaining  vision, people can continue to enjoy doing important daily activities.  Here are some examples.

Mary's story  

Mary is slowly losing her  "straight-ahead" vision, which allows her to read and recognize faces.  She has age-related macular degeneration, an eye disease that affects  central vision.

While Mary's eye care professional has  reassured her that she will not lose her vision completely, she is  frustrated because she does not see as well as before.

       
"The specialist helped me find devices that work best." 

Mary thought that nothing she did would help. Then her eye care professional suggested that she see a specialist in low vision.

A specialist in low vision is an  optometrist or ophthalmologist who is trained to evaluate vision. This  person can prescribe visual devices and teach people how to use them.

There are a wide variety of devices  that help people make the most of their remaining vision. The specialist  recommended special magnifying devices for Mary that helped her see  things more clearly.

Mary also went to a vision  rehabilitation program that taught her new ways of doing tasks. Someone  from the program came to Mary's home to see what changes could be made.  She also learned about helpful devices, such as talking clocks that tell  the time with a press of a button. Large print books and publications  made it easier to read and allowed Mary to keep enjoying one of her  favorite activities.

Jim's story  

Jim has lost a lot of his side vision because of glaucoma. He found it difficult to do his job.

He made some changes to his office so  he could work better. A talking computer keeps him up-to-date on sales  figures. Writing was very difficult until he used better lighting. A  vision rehabilitation teacher showed Jim how to use a writing guide to  help write clear notes and employee memos.

       
"A closed circuit television helps me manage my work and staff." 

Learning to get around safely from an orientation and mobility specialist helped him travel independently.

He also joined a support group to talk  about the challenges, frustrations, fears, and unhappiness that can come  from living with low vision. At first, he felt that his vision loss  would keep him from doing the things he liked to do. In the end, he  found that wasn't true.

Crystal's story  

Crystal lost some vision because of diabetes.

Rather than limit her activities, she  chose to look at them as challenges. Crystal met with a vision  rehabilitation professional. She received training on how to use certain  low vision aids. As a result, Crystal made several changes to her home  and simplified her life.

       
"With training, it became easier to keep my independence." 

First, raised markings were applied to  the most common settings on her microwave dial. This allowed her to more  safely adjust the oven.

Better lighting in her stairways,  closets, and home workshop made it safer to move about. A magnifier for  reading food labels made controlling her diet easy. Special checks with  large print and raised markings simplified paying bills. A special  needle allowed her to continue sewing, one of her favorite activities.

For Crystal, the result was increased safety, more freedom, and restored confidence.

Mike's story  

Mike also has low vision because of age-related macular degeneration. But he has found ways to adapt to his vision loss.

       
"I learned to use a closed circuit television to keep reading enjoyable." 

Mike's doctor referred him to a vision  rehabilitation program. As a result of his evaluation, Mike uses a  closed circuit television at home. It enlarges the print in letters,  bills, newspapers, and magazines. He uses a telescopic lens for getting  around his neighborhood. A hand-held magnifier helps him read his mail  in his favorite chair and menus at restaurants. Mike learned to adapt,  and low vision has not stopped him from enjoying life.

What can I do if I have low vision?  

Many people with low vision are taking  charge. They want more information about devices and services that can  help them keep their independence.

      


Scene as viewed by a person with normal vision.     



Scene as viewed by a person with age-related macular degeneration.
    


Scene as viewed by a person with cataract.

  

 
Scene as viewed by a person with diabetic retinopathy.     


Scene as viewed by a person with glaucoma.

 Talk with your eye care professional  

It's important to talk with your eye  care professional about your vision problems. Even though it may be  difficult, ask for help. Find out where you can get more information  about services and devices that can help you.

What Jane, Jim, Crystal, and Mike have  in common is that they're taking charge of their health. They have  different types of vision loss from different eye diseases. Yet each of  them asked about available resources that might help them continue to  live independently. Each needed specific visual devices and training on  how to use them.

Many people require more than one  visual device. They may need magnifying lenses for close-up viewing, and  telescopic lenses for seeing in the distance. Some people may need to  learn how to get around their neighborhoods.

If your eye care professional says, "Nothing more can be done for your vision," ask about vision rehabilitation.

These programs offer a wide range of  services, such as low vision evaluations and special training to use  visual and adaptive devices. They also offer guidance for modifying your  home as well as group support from others with low vision.

Investigate and learn  

Be persistent. Remember that you are  your best health advocate. Investigate and learn as much as you can,  especially if you have been told that you may lose more vision. It is  important that you ask questions about vision rehabilitation and get  answers. Many resources are available to help you.

Write down questions to ask your doctor, or take a tape recorder with you.

Rehabilitation programs, devices, and  technology can help you adapt to vision loss. They may help you keep  doing many of the things you did before.

Know that, like Mary, Jim, Crystal, and Mike, you can make the difference in living with low vision.

Where can I get more information?  

For more information about low vision, contact:

Your state or local rehabilitation agency for the blind and visually impaired.

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
(415) 561-8500
http://www.aao.org

American Association of the Deaf-Blind (AADB)
814 Thayer Avenue, Suite 302
Silver Spring, MD 20910-4500
(301) 495-4403
(301) 495-4402--TTY
http://www.aadb.org

American Council of the Blind
1155 15th Street, NW, Suite 1004
Washington, DC 20005
1-800-424-8666
(202) 467-5081
http://www.acb.org

American Foundation for the Blind
11 Penn Plaza, Suite 300
New York, NY 10001
1-800-232-5463
(212) 502-7600
http://www.afb.org

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD 20871
1-800-437-2423
(301) 948-3244
http://www.ahaf.org

American Printing House for the Blind
1839 Frankfort Avenue
P.O. Box 6085
Louisville, KY 40206-0085
1-800-223-1839
(502) 895-2405
http://www.aph.org

Associated Services for the Blind
919 Walnut Street, 2nd Floor
Philadelphia, PA 19107
(215) 627-0600
http://www.asb.org

Association for Education and Rehabilitation of the Blind and Visually Impaired
1703 N. Beauregard Street, Suite 440
Alexandria, VA 22311
(703) 671-4500
1-877-492-2708
http://www.aerbvi.org

Association for Retinopathy of Prematurity and Related Diseases (ROPARD)
P.O. Box 250425
Franklin, MI 48025
1-800-788-2020
http://www.ropard.org

Blinded Veterans Association
477 H Street, NW
Washington, DC 20001
1-800-669-7079
(202) 371-8880
http://www.bva.org

Braille Circulating Library, Inc.
2700 Stuart Avenue
Richmond, VA 23220
(804) 359-3743
(804) 359-3771

Choice Magazine Listening
85 Channel Drive
Port Washington, NY 11050
1-888-724-6423
(516) 883-8280
http://www.choicemagazinelistening.org

Christian Record Services, Inc.
4444 South 52nd Street
Lincoln, NE 68516
(402) 488-0981
http://www.christianrecord.org

Council of Citizens with Low Vision International
1859 N. Washington Avenue, Suite 2000
Clearwater, FL 33755-1862
1-800-733-2258
(727) 443-0350
http://www.cclvi.org

DB-LINK: National Information Clearinghouse on Children Who are Deaf-Blind
345 N. Monmouth Avenue
Monmouth, OR 97361
1-800-438-9376
1-800-854-7013--TTY
http://www.tr.wou.edu/dblink/

Guide Dogs for the Blind
P.O. Box 151200
San Rafael, CA 94915-1200
1-800-295-4050
http://www.guidedogs.com

(The) Hadley School for the Blind
700 Elm Street
Winnetka, IL 60093
1-800-323-4238
(847) 446-8111
http://www.hadley-school.org

Helen Keller National Center for Deaf-Blind Youths & Adults (HKNC)
111 Middle Neck Road
Sands Point, NY 11050
(516) 944-8900
http://www.hknc.org

Independent Living Services for Older Individuals Who Are Blind
U.S. Department of Education, OSERS
400 Maryland Avenue, SW, Room 3326, MES
Washington, DC 20202-2741
(202) 205-9362
http://www.ed.gov/programs/rsailob/index.htm

Jewish Braille Institute of America
110 E. 30th Street
New York, NY 10016
1-800-433-1531
(212) 889-2525
http://www.jewishbraille.org

(The) Jewish Guild for the Blind
15 West 65th Street
New York, NY 10023
1-800-284-4422
(212) 769-6200
http://www.jgb.org

Lighthouse International
111 E. 59th Street
New York, NY 10022
1-800-829-0500
(212) 821-9200
(212) 821-9713 (TDD)
info@lighthouse.org
http://www.lighthouse.org

Low Vision Gateway
http://www.lowvision.org

National Association for Parents of Children with Visual Impairments
P.O. Box 317
Watertown, MA 02471
1-800-562-6265
(617) 972-7441
http://www.spedex.com/napvi

National Association for Visually Handicapped
22 W. 21st Street, 6th Floor
New York, NY 10010
(212) 889-3141
(212) 255-2804
http://www.navh.org

National Family Association for Deaf-Blind (NFADB)
111 Middle Neck Road
Sands Point, NY 11050
1-800-255-0411
http://www.nfadb.org

National Federation of the Blind
1800 Johnson Street
Baltimore, MD 21230
(410) 659-9314
http://www.nfb.org

National Library Service for Blind and Physically Handicapped
Library of Congress
Washington, DC 20542
1-800-424-8567
(202) 707-5100
(202) 707-0744 (TDD)
nls@loc.gov
http://www.loc.gov/nls

Recording for the Blind and Dyslexic - Headquarters
20 Roszel Road
Princeton, NJ 08540
1-800-221-4792
(609) 520-8031
http://www.rfbd.org

Resources for Rehabilitation
22 Bonad Road
Winchester, MA 01890
781-368-9094
info@rfr.org
http://www.rfr.org

Talking Tapes/Textbooks for the Blind
16 Sunnen Drive, Suite 162
St. Louis, MO 63143-3800
1-877-926-0500
(314) 646-0500
http://www.talkingtapes.org

VISIONS/Services for the Blind and Visually Impaired
500 Greenwich Street, 3rd Floor
New York, NY 10013-1354
1-888-245-8333
(212) 625-1616
http://www.visionsvcb.org

Xavier Society for the Blind
154 E. 23rd Street
New York, NY 10010-4595
(212) 473-7800
1-800-637-9193

What can I do about my low vision?  

Although many people maintain good  vision throughout their lifetimes, people over age 65 are at increased  risk of developing low vision. You and your eye care professional or  specialist in low vision need to work in partnership to achieve what is  best for you. An important part of this relationship is good  communication.

Here are some questions to ask your eye care professional or specialist in low vision to get the discussion started:

Questions to ask your eye care professional  

  • What changes can I expect in my vision?  
  • Will my vision loss get worse? How much of my vision will I lose?  
  • Will regular eyeglasses improve my vision?  
  • What medical/surgical treatments are available for my condition?  
  • What can I do to protect or prolong my vision?  
  • Will diet, exercise, or other lifestyle changes help?  
  • If my vision can't be corrected, can you refer me to a specialist in low vision?  
  • Where can I get a low vision examination and evaluation? Where can I get vision rehabilitation? 

Questions to ask your specialist in low vision  

  • How can I continue my normal, routine activities?  
  • Are there resources to help me in my job?  
  • Will any special devices help me with daily activities like reading, sewing, cooking, or fixing things around the house?  
  • What training and services are available to help me live better and more safely with low vision?  
  • Where can I find individual or group support to cope with my vision loss? 

Glossary  

Age-Related Macular Degeneration (AMD)--  An eye disease that results in a loss of central, "straight-ahead"  vision. AMD is the leading cause of vision loss in older Americans.

Cataract--A clouding of  the lens. People with cataracts see through a haze. In a usually safe  and successful surgery, the cloudy lens can be replaced with a plastic  lens.

Diabetes--A chronic disease related to high blood sugar that may lead to vision loss.

Eye Care Professional--An ophthalmologist ( MD)  or optometrist ( OD ).


Glaucoma--An eye disease,  related to high pressure inside the eye, that damages the optic nerve  and leads to vision loss. Glaucoma affects peripheral, or side, vision.

Low Vision--A visual  impairment, not corrected by standard eyeglasses, contact lenses,  medication, or surgery, that interferes with the ability to perform  everyday activities.

Ophthalmologist--A medical  doctor   ( Eye MD ) who diagnoses and treats with surgery and  medications all diseases and disorders of the eye, and can prescribe  glasses and contact lenses.

Optician--A trained professional who grinds, fits, and dispenses glasses by prescription from an optometrist or ophthalmologist.

Optometrist--An  eye care provider  ( OD ) who prescribes glasses and contact lenses,  and in some states may diagnose and treat certain conditions and  diseases of the eye with the restricted use of some medications. 


Orientation and Mobility Specialist--A person who trains people with low vision to move about safely in the home and travel by themselves.

Specialist in Low Vision--An  ophthalmologist or optometrist who specializes in the evaluation of low  vision. This person can prescribe visual devices and teach people how  to use them.

Vision Rehabilitation Teacher--A  person who trains people with low vision to use optical and nonoptical  devices, adaptive techniques, and community resources.

Visual and Adaptive Devices--Prescription  and nonprescription devices that help people with low vision enhance  their remaining vision. Some examples include magnifiers, large print  books, check-writing guides, white canes, and telescopic lenses.

 

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