Glaucoma: Living With Reduced Vision

There are many low-vision accommodations you can make in your home to make living with reduced vision easier and safer. Vision rehabilitation and training specialists can help you identify and learn to make reduced-vision accommodations that will work for you. These are some suggestions.

Using contrast

Contrast makes use of your eyes' ability to distinguish objects and their surroundings based on differences in brightness or color, rather than shape or location. If you have reduced vision, you may need more light to be able to distinguish objects with similar brightness or color (low contrast).

• Place light objects against dark backgrounds, or dark objects against a light background. For example, if you have white or light-colored walls, use dark switch plates to mark the location of light switches. You can also use lighted switches that glow softly, making them easier to identify.
• You can also use paint in a contrasting color to mark electrical outlets, oven dials, thermostats, and other items so that they are easier to find and use.
• Paint door frames in a contrasting color; if the door is light, paint the frame with a dark color. Use dark doorknobs on light-colored doors.
• In your bathroom, use contrasting color for items such as cups, soap dishes, and even the soap.

Low-vision aids

Low-vision aids are special lenses or electronic systems that make images appear larger. They may include:

• Magnifying lenses. These may range from simple handheld lenses for reading to special eyeglasses or magnifiers much like the lenses that jewelers use. Some magnifying lenses have a built-in light for better illumination, and some are mounted on stands so your hands are free. For distance vision, small handheld telescopes or lenses that clip onto your eyeglasses may be used.
• Video enlargement systems. These are electronic systems that include a closed-circuit television camera (CCTV) or video camera that can be used to transmit an enlarged image of print, pictures, or other items onto a screen where it is easier for you to see. These systems can also sometimes adjust brightness and contrast to make the enlarged image easier to see. Some video systems have both the camera and screens built into a head-mounted device that looks like a pair of large goggles, allowing a person to move around while using them.
• Computer display and enlargement systems. Large screens and software that enlarge print, pictures, and other visual information are available. Computers also allow you to alter brightness, contrast, color, and other parts of the display to make it easier to see what is on the screen. Computers are sometimes used with video enlargement systems.

Adaptive technology

Adaptive technology is used in devices or products that may not necessarily help you see better but can make life easier and safer. Many are designed to help you perform common tasks that may be more difficult when you have reduced vision. Examples of adaptive technology include:

• Large-print items. Books, newspapers, magazines, medicine labels, bank checks, and playing cards are often available in large print. Many people with low vision also use recordings of books and other printed materials.
• Special papers and writing aids. These may be something as simple as paper with extra-bold lines that help you write information on checks in the proper spaces.
• Adaptive appliances. These are common household items that have been adapted for use by people with low vision, such as clocks and watches with electronic voices that announce the time, or clocks, telephones, and calculators with extra-large buttons and numerals that can be seen more easily. Kitchen appliances with similar features, such as ovens, are also available.
• Speech software for computer systems. Special software allows computers to recognize spoken commands or convert dictated speech into text. Speech synthesis software allows computers to speak text and read documents.
• Optical character recognition (OCR) software. OCR systems allow you to scan documents and convert them into computer text that can be enlarged for display or read aloud by a speech synthesis program.

Continue to Why?

Although making accommodations, using vision aids, and learning to use adaptive technologies may not improve your vision, they can help you to make the best use of your remaining vision and can make living with reduced vision much easier and safer. Low vision due to glaucoma should not prevent you from leading a full and active life. It is important to keep in mind that even though glaucoma may affect your vision, if detected early and treated, it does not necessarily cause complete blindness. Many people retain some vision.

Following a low-vision evaluation, your eye care doctor will be able to suggest specific accommodations to make the best use of your vision. These may include:

• New prescriptions for corrective lenses, such as eyeglasses. Although lenses cannot treat or restore vision loss from glaucoma, corrective lenses can sometimes help you make better use of your remaining vision. For example, lenses that magnify what you see may help compensate for some loss of central vision.
• Learning to compensate for blind spots (scotomas) and other defects in your visual field. People with normal vision rely on their sharp central vision. If you have lost central vision from glaucoma, your doctor or a low-vision specialist may be able to help you learn to better use other areas of your visual field and how to focus your attention on objects that are not at the center of your visual field. These techniques, called eccentric fixation training, may take some time to learn and do not work for everyone.

Using low-vision aids and adaptive technology may help you make the best use of your remaining vision. Your doctor can also refer you to counseling, rehabilitation, and training specialists who can help you adjust to living with low vision. The more skills and resources you learn to use, the more you will be able to do. By learning to live with your reduced vision, you can continue to work, live independently, and preserve your mobility as much as possible.

Continue to How?

You can take steps to overcome the challenges of living with low vision and to make the best use of the vision you do have. Resources are available to help you meet these challenges and maintain your quality of life.

Lighting

• Position lighting so that it is aimed at what you want to see, and away from your eyes.
• Add table and floor lamps in areas where extra lighting is frequently needed.
• Use window coverings that allow you to adjust the level of natural lighting.
• Make sure potentially hazardous areas such as entries and stairways are well-lit.

Labeling and marking

• Use high contrast, such as bold black lettering on a white background, when making labels, signs, and other markings. Post signs at eye level.
• Label any medications you take so that they are easily and clearly identified. Use colored, high-contrast labels to "color code" medications, spices, foods, and other items.
• Mark the positions of the temperature settings you use most frequently on your stove and oven controls, as well as the "on" and "off" positions. Some appliances are available with extra-large, high-contrast markings and indicators.
• In the kitchen and bathroom, mark the settings for the faucets that provide the right water temperature. To prevent overfilling a sink or bathtub, mark the water level you want with a strip of waterproof tape or waterproof marker.
• Mark the areas around stairways and ramps with paint or tape, preferably with a high-contrast color such as dark tape on light carpeting.

Avoiding potential hazards

• Replace or remove any worn carpeting or floor coverings. If you use throw rugs or area rugs, tape them down or remove them.
• Avoid smooth floor coverings, and do not wax kitchen and bathroom floors. Use nonskid, nonglare cleaners on smooth floors.
• Remove electrical cords from areas where you need to walk. If this is not possible, tape them down so you will not trip over them.
• Arrange your furniture so it does not stick out into areas where you need to walk. Keep chairs pushed in under tables and desks when not in use. Similarly, keep desk, cabinet, and bureau drawers closed.
• Keep doors either fully opened or fully closed, but not halfway. Keep doors that stick out into a room or hallway closed.
• Make sure the handrails on stairways and ramps extend beyond the top and bottom steps, because people often stumble when they miss a step at the top or bottom of an incline. Consider installing handrails in other potentially hazardous areas.

Seek counseling, rehabilitation, and training

Low-vision specialists, groups, and agencies that offer counseling, training, and other special services related to vision loss are available. Low-vision rehabilitation specialists can provide you with detailed practical information and training on managing your household, personal grooming, cooking, shopping, traveling away from home, and other activities that can be more challenging when you have low vision. They can also help you find ways to cope with reduced vision in the workplace. These specialists may include:

• Rehabilitation counselors and teachers who can address specific needs.
• Occupational therapists.
• Orientation and mobility specialists.
• Low-vision specialists.
• Experts in technology adapted for visually impaired people.
• Counselors and others who can provide support in dealing with emotional and psychological effects.

Develop your personal support network

Many resources are available to help you overcome the challenges of living with reduced vision, make the best use of the vision you do have, and maintain your quality of life. Your family and friends as well as your health care and social services providers can help you.

Learning that you have glaucoma can be difficult. You may feel fear and anxiety that loss of vision from glaucoma will make you less able to function on your own. These feelings are normal. If you need help in dealing with them, talk to your doctor and to your family and friends. Because glaucoma is a lifelong disease, it may be helpful for you to join a support group for people who have the disease.

Continue to Where?

Now that you have read this information, you are ready to find ways to live with low vision.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to mark areas or make notes where you have questions. Your doctor may have additional suggestions on how you can live with low vision.

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