Before my company’s annual fall rehab conference, I thought I knew how to help my patients with low vision. But I was happy to learn a lot of useful information, including some of the tips below. I hope you find something useful to help your patients as well!
Free DIRECT download: Make the most of your vision (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
The main presenters at the conference were Michele Tarantino, OTD, MPH, OTR/L, CLVT, an occupational therapist and low vision specialist, and Evan J. Tirado, OD, an ophthamologist. The information in this post relies heavily on their presentations, with additional information from online sources.
Outline:
- What is low vision?
- Make it bigger.
- Make it bolder.
- Make it brighter.
- 10 low vision tips for functional activities.
- Refer to a low vision specialist.
- Find a support group.
- Related Eat, Speak, & Think posts.
- Try a strategy and report back.
What is low vision?
Unlike the legal definition of blindness, which is very technical, low vision is defined according to how a person is able to complete desired tasks and activities.
A person has low-vision if they “cannot do what they want to do with the level of vision they have.”
Evan J. Tirado, OD
This dovetails perfectly with how we assess and treat our patients, by focusing on function. As speech-language pathologists, we work with people who have trouble seeing:
- Calendars and schedules.
- Newspapers, books, magazines, mail, and forms.
- Checks and checkbook register.
- Recipes and written directions.
- Medication labels and pills.
- Paper money and coins.
- Photographs.
- Materials for leisure activities.
We can help our patients achieve their goals by using a few simple strategies to maximize their vision.
Have you experienced how the world looks through eyes with different impairments?
Two-minute video simulation of visual impairments
This video shows you what the world looks like to people who have macular degeneration, cataracts, glaucoma, retinitis pigmentosa, diabetic retinopathy, or hemianopsia.
Try these tips if there’s any question of visual impairment
People get used to their vision and may say they can see “fine”, even if their vision is impairing their function. So if there’s any question, please give some of these strategies a try. I was amazed to see how simple changes can make a big difference.
The tips fall under the strategies of making things “bigger, bolder, and brighter”, as Michele put it. Many of these tips come from her presentation “Low Vision Treatment Strategies and Resources.”
Make it bigger
We all know that things look bigger the closer we are. So one easy solution is to get closer.
Get closer
Ask your patient to:
- Move closer to what they’re looking at.
- Bring it closer to them.
- Hold reading material or small objects at chest-height.
Use a magnifier
Another strategy to try is using a magnifier. The stronger the magnifier, the more likely a person will have to be trained how to use it. And even just selecting the right magnifier takes skill.
But here are some general tips for the basic hand-held magnifier:
- Hold the magnifier close to the eye, Sherlock Holmes style.
- Hold the item being magnified at chest level.
- Use a lamp that directs light onto the object, but not onto your patient’s face.
Besides basic handheld magnifiers, your patient can also use:
- Digital handheld magnifiers.
- Apps on mobile devices to enlarge the print or image.
- Stand magnifiers.
Enlarge it
One final tip for making it bigger is to enlarge the print or image. You can enlarge it on a copier or scanner, or re-type in a larger font.
Ask your patient to read a sentence or paragraph in different font sizes to see what they like best. Too big can be as hard to read as too small!
Make it bolder
Increase the contrast
Objects are easier to see when there is a strong color contrast. This short video shows several examples of good and poor color contrast in the home:
Here are a few general tips from VisionAware.org:
- Choose bright, solid colors instead of pastels or patterns.
- Use a dark background for light objects (and vice versa).
- For printed text, use a black background with white or bright yellow print.
For more information:
- Contrast and Color from VisionAware.org.
Decrease glare
Glare washes out color contrast, making things very hard to see. It’s caused by light that’s too bright or that’s bouncing off reflective surfaces.
Some vision problems make people very sensitive to glare. This means that your patient may see glare where you don’t.
General tips:
- Position the light so that it’s coming over the shoulder or off to one side.
- Avoid or cover shiny, reflective surfaces.
- Use a typoscope* (black card with a rectangle cut for a line of text to show).
- Try wearing sunglasses or a visor.
*This is an Amazon affiliate link. As an Amazon associate, I may earn a small commission on qualifying purchases. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Make it brighter
Many vision problems cause a dimming effect. You may see fine with the current lighting, while it’s too dim for your patient to see well.
Bring the light closer
Instead of brightly lighting the whole room, use a light-source that directs the light onto the area your patient is working on. A goose-neck lamp is recommended because it’s easily adjustable.
Bringing the light closer is a powerful way to make things brighter. As Dr. Tirado said during the presentation, bringing the light-source 1/3 closer makes it nine times brighter. This is due to the Inverse Square Law of Lighting.
Here’s a short video to explain:
For more information:
- Better Lighting for Better Sight video series (with transcripts) on VisionAware.org.
Choose a different light bulb
I won’t even pretend to understand how different forms of light are processed by eyes with impaired vision. However, it’s clear that some light bulbs are better for supporting eye health and functional vision.
One characteristic of light bulbs is Correlated Color Temperature, which generally ranges between 2000K and 6500K (K = Kelvin). Lightbulbs at the low end produce a warm light, whereas ones at the high end produce a cool light. Westinghouse Lighting has a great chart to help you visualize the differences.
In general, people with low-vision often see better with light bulbs under 5000K. Dr. Tirado recommends between 2700K and 3500K. It may be necessary to try a few different bulbs.
VisionAware.org recommends using a fluorescent light bulb to light rooms and an LED light bulb in goose-neck lamps for close work. They recommend looking for bulbs around 4200K, but under 5000K.
10 low vision tips for functional activities
- Sit closer to the TV.
- Move the computer screen closer.
- Change the background on the computer or phone to a black screen, use white or bright yellow text, and use bigger icons.
- Check out other low vision accessibility features on computers and smart phones.
- Create a high-contrast work space. Cover the work area with black shelf liner and arrange materials around the perimeter. Place materials in bright-colored baskets or bins.
- Choose a strongly-contrasting color to mark edges (for instance, the edges of reading material, baskets or bins, the calendar hanging on the wall).
- Use touch dots* in a contrasting color to mark a few key buttons on remote controls or the microwave. (The fewer, the better! Consider just the 30-second button on the microwave.)
- Avoid clear drinking glasses or dishes.
- Organize materials and “make a home” for them.
- Make or buy writing guides (stencils) for checks, envelopes, etc.
*This is an Amazon affiliate link. As an Amazon associate, I may earn a small commission on qualifying purchases. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Refer to a low vision specialist
If your organization isn’t lucky enough to have a low vision specialist, your patient may have access to other resources. For example:
- Search online for “state services for the blind” for your state.
- US Department of Veterans Affairs offers excellent services for veterans with visual impairment.
- Lions Low Vision Centers.
Find a support group
There are many online and in-person support groups. You can do an online search, or take a look at VisionAware’s Support Groups page for links to many resources.
Related Eat, Speak & Think posts
I chose the article on medication because many of these strategies and products are helpful for people with low vision. Since this is an article on one of our senses, I chose two posts on impaired hearing.
- 31 creative ways you can remember to take your medication.
- Trouble hearing on the phone? 5 ways to communicate without an internet connection.
- 6 free internet-based telephone relay services if you have trouble hearing.
Try a strategy and report back
I hope you found at least one new idea to make things bigger, bolder, or brighter. Please share what works for your patients!
There’s so much information available to help people who have low vision. I plan to write more about how our patients can use technology to achieve their goals for functional activities and life participation.
Free DIRECT download: Make the most of your vision (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by Will Malott on Unsplash.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
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