Eyes - vision loss

Vision loss can change your life dramatically. At first, everyday activities may be difficult or impossible. However, support and advice are available to help people who are blind or have vision loss live independently and adapt to life with vision impairment. For many people, there is no need to give up activities they enjoy.

Vision loss can affect people of all ages, but approximately two thirds of those who are vision impaired are over the age of 65. There are many types of vision impairment and each has a different effect on a person’s ability to see and on their mobility. Some vision loss can be prevented, while other conditions may be hereditary or develop as people age. About six per cent of people in Australia with vision impairment are totally blind.

Types of vision loss

The major causes and effects of vision impairment are:

• age-related macular degeneration – causes distortion or loss of central vision in older people, resulting in difficulties with activities such as reading and recognising faces
• diabetic retinopathy – symptoms include blurring and patchiness in vision. The underlying cause is diabetes
• glaucoma – causes tunnel vision and affects safe mobility and driving
• cataracts – cause blurring of vision and increased sensitivity to glare, but can be corrected by surgery
• refractive error – half of all vision impairment in Australia is due to under-corrected refractive error. Types of refractive error include long-sightedness, short-sightedness, astigmatism and presbyopia. Refractive error can be improved by wearing glasses
• vision loss in children – there are many diseases, defects, malformations, infections and disorders that can affect the visual system in infants. Seeing is an important way for infants to learn. Vision impairment can influence the normal development of body control, hand use, language and social behaviours.

Making things more visible

There are many types of vision impairment and each has a different impact on a person’s ability to see, their confidence in getting around safely and their mobility. However, there are things you can do to help maintain your independence and quality of life. The following suggestions can be used for a wide range of activities.

Enlarge and magnify to improve visibility

It may help if you enlarge or magnify things you are looking at. For example:

• Use large-print personal diaries and phone books.
• Use a photocopier to enlarge recipes, music notes and other information.
• Move closer to the object you are looking at (for example, the television).
• Enlarge the type size (font) on your computer screen.
• Update your prescription glasses, for your best possible vision.
• Use handheld or mounted magnifiers to help with reading and sewing. These should be prescribed for the type and degree of vision impairment.
• Use telephones with large buttons.

Use contrast to improve visibility

Contrast can help you see things more clearly. Black on white or white on black produces the best contrast. Examples of ways to use contrast to help in everyday activities include:

• Use black felt-tip, water-based pens.
• Put contrasting-coloured strips on the edges of steps and cupboards. On dark surfaces, these can be a light shade such as white or yellow.
• Pour dark liquids into white cups and light liquids into dark cups.
• Paint the insides of cupboards white to maximise the brightness and contrast so that items are easier to find.
• Use plain, dark tablecloths or mats with white dishes.

Use better lighting to improve visibility

Improving both general and focal or task lighting can make objects and printed material easier to see.

Using your other senses with vision loss

Ways to use your other senses to help supplement your vision include:

• touch – add tactile markings to appliances, such as stoves and washing machines, to indicate off and on settings. Commonly used switches and settings can be marked so they are easy to distinguish from others
• hearing – use talking and audible devices, such as clocks and kitchen scales
• taste – use your sense of taste to tell the difference between different foods, herbs and spices
• smell – you can check for freshness of fruit, vegetables or other foods and check if food is cooked or burning.

It may take time to learn to trust your other senses. Give yourself time to practice and build up your confidence in new ways of doing things.

Vision loss and being organised

Being organised will make your life easier to manage. Some tips include:

• Eliminate unnecessary clutter around the home.
• Keep items in their place.
• Allow extra time to orient yourself and move around unfamiliar spaces.

Solutions for everyday tasks if you have vision loss

Many everyday activities can be successfully adapted so that a person with impaired vision can continue to live safely and independently. A few examples are listed below. These suggestions apply to a range of other activities as well.

Vision loss and banking, money and paying bills

Suggestions include:

• Use a black felt-tipped pen and a template to fill in forms. Templates may be available from your bank or you could ask that they be made up for you.
• Fill in the forms at home, using a magnifier and focal lighting.
• Familiarise yourself with one type of automatic teller machine (ATM). A keyboard-style ATM is easier to use than a touch screen. An occupational therapist can help you with training in how to use an ATM.
• Using electronic banking (EFTPOS) with a PIN number may be easier than filling out deposit and withdrawal slips or handling cash.
• Most bills can now be paid by telephone.
• Many bills are available in large print. Contact your service provider to check this.
• Learn to distinguish between different coins by checking for size, weight and edge-milling. You can tell the different notes apart by checking for length (longer notes for larger amounts). A note guide may be useful.
• Change smaller coins into larger coins or notes at the bank.
• Separate gold and silver coins in your wallet. Fold specific notes, or store notes in different compartments, to make it easier to locate the exact amount that you need. Organising your wallet before you leave home may make money-handling easier when shopping.

Vision loss and dusting and vacuuming

Suggestions include:

• Spray cleaning liquid directly onto the cloth. Wrap the cloth around the nozzle to avoid accidentally spraying the liquid near your face or anywhere else.
• Move furniture and table-top items before beginning to dust or vacuum. Be systematic, moving from one end to the other. Divide areas into smaller parts.
• Use tactile markings applied to the vacuum cleaner to help you find the correct settings.

Vision loss and making the bed

Suggestions include:

• Attach safety pins to one corner of a fitted sheet to help with orientation.
• To place a cover on a doona, start with the doona cover inside out. Then place your hands inside the cover, grasp the corners of the doona and shake, letting the cover drop over the doona.

Vision loss and dish washing

Suggestions include:

• Wash one item at a time, rather than filling the sink with every item.
• Run your fingertips over plates and dishes to check for cleanliness.
• Dish racks may help you to organise the dishes on the sink.
• Use tactile markings applied to a dishwasher to enable you to use the machine independently.

Vision loss and cooking

Suggestions include:

• Apply tactile markings to various appliances to help you accurately use the controls and dials.
• Look for recipes in audio, braille or large-print formats.
• Convert measurements (such as millilitres or grams) to cups and spoons, choosing differently coloured measuring equipment to increase contrast. Talking scales may help.
• Place non-slip matting, in a contrasting colour, under a chopping board to keep items more stable.
• Try using contrasting-coloured chopping boards and focal lighting to help you see more detail and cut food safely and accurately.
• Make sure both the bench space and sink are clear when preparing food and cooking. This will make it easier to trail across the bench or sink area to locate items and separate food scraps from food to be cooked.
• Heavy, wide-based saucepans and frypans with high sides are more stable on a stovetop and keep ingredients contained when stirring to avoid spills.
• Use trays or containers to store similar types of food. Keep items organised and stored in consistent locations.
• Try ready-made sauces to help simplify cooking.

Vision loss and doing laundry

Suggestions include:

• Have separate baskets for light and dark clothing.
• Pin sock pairs together before you put them through the wash.
• Apply tactile or contrasting-coloured markings to laundry appliances to make it easier to operate them.
• Try indoor clothes-stands for drying clothes – they may be easier to manage than an outside washing line.
• Use coathangers for drying t-shirts and shirts to minimise ironing.

Vision loss and personal hygiene

Suggestions include:

• Mark your toothbrush with a tactile or contrasting-coloured tag so you can distinguish it from others.
• When putting paste on your toothbrush, place your index finger on the brush to guide the placement of the paste, or squeeze the paste onto your fingertip first and then wipe this onto the brush.
• Use personal-hygiene products in pump packs that squeeze out pre-measured amounts.
• Shampoo and conditioner in differently coloured or shaped bottles may assist with identification. Rubber bands or other tactile markings may also be useful for identification.

Vision loss and writing letters

Suggestions include:

• Use black felt-tipped pens. Black on white provides the greatest contrast. Other colour combinations with high contrast may also be useful.
• Apply large-print contrast stickers or tactile marks to a keyboard to make typing easier.
• Use a document holder with a line-marker when typing from another document.
• Install adaptive software on your computer to help with writing tasks.
• Contact organisations such as Vision Australia to find out about consultancy and training in using adaptive technology for writing tasks.

Getting out and about with impaired vision

Having vision loss need not mean staying at home. If you have lost the confidence to use public transport or even go to the local shops, you can get support and training from an Orientation and Mobility Specialist to assist you to get about safely and confidently. A guide dog may be the answer – they are specially bred and trained to enable people who are blind or vision impaired to achieve freedom, mobility and independence.

Recreation is important for an enjoyable and active life. There are a variety of organised sports for people with vision loss – such as bowling, golf, tandem cycling, cricket and rowing – as well as opportunities to travel in Australia and overseas. These activities may require the assistance of family and friends or the use of modified equipment.

Technology and vision loss

Technology allows people with vision loss to access information that was previously confined to the printed word. A range of assisted technologies are available. Computers can be an important information source. People of all ages use screen readers to translate words on a computer screen into large print or the spoken word.

Vision loss services

Vision loss services provide support and advice to people of all ages and with all degrees of vision impairment or blindness. You can get assessment of optical and other devices as well as support in developing strategies to make best use of your remaining vision. Occupational therapists offer advice and guidance on increasing your independence in a wide variety of everyday activities. You may also need support in making changes to your home and workplace or training in the use of adaptive equipment or a guide dog.

The kinds of support available include:

• Training in the use of different mobility devices, such as a white cane, or in living with a guide dog. This helps people to move about safely and confidently in their community
• Advice on special devices such as large print and touch markers. These allow people to use appliances like washing machines and ovens more easily and safely
• Radio stations for people who are unable to read the standard printed word. RPH Print Radio stations read out newspapers, magazines and books on air as well as providing other specialist programs of interest
• Libraries of books, recipes and government information available in large print, cassette, braille or CD format
• A wide range of equipment to help people with vision impairment in their everyday lives – for example needle threaders, talking watches and clocks, coin and note holders
• For people with some vision, a growing range of videos that include descriptions of the visual information when there are gaps in the dialogue
• Low-vision clinics offering spectacles, magnifiers, telescopes and other devices that can enhance remaining vision.

Where to get help

• Your GP (doctor)
• Occupational therapist
• Optometrist
• Ophthalmologist
• Vision Australia Tel. 1800 033 660
• Guide Dogs Victoria Tel. 1800 804 805
• Seeing Eye Dogs Australia Tel. 1800 422 007
• Blind Citizens Australia Tel. 1800 033 660