Vision Problems: Living With Poor Eyesight

Find your vision strengths

Contact your local or state organization for the visually impaired for a low-vision evaluation. It can help you find out the limitations of your eyesight and what changes might help you take advantage of your strengths. A low-vision specialist can help you train your eyes to look around your blind spots. For example, if you have lost central vision, you can train your eyes to look at objects from your outer vision areas.

Adapting your lifestyle to poor eyesight is sometimes challenging and can involve changes in the way you do the activities you enjoy. But if you use your vision strengths, you can continue to do most—if not all—of your usual activities.

There are also many vision aids that are specially made for people who have poor eyesight. These aids include magnifiers that enlarge printed materials and special papers with bold lines for writing checks. A good low-vision evaluation can help you find out which vision aids would be most helpful for you.

Continue to Why?

Poor eyesight should not prevent you from having a full and active life. The more vision adaptations, enhancing skills, and adaptive technologies you learn and use, the more independent and active you can be.

Although you may not be able to improve your vision, there are many tools that can help you to make the best use of your remaining vision. And they can make living with reduced vision much easier and safer.

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

• Getting new prescriptions for corrective lenses, such as eyeglasses. Lenses don't treat or restore vision loss from some medical conditions. But 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, for example, you have lost central vision from macular degeneration, your doctor or a low-vision specialist may be able to help you learn to better use other areas of your vision. You can learn to focus your attention on objects that aren't at the center of your vision. These techniques may take some time to learn, though. And they don't work for everyone.

Continue to How?

Some simple changes can help you use your remaining vision to its full potential and allow you to live as independently as possible. Here are some keys to success.

Making changes at home

Make simple changes

• Make a list of things you have trouble doing. Use the checklist for identifying low-vision aids for daily activities(What is a PDF document?).
• Make simple accommodations at home that will help you manage your household chores and care for your personal needs.
• Use low-vision aids and adaptive technology, such as lenses and other devices, to enhance your remaining vision.

These are a few ideas on how to make living with low vision easier and safer. For more ideas, see a low-vision rehabilitation specialist.

Use lighting

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

Use contrast

Contrast helps your eyes 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).

• Place light objects against a dark background or dark objects against a light background. For example, if you have white or light-colored walls, use dark switch plates for your light switches. Or use lighted switches that glow softly. They are easier to identify.
• You can also use paint in a contrasting color to mark electrical outlets, oven dials, thermostats, and other items. This will make the items easier to find and use.
• Paint door frames in a contrasting color. For example, 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.

Label and mark

• Use high contrast when you make labels, signs, and other markings. For example, use bold black lettering on a white background. 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 you use most frequently on your stove and oven controls, as well as the "on" and "off" positions. Some appliances have 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 you want with a strip of waterproof tape or a waterproof marker.
• Mark the areas around stairways and ramps with paint or tape. A high-contrast color such as dark tape on light carpeting works best.

Avoid 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 don't wax kitchen and bathroom floors. Use nonskid, nonglare cleaners on smooth floors.
• Remove electrical cords from areas where you need to walk. If this isn't possible, tape them down so you won't trip over them.
• Arrange your furniture so that it doesn't stick out into areas where you need to walk. Keep chairs pushed in under tables and desks when not in use. Keep desk, cabinet, and bureau drawers closed.
• Keep doors either fully opened or fully closed, but not halfway. If doors stick out into a room or hallway, keep them closed.
• Make sure the handrails on stairways and ramps extend beyond the top and bottom steps. People often stumble when they miss a step at the top or bottom of an incline. Consider installing handrails in other potentially hazardous areas.

Using visual aids and other adaptive technologies

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, such as:

• Magnifying lenses. These may range from simple handheld lenses for reading to special eyeglasses or magnifiers much like the lenses that jewelers use. Some lenses have a built-in light for better illumination. And some are mounted on stands so 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 can be used to send an enlarged image of print, pictures, or other items onto a screen where it is easier for you to see. Examples include a closed-circuit television camera (CCTV) or video camera. 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. This allows a 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. This can make it easier to see what is on the screen. Computers are sometimes used with video enlargement systems.

Diabetes aids

If your low vision is caused by diabetes, some aids that may help you include:

• Needle guides and other devices. They can help you locate and stick the needle through the rubber stopper on your insulin bottle and help you prepare mixed- or single-dose insulin injections. There are also bottle-holding devices that help you hold the bottle and syringe to safely withdraw insulin. There are devices to help you draw the same amount of insulin every time. Insulin pens that show the units by clicking or have large-print markings can be used to give insulin that comes in a cartridge. Other needle aids help you inject insulin with pens or syringes.
• "Talking" or large-print home blood sugar meters. A large-print meter can help you see your blood sugar result clearly. There are also some "talking" meters.
• "Talking" or large-print food scales. If you need to weigh your food, there are large-print or talking food scales. You can also estimate portion sizes by other means. For example, 1 cup is about the amount you can place in your cupped hand.
• Computerized blood sugar records. Most home blood sugar meter companies have computer software that allows your blood sugar results to be entered directly into a computer. Then you don't have to keep handwritten records. You can also print these in large print so that you can read the records.
• Tape recorder for record keeping. You can record your daily blood sugar results and other information directly into a tape recorder.

Adaptive technology

Adaptive technology is used in devices or products that may not help you see better but can make life easier and safer. Many are designed to help you perform common tasks that may be harder when you have impaired vision. Examples 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 audio versions 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. Examples are clocks and watches with electronic voices that announce the time. Or you can find clocks, telephones, and calculators with extra-large buttons and numerals that can be seen more easily. Kitchen appliances such as ovens with similar features are also available.
• 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. Then the text 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 computer programs or 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, you may be able to get help through your state's Commission for the Blind.

Getting around

Having low vision can lead to losing your ability to drive. It's hard to give up the convenience of going where you want whenever you want. But you don't have to be homebound. You have options for getting around safely.

• Ask your family and friends for help. If asking for help is hard for you, you could offer to pay for their time or gas to take you on errands.
• Use public transportation. Check with your local transit company for schedules. Also see if your area has paratransit services that can take you door-to-door where you need to go.
• Think about using taxis. It may sound expensive. But don't forget that it also costs a lot to own a car, buy gas, and pay for insurance and maintenance.
• Ask your eye doctor or counselor about organizations in your community that offer low-cost alternative transportation.

Getting support

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

Seek counseling, rehabilitation, and training

Look for low-vision specialists and groups and agencies that offer counseling, training, and other special services related to vision loss. Low-vision rehabilitation specialists can give you 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. They 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.

Continue to Where?

Now that you have read this information, you are ready to find ways to adapt to your low vision so that you can continue to care for yourself.

Talk with your eye specialist

If you have questions about this information, take it with you when you visit your eye specialist. You may want to mark areas or make notes in the margins of the pages where you have questions.

If you need help finding vision aids, talk with your eye specialist about having a low-vision evaluation by a low-vision specialist. A low-vision specialist can help you find out which aids will enhance your remaining vision.

If you would like more information about low-vision enhancements, the following resources are available:

Organizations

American Foundation for the Blind
11 Penn Plaza
Suite 300
New York, NY  10001
Phone:	1-800-AFB-LINE (1-800-232-5463) (212) 502-7600
Fax:	(212) 502-7777
Email:	afbinfo@afb.net
Web Address:	www.afb.org
The American Foundation for the Blind is dedicated to addressing the critical issues of literacy, independent living, employment, and access through technology for the 10 million Americans who are blind or visually impaired.
Lighthouse International
111 East 59th Street
New York, NY  10022-1202
Phone:	(212) 821-9200 1-800-829-0500
Fax:	(212) 821-9707
TDD:	(212) 821-9713 (TTY)
Web Address:	www.lighthouse.org
Lighthouse International is a not-for-profit organization dedicated to helping people of all ages to overcome vision impairment through vision rehabilitation services, education, research, and advocacy.
National Eye Institute, National Institutes of Health
Information Office
31 Center Drive MSC 2510
Bethesda, MD  20892-2510
Phone:	(301) 496-5248
Email:	2020@nei.nih.gov
Web Address:	www.nei.nih.gov
As part of the U.S. National Institutes of Health, the National Eye Institute provides information on eye diseases and vision research. Publications are available to the public at no charge. The Web site includes links to various information resources.
Prevent Blindness America
211 West Wacker Drive
Suite 1700
Chicago, IL  60606
Phone:	1-800-331-2020
Web Address:	www.preventblindness.org
Prevent Blindness America assists the visually impaired and provides consumer information on vision problems and vision aids. Its website has information about eye health and safety for children and adults. Many states have local affiliates.