Eyes - vision loss

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

Vision loss can affect people of all ages, but around 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 sight and mobility. Some vision loss can be prevented, while other conditions may be inherited or develop with age. A small proportion of people with vision impairment are totally blind.

Common causes of vision impairment#

• Age-related macular degeneration causes distortion or loss of central vision in older people, leading to difficulties with tasks such as reading and recognising faces.
• Refractive error accounts for about half of all vision impairment in many countries when it is under-corrected. Types include long-sightedness, short-sightedness, astigmatism and presbyopia, and most can be improved by wearing glasses.
• Diabetic retinopathy causes blurring and patchiness in vision. The underlying cause is diabetes.
• Glaucoma causes tunnel vision and affects safe mobility and driving.
• Cataracts cause blurring and increased sensitivity to glare, but can often be corrected by surgery.
• Vision loss in children can result from many diseases, defects, malformations, infections and disorders affecting the visual system. Because seeing is an important way for infants to learn, vision impairment can influence the normal development of body control, hand use, language and social behaviour.

Making things easier to see#

Whatever the cause, there are many things you can do to maintain your independence and quality of life. The suggestions below apply to a wide range of activities.

Enlarge and magnify#

• Use large-print diaries and address books.
• Use a photocopier to enlarge recipes, music notes and other information.
• Move closer to what you are looking at, such as the television.
• Enlarge the type size on your computer screen.
• Keep your prescription glasses up to date for your best possible vision.
• Use handheld or mounted magnifiers for reading and sewing. These should be prescribed for your type and degree of vision impairment.
• Use telephones with large buttons.

Use contrast#

Contrast can help you see things more clearly, and black on white or white on black gives the best results. For example:

• Use black felt-tip or water-based pens.
• Put contrasting strips on the edges of steps. On dark surfaces, use 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 brighten them and make items easier to find.
• Use plain, dark tablecloths or mats with white dishes.

Use better lighting and your other senses#

Improving both general lighting and focused task lighting makes objects and printed material easier to see. You can also use your other senses to supplement your vision:

• Touch – add tactile markings to appliances such as stoves and washing machines to indicate off and on settings, and mark commonly used switches so they stand out.
• Hearing – use talking and audible devices, such as clocks and kitchen scales.
• Smell – check the freshness of food and tell whether food is cooking or starting to burn.
• Taste – use taste to tell different foods, herbs and spices apart.

It may take time to learn to trust your other senses, so give yourself time to practise and build confidence in new ways of doing things.

Staying organised#

Being organised makes daily life easier to manage. Some tips include:

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

Many everyday activities can be adapted so that a person with impaired vision can keep living safely and independently. A few examples follow, and the same ideas apply to many other tasks.

Banking and money#

• Use a black felt-tipped pen and a template to fill in forms. Templates may be available from your bank, or you can have them made up.
• Fill in forms at home using a magnifier and focused lighting.
• Familiarise yourself with one type of automatic teller machine (ATM). A keyboard-style ATM is easier to use than a touch screen, and an occupational therapist can train you in using one.
• Electronic banking with a PIN may be easier than deposit and withdrawal slips or handling cash.
• Most bills can now be paid by telephone, and many are available in large print, ask your provider.
• Tell coins apart by size, weight and edge milling, and notes apart by length, where longer notes mean larger amounts. A note guide may help.
• Separate different coins in your wallet, and fold particular notes or store them in different compartments so you can find the right amount. Organising your wallet before you leave home makes paying easier.

Cleaning, dusting and vacuuming#

• Spray cleaning liquid directly onto the cloth, wrapping the cloth around the nozzle to avoid spraying near your face.
• Move furniture and tabletop items before you dust or vacuum.
• Work systematically from one end to the other, dividing areas into smaller parts.
• Use tactile markings on the vacuum cleaner to find the correct settings.

Making the bed#

• Attach safety pins to one corner of a fitted sheet to help with orientation.
• To put a cover on a duvet, turn the cover inside out, place your hands inside, grasp the corners of the duvet and shake so the cover drops over it.

Washing dishes#

• Wash one item at a time rather than filling the sink.
• Run your fingertips over plates and dishes to check they are clean.
• Use a dish rack to organise dishes, and apply tactile markings to a dishwasher so you can use it independently.

Cooking#

• Apply tactile markings to appliances so you can use the controls accurately.
• Look for recipes in audio, braille or large-print formats.
• Convert measurements to cups and spoons, using differently coloured measuring equipment for contrast. Talking scales may help.
• Place non-slip matting in a contrasting colour under a chopping board to keep it stable, and use contrasting chopping boards and focused lighting to cut food safely.
• Keep the bench and sink clear so you can trail across them to find items and separate scraps from food to be cooked.
• Heavy, wide-based saucepans and pans with high sides are more stable and help contain ingredients.
• Store similar foods together in trays or containers and keep them in consistent places. Ready-made sauces can simplify cooking.

Laundry#

• Use separate baskets for light and dark clothing.
• Pin sock pairs together before washing.
• Apply tactile or contrasting markings to laundry appliances.
• Indoor clothes stands may be easier to manage than an outside line, and hanging shirts to dry minimises ironing.

Personal hygiene#

• Mark your toothbrush with a tactile or contrasting tag so you can tell it apart from others.
• When applying toothpaste, place your index finger on the brush to guide it, or squeeze the paste onto your fingertip first and wipe it on.
• Use products in pump packs that dispense pre-measured amounts.
• Differently coloured or shaped bottles, or rubber bands and other tactile markers, help you identify shampoo, conditioner and similar products.

Writing and computers#

• Use black felt-tipped pens, as black on white gives the greatest contrast. Other high-contrast colour combinations can also help.
• 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 to help with writing tasks. Specialist vision-loss organisations can advise on, and provide training in, adaptive technology.

Getting out and about#

Having vision loss need not mean staying at home. If you have lost confidence using public transport or going to the shops, an orientation and mobility specialist can help you get around safely and confidently. A guide dog may also be an option, these dogs are specially bred and trained to help people who are blind or vision impaired achieve mobility and independence.

Recreation is important for an active, enjoyable life. There are many organised sports for people with vision loss, such as bowling, golf, tandem cycling, cricket and rowing, as well as opportunities to travel. These activities may need the help of family and friends or the use of modified equipment.

Technology and support services#

Technology now allows people with vision loss to access information that was once limited to print. People of all ages use screen readers that turn words on a screen into large print or speech, and a range of assistive technologies is available.

Vision-loss services support people of all ages and all degrees of vision impairment or blindness. You can have optical and other devices assessed and get help developing strategies to make the best use of your remaining vision. Occupational therapists can advise on increasing your independence in everyday activities, and you may also get support with changes to your home or workplace, or training in adaptive equipment or a guide dog. The kinds of support available include:

• Training in mobility devices, such as a white cane, or in living with a guide dog, to help you move about safely and confidently.
• Advice on special devices, such as large-print labels and tactile markers, that make appliances like washing machines and ovens easier and safer to use.
• Radio reading services that read out newspapers, magazines and books on air, along with other specialist programs.
• Libraries of books, recipes and public information in large print, audio, braille or other accessible formats.
• A wide range of everyday aids, such as needle threaders, talking watches and clocks, and coin and note holders.
• Described video, which includes narration of the visual content during gaps in the dialogue, for people with some vision.
• Low-vision clinics offering spectacles, magnifiers, telescopes and other devices that enhance remaining vision.

Key points#

• Some vision loss can be prevented, while other conditions may be inherited or develop with age.
• Seeing is an important way for infants to learn, so vision impairment can affect a child’s development.
• There are many things you can do to maintain your independence and quality of life.
• A keyboard-style ATM is easier to use than a touch screen.
• Large-print contrast stickers or tactile marks on a keyboard make typing easier.