What if you couldn't use your vision to tell sugar from salt when cooking or set the correct oven temperature—much less read a recipe at home or a menu in a restaurant? These are just a few of the everyday challenges people with low vision face.
The term "low vision" refers to vision loss that can't be corrected by surgical or medical treatments or regular eyeglasses. It may result in blind spots, blurry sight, loss of central or peripheral vision, or depth perception. The most common causes are age-related macular degeneration, glaucoma, and diabetic retinopathy.
Low vision affects millions of Americans, and as baby boomers age, the numbers grow every day. The good news is people with low vision have access to a range of assistive devices, all designed to make everyday life more manageable.
Experts at the John A. Moran Eye Center at the University of Utah offer tips on everyday living with low vision, from simple tactile stickers to high-tech apps.
First Step: Get a Dilated Eye Exam
As the vision rehabilitation specialist for the Moran Eye Center's Patient Support Program, Robert M. Christiansen, MD, works one-on-one with patients to determine which devices suit them best.
"Before low-vision patients come to see me or start spending money on vision rehab devices, they need to get a thorough eye exam from their ophthalmologist," he says. "Their vision may be declining because of a treatable condition, such as glaucoma, cataracts, or something like a retinal detachment. If that's the case, skipping the exam may result in delayed treatment, making matters worse. And, choosing the wrong device can be worse than no device at all."
For example, Christiansen says, a person could order a hand magnifier that increases type size by eight times when they only need one that magnifies by four times.
"It might be too much, and they may then think, incorrectly, that nothing will help them," he says. "Once they have a complete diagnosis, we can work together to make the most of their vision."
Favorite Assistive Devices
Christiansen and Patient Support Program Director Lisa Ord, LCSW, PhD, share their favorite devices below, noting the list is just the beginning of what is possible.
"What works for one person may not work for another," says Ord. "But there is something for just about everyone out there."
- Strong Bifocals: Eyeglasses are the No. 1 choice for vision correction, but a strong bifocal is also a tremendous device. Christiansen works directly with Moran's optical shop to make super-high-powered bifocals to improve close-up vision. The high-powered versions can go up to +4.50 (normal might be +2.50). These bifocals focus up close, from three to six inches from the eyes. If the bifocal doesn't work, reading glasses of up to 16 diopters, the highest magnification, are available.
- Magnifiers: Hand magnifiers are beneficial for reading smaller print. They're easy and natural to use. Portable electronic magnifiers resemble a lightweight tablet computer. They can be held in front of reading material or items in a store and display a magnified view of any print on an LED screen.
- Hand-held telescopes or binoculars may help with distance vision at sports events, seeing the whiteboard in school, or watching TV.
- Video Magnifiers: These desktop devices include a camera lens that displays highly magnified images on a video monitor or computer screen.
- Filters: Filter eyeglasses or clip-ons for eyeglasses can improve contrast for various types of low vision or light sensitivity.
- Bump Dots: Bump dots in various sizes and colors are tactile stickers you can use to label things, such as the settings on a stove dial or specific spots on a computer keyboard or a TV remote control.
- Specialized Keyboards: High-contrast/large letter computer keyboards make typing easier.
- Voice Software: Built-in or downloaded voice-to-text or text-to-voice software is available for computers and phones.
Once you have recommendations on specific devices, you can find them in some optical shops or ask your ophthalmologist where and what strength to order.
Patients may also try some devices through Moran's no-cost support and education groups.
Smartphone Apps for Low Vision
Today's smartphones open a world of options with dozens of available apps. Many general-use apps are built-in, such as voice commands, magnifiers, talking voicemail, display and text size options, and maps.
One of the most accessible free apps for blind and low-vision users, Be My Eyes, connects them with sighted volunteers and company representatives through a live video call that can offer visual assistance.
On the more advanced side, apps include artificial intelligence that narrates the environment around the user.
In addition to practical assistance, smartphones offer access to talking books, newspapers, and games.
"Your best bet for learning about all the options and getting one-on-one instruction to make the best use of a smartphone is to visit your local blind center," advises Ord.
In Salt Lake City, she refers patients to Jerry C. Nealy, a rehabilitation teacher and field instructor for Utah's Division of Services for the Blind and Visually Impaired. One of the top experts on smartphone apps for low vision, Nealy may be reached at 801-323-4353 or jerrynealey@utah.gov.