Low Vision Aids and Low Vision Rehabilitation
Losing vision does not mean giving up your activities, but it does mean applying new ways of doing them. Is it difficult to read newspapers and price tags, set dials, or manage glare? There are numerous tools, techniques and resources for people with low vision, including low vision aids and low vision rehabilitation.
If your family member or friend has vision loss, he or she needs to be empowered to do as much as possible independently. Recognize the challenges of vision loss, but don’t take over their tasks. Instead, help identify the adjustments they need to make to maximize their independence.
Make the most of your remaining vision
Find and use your “next-best spot”: scotomas and PRLs When the center of your vision is obscured by a blind spot (scotoma), it is helpful to locate your “next best spot” (the Preferred Retinal Locus or PRL). To find your PRL, imagine that the object you want to see is in the center of a large clock face. Move your eyes along the clock numbers and notice when you see the center object most clearly. Use that same viewing direction for other objects.
Low vision aids
There are numerous tips and devices to help you remain independent with low vision, including making things brighter and bigger, reorganizing your home or work environment, using audio books and devices and more.
Make things brighter
- Improve lighting. Use a gooseneck lamp directed onto your task. Carry a penlight.
- Reduce glare. Indoors, cover wood tables and shiny counters; wear yellow clip-on or fitover glasses. Outdoors, try dark yellow or amber glasses. Visors can be useful indoors or out.
- Increase contrast. Use a black ink gel or felt pen, not a ballpoint. Draw a dark line where you need to sign. Use a white cup for coffee, for example.
Make things bigger
- Move closer. Sit close to the TV, and up front at performances.
- Enlarge. Get large checks, large-print playing cards, bingo cards, crosswords, phone dials, TV remotes, calendars, keyboards, and books.
- Magnify. Low vision magnifiers come in many powers and types, suited to different people and different tasks: hand-held for price tags and menus, stands and video magnifiers (CCTVs or closed circuit TVs) for sentences, magnifying computer mouse.
- Designate spots for the items in your refrigerator, and for your keys and wallet. Minimize clutter. Separate black clothes from blue.
- Label things clearly
Mark thermostats and dials with high contrast markers from a fabric store; label medications with markers or rubber bands; safety-pin the labels of similar-colored clothing.
Substitute ears for eyes Use electronic books, e-book readers and audio books. Talking watches, clocks, calculators, glucometers, and computers are also helpful. Use reading services.
Don’t isolate yourself. Keep your social group, volunteer job, or golf game. It might require lighting, large print cards, a magnifier, a ride, or someone to watch your golf ball. Ask for the help you need. There is nothing independent about staying home to avoid asking for help.
If you are able to drive, pick your times and map routes carefully. Consider yellow or amber sunglasses for glare. But be prepared to consider whether or not driving is a good idea. Ask yourself the following questions: Do cars appear unexpectedly? Do drivers honk at you? Are you having fender-benders? If “yes,” consider transportation alternatives. Hire a driver or arrange for a taxi. Share your car or buy gas for a friend who drives. Use senior and public transit systems. Try a three-wheel bike or battery-powered scooter at walking speed. Walk if you are able. The future will offer even more solutions.
Newer technology for low vision aids
- While low vision devices like closed-circuit TV (CCTV) magnifiers have long been the standard in assistive technology, advances in consumer electronics are also improving quality of life for people with low vision.
- E-readers. The Kindle® , the iPad® and other electronic readers (e-readers) are portable and more affordable alternatives to the CCTV. E-readers can be used on-the-go and can be one-tenth the price of CCTVs in some instances. The Kindle and the iPad allow the user to adjust the font size and contrast settings of the display. Both have text-to-speech functionality and can read aloud to the user. It’s important to keep in mind that e-readers don’t offer the same level of magnification as CCTVs and will not meet the needs of everyone with low vision. For example, be sure the display of the device works for your contrast sensitivity. Not all e-readers offer reversed-polarity (white letters on black background) displays, which reduce glare and may be easier to read for some people.
Smartphones and tablets
- Both Apple- and Android-based smartphones and tablets offer a range of apps and built-in functions to help people with low vision:
- Magnify. iRead, iLoupe, and Magnify use your device’s camera and light source to magnify and illuminate text. While these apps won’t match the power of a CCTV, they’re portable, less-expensive alternatives for those who need some level of magnification. Browse your Apple or Android app store for pricing and availability.
- Smart money. EyeNote is a free app available for Apple products that scans and identifies the denomination of U.S. paper money by reading aloud or emitting an ascending number of beeps or pulsed vibrations for each bill.
- SightBook. This free app digitally communicates your vision changes to your ophthalmologist by measuring your visual function with a set of near vision tests. Significant changes in vision are recorded and then sent wirelessly to your doctor. The app is free and available on iTunes. Visit www.digisight.net for more information to share with your Eye M.D.
MapQuest. Available for Apple and Android phones, the MapQuest app provides voice-guided directions and tells the driver when to turn. If you make a wrong turn, MapQuest will re-route you automatically.
- Voice interface. Siri, the voice recognition system on the iPhone 4S, can be a helpful low-vision aid as it allows the user to check the weather, email, or their calendar without having to visually navigate a series of icons. Android-based phones also have voice-recognition capability allowing the user to dictate texts or emails without having to type.
- These new advances in consumer technology are not a cure-all for those with low vision. Many people will need additional devices and aids along with the assistance of their vision rehabilitation specialist to achieve best possible vision. However, for many people, these digital devices and apps offer more options for portable, lower-cost low vision aids.
Low vision rehabilitation
If you have low vision, you can greatly improve your quality of life through vision rehabilitation. Low vision rehabilitation teaches you how to use your remaining vision more effectively.
When checking out low vision rehabilitation services near you, ask if services include:
- A low vision evaluation by an ophthalmologist or optometrist.
- Prescription for devices: Are some devices loaned before purchase, or returnable?
- Rehabilitation training: reading, writing, shopping, cooking, lighting and glare control?
- Home assessment?
- Mobility services?
- Resources and support groups?
- Are services free, billed to Medicare or other insurances? If not, what is the charge? (Note: Medicare covers most services, but not devices.)