Macular Degeneration: Coping With Reduced Vision

There are many changes that you can make in your home to make living with low vision easier and safer. Vision rehabilitation and training specialists can help you identify and learn to make low-vision adjustments that will work for you. These are some suggestions.

Changing your lighting

• Position lighting so that it is aimed at what you want to see and away from your eyes.
• Add table and floor lamps in areas where extra lighting is frequently needed.
• Use window coverings that allow you to adjust the level of natural lighting.
• Make sure that areas that could be dangerous, such as entries and stairways, are well lit.

Using contrast

Contrast makes use of your eyes' ability to distinguish objects and their surroundings based on differences in brightness or color, rather than shape or location. If you have low vision, you may need more light to be able to distinguish objects with similar brightness or color (low-contrast objects).

• Place light objects against dark backgrounds or dark objects against a light background. For example, if you have white or light-colored walls, use dark switch plates to mark the location of light switches. You can also use lighted switches that glow softly to make them easier to identify.
• Use paint in a contrasting color to mark electrical outlets, oven dials, thermostats, and other items so that they are easier to find and use.
• Paint door frames in a contrasting color. If the door is light, paint the frame with a dark color. Use dark doorknobs on light-colored doors.
• In your bathroom, use contrasting color for items such as cups, soap dishes, and even the soap.

Labeling and marking

• Use high contrast, such as bold black lettering on a white background, when making labels, signs, and other markings. Post signs at eye level.
• Label any medicines you take so that they are easily and clearly identified. Use colored, high-contrast labels to "color code" medicines, spices, foods, and other items.
• Mark the positions of the temperature settings that you use the most on your stove and oven controls, as well as the "on" and "off" positions. Some appliances are available with extra-large, high-contrast markings and indicators.
• In the kitchen and bathroom, mark the settings for the faucets that provide the right water temperature. To prevent overfilling a sink or bathtub, mark the water level that you want with a strip of waterproof tape or waterproof marker.
• Mark the areas around stairways and ramps with paint or tape, preferably with a high-contrast color such as dark tape on light carpeting.

Avoiding potential hazards

• Replace or remove any worn carpeting or floor coverings. If you use throw rugs or area rugs, tape them down or remove them.
• Avoid smooth floor coverings, and do not wax kitchen and bathroom floors. Use nonskid, nonglare cleaners on smooth floors.
• Remove electrical cords from areas where you need to walk. If this is not possible, tape them down so that you will not trip over them.
• Arrange your furniture so that it does not stick out into areas where you need to walk. Keep chairs pushed in under tables and desks when not in use. Similarly, keep desk, cabinet, and bureau drawers closed.
• Keep doors either fully opened or fully closed, but not halfway. Keep doors that stick out into a room or hallway closed.
• Make sure that the handrails on stairways and ramps extend beyond the top and bottom steps, because people often stumble when they miss a step at the top or bottom of an incline. Consider installing handrails in other areas that could be dangerous.

Continue to Why?

Although using vision aids and learning to use adaptive technologies may not improve your vision, they can help you to make the best use of your remaining vision and can make living with reduced vision much easier and safer.

Your eye care doctor will be able to suggest specific changes you can make. These may include:

• Getting new prescriptions for corrective lenses, such as eyeglasses. Although lenses do not treat or restore vision loss from AMD, corrective lenses can sometimes help you make better use of your remaining vision.
• Learning how to compensate for blind spots and other defects in your visual field. If you have lost central vision from AMD, your doctor or a low-vision specialist may be able to help you learn to better use other areas of your vision and to focus your attention on objects that are not at the center of your vision. These techniques may take some time to learn and do not work for everyone.

Learning to use low-vision aids and adaptive technologies may help you make the best use of your remaining vision.

Low-vision aids

Low-vision aids are special lenses or electronic systems that make images appear larger. They include:

• Magnifying lenses. These may range from simple handheld lenses for reading to special eyeglasses or magnifiers much like the lenses that jewelers use. Some magnifying lenses have a built-in light for better illumination. And some are mounted on stands so that your hands are free. For distance vision, small handheld telescopes or lenses that clip onto your eyeglasses may be used.
• Video enlargement systems. These are electronic systems that include a closed-circuit television camera (CCTV) or video camera that can transmit an enlarged image of print, pictures, or other items onto a screen where it is easier for you to see. These systems can also sometimes adjust brightness and contrast to make the enlarged image easier to see. Some video systems have both the camera and screens built into a head-mounted device that looks like a pair of large goggles, which allows the person to move around while using them.
• Computer display and enlargement systems. Large screens and software that enlarge print, pictures, and other visual information are available. Computers also allow you to alter brightness, contrast, color, and other parts of the display to make it easier to see what is on the screen. Computers are sometimes used with video enlargement systems.

Adaptive technology

Some devices or products may not necessarily help you see better, but they help you perform common tasks that may be more difficult when you have impaired vision. Examples of adaptive technology include:

• Large-print items. Books, newspapers, magazines, medicine labels, bank checks, and playing cards are often available in large print. Many people with low vision also use recordings of books and other printed materials.
• Special papers and writing aids. These may be something as simple as paper with extra-bold lines that help you write information on checks in the proper spaces.
• Adaptive appliances. These are common household items that have been adapted for use by people with low vision. Items include clocks and watches with electronic voices that announce the time or clocks, telephones, and calculators with extra-large buttons and numerals that can be seen more easily. Kitchen appliances such as ovens are also available with similar features.
• Speech software for computer systems. Special software allows computers to recognize spoken commands or to convert dictated speech into text. Speech synthesis software allows computers to speak text and read documents.
• Optical character recognition (OCR) software. OCR systems allow you to scan documents and convert them into computer text that can be enlarged for display or read aloud by a speech synthesis program.

Some of these measures are easy to build into your life. Others require big changes in the way that you do things at home, at work, or elsewhere. Some measures, such as adaptive technologies that use computers or other electronic systems, can be costly or may take time to learn to use properly. You will need to decide which ones will work best for you. If you are legally blind, assistance may be available through your state's Commission for the Blind.

Continue to How?

There are many resources available to help you meet the challenges of living with reduced vision and keep your quality of life.

Seek counseling, rehabilitation, and training

Low-vision specialists and groups and agencies that offer counseling, training, and other special services related to vision loss are available. Low-vision rehabilitation specialists can provide you with detailed practical information and training on managing your household and other activities of daily life that can be more challenging when you have low vision. These specialists can also help you find ways to cope with low vision in the workplace. Specialists may include:

• Rehabilitation counselors and teachers who can address specific needs.
• Occupational therapists.
• Orientation and mobility specialists.
• Low-vision specialists.
• Experts in technology adapted for people with visual impairment.
• Professional counselors, who can offer guidance and support in dealing with the emotional and psychological effects of living with impaired vision.

Build your personal support network

There are many resources available to help you overcome the challenges of living with low vision, to make the best use of the vision you do have, and to keep your quality of life. Your family and friends as well as your health care and social services professionals can help you.

Finding out that you have AMD can be very hard. You may feel fear and anxiety that loss of vision from AMD will make you less able to function on your own and that you may lose your independence. These feelings are perfectly normal. If you need help in dealing with them, talk to your doctor and to your family and friends.

Your doctor can also refer you to counseling, rehabilitation, and training specialists who can help you adjust to living with low vision. The more skills and resources you learn to use, the more you will be able to do. By learning to live with your low vision, you can continue to work, live independently, and preserve your mobility as much as possible.

Continue to Where?

Now that you have read this information, you are ready to find ways to live with low vision.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to mark areas or make notes where you have questions. Your doctor may have additional suggestions on how you can live with low vision.