Living With Low Vision

If someone you know has vision loss, chances are the world appears distorted, blurry or lacking detail.

Some changes in the aging eye are expected, and considered to be normal. People may find that their ability to focus becomes diminished, they need more light, or lose sensitivity to color and contrast. These changes can usually be accommodated with prescription glasses, low power magnifiers, better contrast, or more efficient lighting.

Yet, for more than seven million people over the age of 65, vision-loss isn’t remedied with glasses, contact lenses, surgery or medication. Such eye diseases, resistant to these remedies, are characterized by the term “low vision.” These include Macular Degeneration, Glaucoma, Diabetic Retinopathy, cataracts, and vision loss caused by a stroke. Depending on the disease, people refer to their vision as having a blind spot in the middle of the visual field, tunnel-like vision, scattered blind spots, haziness, or loss of sight in half of the visual field.

As a social worker with Community Services for the Blind and Partially Sighted, I have the privilege of offering my services to those who are experiencing low vision. To better understand their challenges, I ask “How does your vision loss affect you?” and “What do you wish others understood about living with low vision?”

In response to the first question, most people immediately mention how much they miss driving and reading. These activities have served as vital links to independence, information, and leisure time. They also mention activities that once seemed simple, and now require energy and patience.The simple tasks of using the phone, computer, or telling time, prove to be more difficult than before. Certain household skills such as, managing medications, navigating curbs and stairs, or sorting through mail, are also more cumbersome. Even attempting to continue with leisure activities: knitting, painting, or golf, just isn’t quite the same.

A particularly poignant response is the loss of seeing the faces of loved ones. Phyllis Roberts, an accomplished artist and musician, recently helped me understand the feelings that many people have when they can no longer see another’s face, or one’s own reflection. Through the medium of watercolor, she depicted how people with Macular Degeneration see the world. In a Picassolike style, amidst a cascade of pastels, she illustrated a half face surrounded by letters and musical notes, fading in sharpness and contrast.

Her painting is a reminder of the incredible importance of face-to-face contact. Studies have shown that from infancy we have focused on faces, and that a baby can recognize his or her mother among many choices. Throughout our lifetime, most of our communication takes place on a nonverbal level.Whether it’s the curve of lips or the raising of an eyebrow, facial expressions play a valuable role in deciphering a range of feelings.

Without the visual cues necessary for “reading” other’s faces, persons with low vision often describe feeling isolated, confused, frustrated or sad when unable to engage in “eye contact.” Instead of facial signals,a person with vision loss might only see a half face. This face could appear to have uneven features,or simply a blank space where a face should be. A world of information, familiarity and connection is lost. “If only I could see the faces of my grandchildren and great-grandchildren,” many reply.

In response to the second question, most people wish that family members and friends understood the challenges, as well as the sense of accomplishment, in seeking out alternative solutions. Whether it is researching optional forms of transportation, discovering books on tape, waking up to a talking clock, calling loved ones on a large button phone, or using a highpowered magnifier, it’s the small accomplishments that bring the greatest joy.

With regard to seeing other’s faces, they offer the following suggestions: 1. Some persons with low vision ask others to sit closely, as oftentimes a face becomes clearer at close proximity. 2. Since visual cues may be missing, a person with low vision might learn to inquire about how someone is feeling. “It sounds as if you might be (angry, bored, happy,worried etc).” 3. Many say that until they come to know someone by the sound of their voice, it’s helpful to introduce yourself by name when beginning a conversation, or upon entering or leaving a room. 4. Some use a closed circuit television, or “reading machine” to see photographs. 5. Magnified mirrors are often helpful to see one’s own face. 6. Those with Macular Degeneration often become adept at using peripheral vision. By “looking off to one side,” oftentimes the central image becomes clearer. 7. In a gathering of several people, it may be difficult to know when it is one’s turn to talk, if visual cues are limited. It is helpful to address the person with low vision by name, and to include them in a conversation.

As a loved one with vision loss adjusts to challenges, family and friends become even more valuable assets to them. The more supportive one’s social network, the greater the likelihood a person will benefit from vision rehabilitation. So, while your face may not be seen clearly, patience and care set the tone for understanding and living with vision loss.

For further information contact Sight Connection, a nonprofit agency serving people in King, Snohomish and Skagit counties since 1965. Vision rehabilitation services include a Low Vision Clinic (meets in Seattle, Bremerton and Sedro Woolley), social work, rehabilitation teaching, mobility training, computer assistance and volunteer services as well as the Sight Connection retail store. 1-800-458-4888.