What is low vision problems?

Many things can cause low vision, including macular degeneration and glaucoma. When you can't see as well, daily life may feel more challenging. But you can do some things to stay independent and keep doing the activities you enjoy.

You can start by making some changes to your home, like adding extra lighting. You can also use devices that can help when you have low vision, such as special eyeglasses and large-print books.

You could also ask others for help. Your doctor can help you find safe ways to stay active. Low-vision specialists can help you learn ways to manage daily life. Family and friends might help you run errands and keep a healthy social life.

A low-vision evaluation will help you and your doctor find ways to make the best use of your remaining vision.

Your doctor will ask questions to find out how your vision loss has affected your life and what changes you have already made to cope with reduced vision. Talk with your doctor about your needs and goals. Questions may include the following:

• What are the problem areas associated with your vision loss? How has your life changed? What activities have become harder, and which ones are the most important to you?
• Can you do home-based tasks using near vision, such as reading your mail or a newspaper or managing bank accounts and paying bills? Have you tried using a magnifying glass?
• What sort of lighting do you have in your home? Do you use a night-light? The doctor may ask other questions about your home environment.
• Can you do tasks that require distance vision, such as recognizing faces or seeing traffic signals? Are you still able to drive?
• Can you still travel and function in your environment? Do you bump into obstacles, such as curbs, or miss steps? Can you find items you want and count your money when shopping? If you are still working, does your vision loss affect how well you can do your job?

Other questions may deal with your current living situation, whether you live alone, and what sort of assistance is available to you. Your family members or others close to you may also be asked to provide information.

Exams for remaining visual ability

Your doctor will do visual tests to find out the quality of your remaining vision, including:

• Visual acuity for both near and distance vision. Visual acuity tests measure the eye's focusing power and your ability to see details at near and far distances. They usually involve reading letters or looking at symbols of different sizes on an eye chart. These tests will also take into account any refractive error in your vision, such as nearsightedness or farsightedness.
• Defects in both central vision and side (peripheral) vision. These tests look for flaws and blind spots (scotomas) in your visual field, which is the entire area seen when your gaze is fixed in one direction. The complete visual field is seen by both eyes at the same time, and it includes the central and peripheral visual fields.
• Contrast sensitivity. These tests measure your eye's ability to distinguish objects and their surroundings based on differences in brightness or color (contrast), rather than shape or location. The tests may also show how much light (illumination) you need to be able to distinguish objects with similar brightness or color (low contrast). Because side (peripheral) vision is less sharp than central vision, contrast may play a more important role in helping you locate and identify objects if you lose some central vision.

Your doctor may also conduct vision tests for brightness acuity (which may show how sensitive you are to glare), color perception, and how well your eyes work together to provide depth perception.

Consultations with other specialists

A low-vision evaluation may also include consultations with specialists such as an occupational therapist or a social worker who can provide counseling and training on dealing with reduced vision to help you keep your quality of life as much as possible. If you are working with your primary care doctor, the consultations will also include an eye care specialist such as an ophthalmologist or optometrist. Your own eye doctor may refer you to another who specializes in low-vision evaluation and rehabilitation.

To understand your home environment and your needs, a low-vision evaluation may also include home visits by your doctor or by rehabilitation specialists.

When the evaluation is complete, you and your doctor will be able to identify ways for you to make the best use of your remaining vision.

Look for low-vision specialists and groups and agencies that offer counseling, training, and other special services related to vision loss. They can give you practical advice and training on managing your household and other activities of daily life. These specialists can also help you find ways to cope with low vision in the workplace. Specialists may include:

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

Many resources are available. They can help you make the best use of the vision you do have and keep your quality of life. Your family and friends can also help you.

Use lighting

• Point lighting at what you want to see. Don't point it at your eyes.
• Add lamps where you need extra lighting.
• Use curtains or shades to adjust how much natural light there is.
• Use good lighting in places where you could easily fall. These include entries and stairways.

Use labels

• Label things that are hard to recognize or that could be confusing. This might include medicines, spices, and foods. Use black letters on a white background. Or you can color-code the items.
• Mark the positions of the temperature settings you use the most on your stove and oven. Also mark the "on" and "off" positions.
• Mark the water temperatures you use on faucets in the kitchen and bathroom. To prevent overfilling a sink or bathtub, use waterproof markers or tape to mark the water level you want.

Avoid falls in your home

• Replace or remove any worn carpeting. Tape down or remove area rugs.
• Do not wax your floors. Use nonskid, nonglare cleaners on smooth floors.
• Remove electrical cords from areas where you need to walk. Or tape them down so you won't trip on them.
• Make sure furniture doesn't stick out into areas where you walk. Keep chairs pushed in under tables and desks. Keep all drawers closed.
• Keep doors fully opened or fully closed. Don't leave them halfway open or shut.
• Use handrails on stairways and ramps. Make sure that they go beyond the top and bottom steps. Then you won't stumble if you miss a step.

Use helpful technology

• Use a magnifying lens. You can buy ones that you hold. Or you can buy ones that attach to glasses. Some have lights built in.
• If your budget allows, you may want to think about a video magnifier system. These systems can make print, pictures, or other items bigger on a screen.
• If you have a computer:
  • Try to adjust the display. You can often change how big the text and pictures appear. Then they will be easier to see and read.
  • You may want to try special software. Some software can recognize spoken commands or change dictated speech into text. Other software allows computers to speak text and read documents.
• Use large-print items. These include books, newspapers, magazines, and medicine labels. You can also listen to recordings of books.
• Think about using devices made for people with low vision. Examples are clocks and watches that announce the time. There are also clocks, telephones, and calculators with extra-large buttons.

Be safe while you stay active

• Ask your doctor what physical activities are safe for you. If you bend, lift things, or move fast, it may affect your health or vision.
• Ask a friend to read you the instructions for a new exercise and to check your technique.
• Walk with someone who can help look for things that may be a danger.
• If you swim laps, use a pool that has ropes between the lanes.

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

Low-vision aids include:

• Magnifying lenses.
• Video enlargement systems. These send an enlarged image of print, pictures, or other items onto a screen where it's easier for you to see.
• Computer display and enlargement systems. These are large screens and software that can enlarge print, pictures, and other visual information.

Adaptive technology can make life easier and safer. Examples include:

• Large-print items, such as books and playing cards.
• Papers and writing aids, such as paper with extra-bold lines.
• Appliances such as clocks with electronic voices.
• Computer software that understands spoken commands and speaks text.
• Optical character recognition (OCR) software. This lets you scan documents and convert them into computer text.