Programs and Services

Information and Referral

General Information on Blindness and Visual Impairment  

THE DIFFERENT DISCIPLINES IN THE EYE CARE FIELD

FONT STYLE AND SIZE COMPARISONS

FREE DIRECTORY ASSISTANCE INFO

FREE MATTER INFO.

GENERAL GUIDELINES FOR THE SIGHTED WORKING WITH PEOPLE WHO ARE BLIND OR VISUALLY IMPAIRED

GUIDING SOMEONE WHO IS BLIND OR VISUALLY IMPAIRED

HOME SAFETY

HOW TO MAXIMIZE REMAINING VISION

LEADING CAUSES OF BLINDNESS AND VISUAL IMPAIRMENT

MAGNIFIER CARE AND USE

O&M OPTIONS, CANE SAFETY, CANE TIPS.

ORGANIZATIONAL TIPS AND TRICKS

QUESTIONS TO ASK YOUR DOCTOR

UNDERSTANDING THE NUMBERS

UNDERSTANDING LIFE WITH LOW VISION

THE DIFFERENT DISCIPLINES IN THE EYE CARE FIELD  

An OPHTHALMOLOGIST is a medical doctor specializing in the care and treatment of eye conditions and who is licensed to perform medical procedures and surgeries as needed.

An OPTOMETRIST is licensed to perform non-surgical refraction for eyeglasses and contact lenses as well as any follow up care related to this refraction. Patients experiencing infections, injuries, or trauma to the eyes should be immediately referred for medical care by an ophthalmologist.

A LOW VISION SPECIALIST is a licensed Doctor of Optometry or Ophthalmology skilled in the examination, treatment, and management of patients with visual impairments not fully treatable by medical, surgical, or conventional eyewear or contact lenses. A low vision specialist can best determine the need and appropriateness for magnification products such as hand-held magnifiers, monoculars, telescopes, closed-circuit televisions, and other low vision devices.

A LOW VISION THERAPIST (LVT/CVLT) is a rehabilitation professional who conducts functional low vision assessments of visual abilities for everyday tasks. LVTs provide instruction in the use of optical devices as well as devising other strategies (including use of non-optical devises and techniques) that allow the patient to accomplish his or her goals.

A VISION REHABILITATION THERAPIST works with individuals whose vision is permanently impaired. The teacher's job is to help identify areas of struggle by using a variety of techniques to work with and around the disability to regain as much function as possible. Skills are taught through learning adaptive kitchen, homemaking, and other daily living activities. Once mastered, training is expanded to traveling outside the home with the aid of a white cane.

An ORIENTATION AND MOBILITY SPECIALIST (O&M/COMS) provides sequential instruction to individuals with visual impairments to determine their position within the environment and in techniques for safe movement from one place to another through the use of their remaining senses. This includes, but is not limited to, instruction in residual vision stimulation and training, upper and lower body protective techniques, cane techniques, soliciting/declining assistance, route planning, analysis and identification of intersections, techniques for crossing streets, the use of public transportation, instructional use of low vision devices, and travel in urban and rural environments. Return to top

Low Vision Clinics Resource List

FONT STYLE AND SIZE COMPARISONS

Computer word processing programs allow for the easy alteration of fonts and size. Generally, people who are blind or visually impaired who have sufficient vision to read text with magnification can read large print text.  A general rule of thumb is to use sans sarif fonts (Definition: a category of typefaces that do not use serifs, small lines at the ends of letters. Popular sans serif fonts include Helvetica, Avant Garde, Arial, and Geneva.)  People who are blind or visually impaired can find it difficult to read serif fonts, such as Times Roman, Palatino.  Below are example of various fonts and sizes.

New Visions  (similar to newspaper print – Courier, 10 pt.)

New Visions  (standard business letter print – Times New Roman, 12 pt.)  

New Visions (standard large print using a sans serif font – Arial, 14 pt.)  

New Visions  (standard font style and size used at the Guild – Arial, 20 pt., bold)  

NEW VISIONS (all capital letters – Arial, 24 pt., bold)  

NEW VISIONS  (Arial, 36 pt., bold)  

NEW VISIONS  (Arial, 48 pt., bold)  

NEW VISIONS 

(Arial, 72 pt., bold)   Return to top

 
FREE DIRECTORY ASSISTANCE

If you cannot read the telephone book, you are entitled to free directory assistance (411) through the telephone company. To take advantage of this service for your home phone, you must do the following:

1. Call the SBC business office at (800) 244-4444. Tell them you want to be sent the forms for free directory assistance.
2. A MEDICAL DOCTOR certifying that you are visually disabled must fill out the application form.
3. Make a photocopy of your signed forms for your records before returning them to SBC.
4. Mail the forms back in the envelope provided. Call the SBC business office about two weeks after you mail the forms to make sure your application has been processed.Once you are registered with the phone company, you should not be charged for any 411 callsReturn to top

 

FREE MATTER
"Free Matter for the Blind and Physically Handicapped" is a postage-free mailing privilege granted for items and materials being mailed for people who are blind or have other disabilities that have been put into an adapted format (i.e. large print, braille, or audiocassette). "Free Matter" materials must be sent unsealed so that they are available for postal inspection.  

Items that may be sent "Free Matter" include:

• Braille materials;
• Audiocassettes and 4-track cassette players;
• Large print materials (in 14-point type or larger);
• Adapted products, such as white canes and other items directly related to the disability; and
• Newsletters, Library of Congress materials, and other general informational materials in adapted formats.  

Items not allowed to be sent "Free Matter" include, but are not limited to, the following:

• Private correspondence, including letters, greeting cards, party invitations, and holiday greetings;
• Utility bills and other bill payments; and
• All other private correspondence of a social, financial, or personal business   Return to top

GENERAL GUIDELINES FOR THE SIGHTED WORKING WITH PEOPLE WHO ARE BLIND OR VISUALLY IMPAIRED

When dealing with any new and unfamiliar situation, one must expect an adjustment period, whether you yourself are experiencing the change or you are just an observer.  Following are general guidelines you may wish to employ while interacting with those who are blind or visually impaired.  Although these strategies may work in most situations, it may be necessary to tailor your interactions to the individual needs of those you encounter.  The points listed, although not exhaustive, represent positive solutions to problems that commonly arise from lack of understanding, experience, or sensitivity to those different from us.

 

·        ATTITUDE IS EVERYTHING – Your attitude toward blindness and visual impairment and what that means in terms of the abilities, needs, and interests of the blind and visually impaired can greatly impact each encounter.  If you set the tone to be a positive and accepting one, others will follow your lead.

·        DON'T ASSUME THEY CAN'T – People who are blind or visually impaired are like everyone else.  They all have their own talents, skills, interests, and individual personalities.  Something you assume they cannot do may just be an issue of "how can they?"  This often applies to both personal and professional situations.  Respecting their accomplishments, however, should not be overshadowed by imposing unrealistic goals or expectations.

·        IF IN DOUBT, ASK – If you find yourself in an awkward or unusual situation and do not know what you should do, ask the person you are trying to help what they would like or what they need for you to do.  They may not want your help in the first place, so allow them the freedom to choose to accept help or not.

·        SHOW RESPECT – Treat personal and business matters with the respect you expect from others and keep their communications and information strictly confidential.  Also show your respect by allowing them to continue making their own decisions, having input into family or workgroup decisions, and let them share in responsibilities.

·        SUPPORT THEIR INDEPENDENCE – Offer your help and encouragement to obtain the tools necessary to be successful in all areas of life (e.g., adaptive equipment for employment, organizational items for the home, electronic magnification for reading, and a white cane or guide dog for safe, independent travel).

·        CONTINUE USING "SIGHTED" WORDS – Our language is full of "sighted" references that we all use—including those blind from birth. Trying to avoid these words only makes both parties self-conscious.  It is perfectly acceptable to tell a person who is blind or visually impaired that you will see them later.

·        USE BASIC COURTESY – Speak directly to the blind or visually impaired person you are addressing, not to their sighted companion.  Offer to shake their hand—verbally if necessary.  And never move their personal belongings without their knowledge and consent.

·        USE VERBAL CUES – Identify yourself when entering a room or in a public setting in order to alleviate any uncertainty of who and where you are.  Introduce others as they approach as well.  When you leave their proximity, say so.  This will avoid the embarrassment of them talking to someone who's not there.  Orient them in a room or to their plate of food by using the positions of a clock (e.g., "There's a set of stairs at 2 o'clock" or "Your meat is at 9 o'clock and your peas are at 12 o'clock").  Refrain from relying on hand gestures or facial expressions to make your point—these will most likely be missed.

·        PHYSICALLY ASSIST WITH PERMISSION ONLY – Offering your arm to assist in negotiating an unfamiliar area, crossing the street, or up and down stairs is completely acceptable, but not always wanted.  Never take the arm of an unwilling participant.  This may disorient them, frighten them, or insult their sense of independence.  If they accept your offer, position yourself so their free hand can hold on to your arm near the elbow, then stay about a half step ahead so that they can anticipate your movements.  Using verbal cues to identify obstacles, what is happening around you, and what your intentions are, is also very helpful.

·        USE HAND-OVER-HAND INSTRUCTION – When you show someone to their seat or are trying to describe how to use an object, taking their hand and placing it on the object in question is often very helpful.  Many blind and visually impaired people learn tactually, so only presenting information verbally may not give them a clear image in their mind until they can feel what you are talking about.

·        USE EQUAL CONSIDERATION – Although the goals and needs of the blind or visually impaired person in a family, work setting, or social situation should be considered and accommodated for, they should not be allowed to take priority over the activities of everyone else involved.

·        DON'T BLAME EVERYTHING ON THEIR VISION – Avoid blaming all their mistakes on blindness--sighted people make mistakes, too!  Also encourage them to tackle a problem you suspect they are avoiding by using their lack of vision as an excuse for not being able to do it.

·        LAUGH A LITTLE – Humor used at the right moment may help relieve tension in an otherwise awkward situation.  However, the blind or visually impaired person may fail to see the funny side of what is happening.  Remember, finding the humor in a given situation is not the same as making fun of the person or the situation.

·        MONEY MATTERS – People who are blind or visually impaired can learn to distinguish their own coins and dollar bills—so let them!  They will, however, need to develop a system to organize their money, which may take some assistance, time, patience, and a little ingenuity.

·        KEEP THEM IN TOUCH WITH THE WORLD – Offer to read their mail, newspapers, magazines, and other printed materials they cannot, but leave the selection to them.  Encourage them to find ways they can also access this information on their own.

·        BLIND NOT DEAF – If the person you are speaking to is blind or visually impaired, but not hearing impaired, use a normal tone of voice and rate of speech you would with anyone else.

·        HEIGHTENED SENSES MYTH – Many people are under the impression that when a person loses one sense that the others become better developed.  This is only a myth—there is no scientific evidence of heightened abilities.  Those affected, however, may appear to have better hearing or sense of touch, but what is really happening is that they have learned to use and rely on these other senses out of necessity, therefore, they attend more readily to these stimuli than those with all senses intact.

·        GIVE USEFUL DIRECTIONS – When giving directions, be specific.  Use terms like "left," "north," and "three blocks."  Telling someone "It's over there," "Go that way," or pointing toward something or somewhere will not help them and will only create more frustration on their part.  Describing obstacles and landmarks is also very helpful.

·        SAFETY FIRST – Keep walkways clear of obstructions that could be hazardous.  If you need to change the position of furniture or other items, let the person know.  Specific examples to watch for are open doors, boxes, power cords, drawers and cabinets left open.  Similarly, don't move items that have been placed in a specific place by the person who is blind or visually impaired.  This will help avoid issues such as the frustration of "losing" something and wasting a lot of time.

·        GUIDE DOGS ON DUTY – Never pet, feed, or distract the attention of a working guide dog.  If they are working, their harness should be on.  Distracting the dog while it is working could be detrimental to it and its owner.

·        GROUP SPEAK – If you find yourself talking in a group with someone who is blind or visually impaired, it is appropriate to address them by name or to lightly touch their arm so that they know you are speaking to them.  Return to top

GUIDING SOMEONE WHO IS BLIND OR VISUALLY IMPAIRED  

“Sighted guide” is a set of techniques used by a sighted or skilled visually impaired person to safely guide a blind or visually impaired person while traveling.  Below are tips to keep in mind when using this method or when teaching another how to use it properly.    

Basic Orientation and Procedure:  

• Others should ask you if you need sighted guide assistance—it is your choice to make.
• Use your white cane in conjunction with the sighted guide technique.
• Take the arm of your sighted guide, not the other way around.
• Gently grasp their arm just above the elbow.
• Walk a half step behind them and slightly to the side so that you can follow their body movements.
• Have the sighted guide walk on the side of you that is most comfortable to you.
• The sighted guide should verbally inform you of obstacles in your way such as curbs, stairs, and other things in your path.

  Navigating Stairs:  

• When walking up and down stairs, stay behind your sighted guide, holding the railing as well as your guide.
• The sighted guide should stop or pause at the start of stairways and let you know if they are going up or down.  They should also stop or pause at the end of the stairs.
• If it will make you feel more comfortable, you can ask the sighted guide to tell you how many stairs to expect.  

Navigating Doorways:  

• When going through doors, the sighted guide should say if the door is being pulled or pushed open and what side it is on.
• At revolving doors, the sighted guide should stop the door with the partition in the middle of the entryway.  They should then place your hand on the partition so you know where to get in.  The sighted guide then gets in on the other side of the partition, leading you.  Once through, the sighted guide should step out and be ready to meet up with you on the other side.
• The white cane can be used to trail the inside of the revolving door.  When you feel a break in the doorframe, you know you are in the open section on the other side of the door.  

  Navigating Tight Spaces:  

• In narrow places, the sighted guide should move their guiding arm behind them so that their hand is at the small of their back.  Slide your hand down to their wrist and step in behind them so you can travel single-file through the space.  When it opens up again, the sighted guide should move their arm back into the correct position while you slide your hand back up to just above their elbow.

General Orientation and Mobility Tips to Remember:  

Trailing – Place your hand on the wall or the back of furniture and follow the line to help you travel smoothly through the space.

• Dropped Items – If you bend over to pick something up, remember to protect your head from hitting other objects.
• Cabinets – Keep cabinet doors closed if not in use to avoid head injuries.
• Doors – Keep doors completely open or closed, not at angles that you may run into.  If a door leads to a stairwell heading downstairs, always keep it shut to avoid falling.
• Handrails – Use handrails when available for stability and to avoid missing steps.
• Unfamiliar Surroundings – When entering a new room or area, ask your sighted guide to help orientate you by walking you around and verbally describing what is there. Return to top

 

HOME SAFETY TIPS

• Keep all stairs and hallways free from clutter
• Keep all cabinet doors and drawers closed
• Keep toilet lids closed
• Doors should be either completely opened or closed
• Use non-slip pads under throw rugs
• Use window treatments and light fixtures to help control lighting conditions and to reduce glare
• Do not store toxic materials near food
• Equip your house with smoke detectors, carbon monoxide detectors, and fire extinguishers that are properly maintained and easily accessible
• Ground fault protectors must be installed within 72" of any water source (National Electrical Code)Return to top

 

HOW TO MAXIMIZE REMAINING VISION  

The following factors can be a barrier to someone’s ability to perform daily activities such as reading and writing, dressing, traveling independently, and eating.  Since many individuals who have low vision sometimes have “good” and “bad” days, their skills in these areas may seem to fluctuate from day-to-day.  However, there are strategies that can be used to maximize the remaining vision that they do have.  Using a combination of as many of these strategies as possible will increase the chances for success when attempting to optimize what vision remains.  Doing so can also reduce eyestrain and fatigue, frustration, and the time needed to complete tasks.  

Color and Color Contrast

• Color-code items such as file folders or containers of like items to help distinguish between them quickly  

• Use color on walls and floors to distinguish boundaries or physical features of rooms or hallways  

• Use contrasting colors to help discriminate one item from the next (e.g. white plate on a dark colored placemat)  

Proper Lighting

·        Control the amount of light available -- either too much or too little light can be problematic  

·        Be aware that too much light variation can be dangerous if one is traveling in and out of light and dark areas in a short period of time, such as shadows created by objects with patches of very bright sunlight, since their eyes will not be able to adapt to the sudden changes as healthy eyes would  

·        The type of light bulb (fluorescent vs. incandescent vs. halogen, etc.) and the number of watts being used can impact the amount and clarity of objects seen and can also impact comfort level and eye strain  

·        The lower the person's vision the closer the light source needs to be to the object being viewed  

·        When doing a task such as reading, the light source should be positioned over the shoulder of the better-seeing eye at about a 45 degree angle to what is being read  

Glare Control

• Reducing glare will also reduce eye strain and fatigue  

• Choose paint on walls and ceilings that will not reflect a lot of light, particularly from windows  

• Use carpet or rugs vs. slick, shiny tile for the floors  

• Use window treatments to control the sunlight throughout the day  

• Compare overhead lighting with floor lamps and wall sconces  

• If glare is a big problem, have person wear a sunshield (wraparound sunglasses that block light from the top, bottom, and sides) or regular sunglasses inside as well as outside  

• Visors can also be worn to deflect glare from above  

• Experiment with different colored lenses for sunshields to find the one that cuts out enough glare without cutting out too much needed light  

Visual clutter

• Limit the number of items, colors, and patterns used together to avoid difficulties in discriminating between them, which often can cause confusion, disorientation, and eye strain (this includes bulletin boards of information, written materials such as flyers, and decorative items like wallpaper and carpeting)  

• Keep in mind that even if there appears to be color contrast between items such as patterned wallpaper and a paper towel dispenser, that the visual clutter of the wallpaper may be so dominant that the color distinction between that and the dispenser may be lost on someone with low vision  

• Use high color contrast to delineate different spaces in the room, storage containers of like items, and items such as a plain colored plate and placemat that distinguishes them form each other as well as the tabletop  

Magnification

• Have the person get closer to the object they are trying to see (magnifying by relative distance)  

• Use larger items designed for those with low vision and write bigger than usual (magnifying by relative size)  

• Use magnifiers best designed for activity

Hand-held magnifiers for general short-term reading

Pocket magnifiers for spot-checking limited information such as price tags and labels

Stand magnifiers have a fixed focal distance for simple writing tasks like signing a check, good for those with strength or dexterity problems in their hands,

Page magnifiers are only good for those with minimal magnification needs

Electronic magnification (closed-circuit televisions or CCTVs) offer the most magnification power available; good for enlarging most items and may be the only tool someone can use to read and write independently)  

Other barriers that may not be able to be controlled that also affect a resident’s ability to properly interpret visual information include:  

• Speed of movement (as movement becomes more rapid or complex such as in certain hand gestures, the less likely they will be to follow or to even be aware of it)  

• Hearing loss (contributes to increased disorientation)Return to top

 

THE LEADING CAUSES OF VISION LOSS AND BLINDNESS

It is estimated that there are approximately 10,000,000 people in the United States with some degree of vision loss. Approximately 2,000,000 of these individuals are considered to be legally blind, but only about 450,000 are considered totally blind. Approximately 53,000 children are visually impaired or blind.  

As one can see from the prevalence shown above, most vision loss occurs in adulthood. Statistically, 1 out of 6 adults over the age of 65 will be affected by some form of visual impairment. The leading causes of adult vision loss include the following:  

Diabetic Retinopathy, the leading cause of blindness in adults under age 60, is due to complications of long-term diabetes. Retinopathy is an abnormal growth of fragile blood vessels, which rupture and cause hemorrhaging in the eye. This hemorrhaging can lead to partial or total retinal detachment, blind spots, or loss of sight due to accumulation of blood inside the eyeball.  

Macular Degeneration is the deterioration of the macula, or central retina, of the eye. Macular degeneration is the leading cause of legal blindness in adults over age 60. There are two types, wet and dry, both types leading to loss of central vision. As the macula deteriorates, the individual develops a central blind spot, loosing detail vision and color perception. The peripheral vision is not affected and will allow the individual to see large shapes, movement, and some colors. While macular degeneration causes significant acuity loss, it does NOT lead to total blindness.  

Glaucoma is a group of diseases characterized by elevated pressure inside the eye and represents the leading cause of preventable blindness in the United States. Continued elevated pressure damages the retina causing progressive tunnel vision, and eventually, total blindness. Glaucoma testing is a standard part of an eye exam and should be done at least once a year. If caught early, treatment is available. People of African-American heritage are at higher risk for glaucoma.  

Cataract is a clouding of the lens of the eye often occurring in older adults. This clouding prevents light from reaching the retina of the eye, causing a dimming of vision and loss of acuity. Cataract surgery removes the clouded lens, and replaces it with an intraocular contact lens. Cataract surgery is usually highly successful and often done on an outpatient basis.  

Vision loss can also be present at birth or occur in early childhood. The leading causes of pediatric vision loss include:

Retinopathy of Prematurity (ROP), formerly called retrolental fibroplasia, is the destructive retinal changes that can occur when prolonged life-sustaining oxygen therapy is given to premature infants. Abnormal blood vessels grow in the eye, break, and cause hemorrhages leading to retinal detachment and scarring. Most people with ROP have profound vision loss, often total blindness.  

Retinobalstoma is cancer of the retina and is a hereditary condition usually present in both eyes. Surgical removal of the eye is the most effective treatment option. If left untreated, the tumor travels up the optic nerve to the brain, causing death.  

Congenital glaucoma affects the eye in the same way as adult onset glaucoma and is sometimes present with other ocular conditions.  

Congenital cataract can be hereditary or caused by a wide range of factors such as in utero exposure to rubella. Many factors can affect successful medical treatment of congenital cataract.   Return to top

CARING FOR YOUR MAGNIFIERS

You have just purchased an optical quality magnifier. Follow these guidelines to ensure the best magnification possible:

• Your magnifier lens is made of acrylic, the same material used in making eyeglass lenses. Therefore, use the same care and caution with all lenses to make sure they do not get scratched. When not in use, keep your magnifier in a protective case or pouch.
• Do not lay your magnifier down in direct sunlight or in any place with extremes of hot or cold temperatures.
• Do not allow your magnifier to come into contact with harsh chemicals or solvents. This can cloud or otherwise damage the lens.
• Clean your magnifier with mild soap and water, rubbing it with your fingertips. Dry with a soft cloth. DO NOT USE PAPER TOWELS OR FACIAL TISSUE TO DRY YOUR LENSES. THIS WILL CAUSE SCRATCHING.  

Some additional tips for lighted magnifiers:

• Remember to turn your magnifier off when not in use.
• If your magnifier fails to light 1) check the bulb to make sure it is not loose, 2) check the batteries to make sure they are secure against the contacts.
• If your magnifier still fails to light try changing the batteries. Be sure to replace the batteries in the same position as the old ones. Use only fresh batteries. We recommend brand name alkaline batteries for best results.
• If you have fresh batteries that have been properly installed, and the bulb is secure, you may have to replace the bulb. The Guild has replacement bulbs for the magnifiers we sell. Keep your receipt from your purchase to help us identify which replacement bulb you need.  

HOW TO USE MAGNIFIERS PROPERLY

When using magnifiers, it is important to understand how to use them properly. Basic principles of physics dictate how this technology works, so If you do not use the magnifier as intended, it won't matter if you have the proper magnification or not. Keep in mind that the stronger the magnification, the smaller the actual magnifier lens and field of vision will be. As such, the working distance to the object being viewed will decrease as the lens strength increases.

Magnification Working Distance
1x at 10"
2X at 5"
3X at 3.3"
4X at 2.5"
5X at 2.0"
6X at 1.6"
7X at 1.4"
8X at 1.25"
10x at 1.0"

Use the following suggestions to determine the proper reading distance for using your magnifier:

1. Find out what magnification power has been prescribed for you and reference the above chart as a reference point.
2. Hold your magnifier up to your eye and move your head down until your nose is almost touching the material you are trying to view.
3. Slowly move away from the page until the print is clearest. This is the point where the lens focuses.
4. Make sure that you are using appropriate lighting, especially if your doctor prescribes very strong lenses.  

You will also find that keeping your head still and moving the reading material is a more comfortable way to read. Maintaining focus is easier if the material is what is moving and not your head. You may have to practice this skill before it feels natural to you.

As with the use of anything new, training and practice are very important. If you have difficulty at first, keep trying, and don't hesitate to contact the prescribing professional to ask more questions. He/she will be able to help you make necessary adjustments. Return to top

ORIENTATION & MOBILITY OPTIONS

The following items are frequently used tools that are available-but they will only help you if you have the skills to use them correctly.  

• Orientation & Mobility (O&M) Devices
• Standard white cane (straight, folding, and telescoping)
• Support cane
• Identification cane
• Cane tips (standard roller tip, roller ball tip, and mushroom cap)
• Guide dog
• Monoculars/binoculars
• Global Positioning System (GPS)
• Laser cane
• Sleep shades  

Reasons for Using O&M Devices:

• Safety in traveling
• Identification for others
• Tools for gathering information about your environmentReturn to top

 

WHITE CANE SAFETY

The following suggestions are intended to provide new white cane users with basic skills in cane usage that will keep them, and those around them, safe. Using proper cane technique and etiquette will not only ensure your safety, but it will also foster more courtesy and understanding with those around you.  

• Cross streets at a new green light-DON'T FOLLOW THE CROWD!
• At steps, drop your cane down first before putting your foot down.
• Trail objects with the back of your hand, not your palm.
• Make yourself visible to others.
• Know how you want others to help you and make it clear to them.
• When not in use, store straight canes in a space that will not endanger others by falling or tripping them.
• Keep folded canes nearby, but out of the way, when not in use.
• Always remember where you left your cane!
• Break down a folding cane by holding it vertically.
• If you find an object with your cane (e.g., the side of a building, a car, etc.), gently tap it until you can get around the obstacle and resume your course.Return to top

 

WHITE CANE TIPS & TECHNIQUES

• Always know where you're going and how you plan to get there.
• Remember that your mind is your best aid-use it to solve problems in new situations.
• Request directions that describe your route, in addition to using directional indicators (e.g., go north).
• Stay alert and pay attention to your surroundings. Be aware of the direction you are traveling in a vehicle and how that relates to the street or place you are trying to reach. If possible, use the sun and shadows to tell you what direction you are facing.
• Always be prepared for changes in your route.
• If you have a folding cane, keep it out and in front of you.
• Generally, the length of your white cane should be from your armpit to the ground.
• Hold the cane with your palm facing out and your index finger pointing down.
• Use your cane even if you are with a sighted guide.
• Teach friends and family how to properly use the sighted guide technique.
• Use the trailing technique to help navigate a room.
• Try both tapping and sliding the cane back and forth to determine which method is best for you and which one would work best in a given situation.
• Be aware that most elevators have braille and raised large print numbers indicating floors and that the lower numbers begin toward the bottom of the panel.
• Wear appropriate sun wear and visors or hats to reduce glare.  Return to top

ORGANIZATIONAL TIPS AND TRICKS

The following suggestions will help you to organize your home or workspace to be more user-friendly.

• Develop a system and stick to it
• Label items clearly, safely, and consistently
• Limit your work space
• Store like items together
• Compartmentalize items like screws and silverware
  Get rid of clutter
• Reduce the amount of paper you use
• Use high-contrasting materials when possible
• Use a pill organizer for daily medications  

With a little creative experimentation, many of these suggestions can be easily implemented using supplies that you already have in your home. Use whatever works best for you! Return to top

Talking with Your Doctor

The National Eye Institute recommends the following questions that you can ask your doctor to achieve your best possible level of health.  

About My Disease or Disorder:

1. What is my diagnosis?
2. What caused my condition?
3. Can my condition be treated?
4. How will this condition affect my vision now and in the future?
5. Should I watch for any particular symptoms and notify you if they occur?
6. Should I make any lifestyle changes?  

About My Treatment

1. What is the treatment for my condition?
2. When will the treatment start and how long will it last?
3. What are the benefits of this treatment and how successful is it?
4. What are the risks and side effects associated with this treatment?
5. Are there foods, drugs, or activities I should avoid while I'm on this treatment?
6. If my treatment includes taking a medication, what should I do if I miss a dose?
7. Are other treatments available?  

About My Tests

1. What kinds of tests will I have?
2. What do you expect to find out from these tests?
3. When will I know the results?
4. Do I have to do anything special to prepare for any of these tests?
5. Do these tests have any side effects?
6. Will I need more tests later?  

Understanding your doctor's responses is essential to good communication. Here are a few more tips:  

• If you don't understand your doctor's responses, ask questions until you do understand.
• Take notes, or get a friend or family member to take notes for you. Or, bring a tape-recorder to assist your recollection of the discussion.
• Ask your doctor to write down his or her instructions to you.
• Ask your doctor for printed material about your condition.
• If you still have trouble understanding your doctor's answers, ask where you can go for more information.  

Other members of your health care team, such as nurses and pharmacists, can be good sources of information. Talk to them, too. Return to top

 

UNDERSTANDING WHAT THE NUMBERS MEAN

Ideal vision, or acuity, is considered to be 20/20. Those with 20/20 vision can see an object 20 feet away as they are intended to see it. Gaining an understanding of what those numbers mean in regard to your own acuity will help you understand your vision condition better.  

The number to the left of the slash (/) is the testing distance. Most people are tested at 20 feet, or its equivalent, resulting in a reading of 20/X. The number to the right of the slash (/) indicates the distance a person with normal vision sees the same object the person being tested can see from 20 feet away. For example, if a person's vision was determined to be 20/40, that would indicate that at a testing distance of 20 feet, the patient was able to read what people with normal vision could read at 40 feet. In Illinois, 20/40, with best correction, is the lowest visual acuity acceptable for full driving privileges.  

Low Vision: 20/70 is considered "low vision." Children in the public school system must be at least 20/70 or lower to receive special education services. Also, 20/70 is the lowest visual acuity acceptable to retain a daytime only restricted driver's license in Illinois.

Legally Blind: 20/200 is considered "legally blind." This is a statutory definition created by the Social Security Administration in 1934 to determine eligibility for disability benefits. Blindness is the only disability with a statutory definition. While this is significant loss of detail vision, legally blind individuals usually retain some level of functional sight.  

• Severe Vision Loss: 20/200 to 20/400 is considered "severe vision loss."
• Profound Vision Loss: Vision below 20/400 is considered "profound vision loss." Accurate measurement of remaining sight below 20/400 is accomplished best by using low vision testing techniques.
• Counting Fingers: Counting fingers (CF) is sometimes used to measure how much an individual can see when a reading cannot be obtained from a traditional eye chart and low vision testing is not done. For example, a notation of "CF 3" on an eye report indicates a general measurement of the ability to count fingers on the examiner's hand at a distance of three feet.
• Light Projection: Light projection (Lproj) refers to the ability to discriminate light from dark and to determine the light source such as a window or lamp.
• Light Perception: Someone with light perception (LP) can distinguish light from dark, but they cannot determine the source of the light.
• No Light Perception. No light perception (NLP) is total blindness. Return to top

UNDERSTANDING LIFE WITH LOW VISION  

When adults begin to lose their vision to the extent that normal daily activities become difficult or impossible to do as they once had, they most likely will go through the same grief process they would when losing a loved one.  This mourning process is normal, but is often exacerbated by other issues occurring simultaneously in their lives.  The loss of other physical abilities, the loss of their peer group, and the isolation that is often experienced as one ages will be magnified by the debilitating effects of vision loss.  These issues become even more pertinent when faced with the prospect of taking residence in a long-term care facility.  

Life with low vision is often overwhelming to those experiencing it as well as for those closest to them.  Frequently those dealing directly with this loss feel that there is no hope; that life is over.  Their adjustment process may be slow and complicated by numerous hurdles that each will encounter at one point or another.  The following are common issues faced particularly by those who are experiencing new vision loss:  

Depression  

• Feeling alone
• Not knowing whom to talk to or who will understand what is happening to them
• Losing their independence and the life they once had
• Thinking that life will now always be difficult or impossible  

Frustration  

• Changing needs and abilities from day-to-day and situation-to-situation
• Being seen by others as lazy, incompetent or suffering from dementia when their vision is actually the underlying issue

Fear  

• Always being dependent on others
• Being a burden to family and friends
• Becoming alienated from family and friends
• Experiencing actual, as well as perceived, safety concerns
• Believing that drastic changes to their lifestyle will occur  

Isolation  

• Losing access to normal daily activities both inside and outside of the home (e.g. cooking, taking care of household finances, traveling, shopping, and pursuing leisure activities and hobbies)
• Experiencing fewer opportunities for socializing with peers and the general public  

Change in Self-Concept  

• Experiencing a lower level of self-esteem and self-image as the visual impairment increases and abilities and activities decrease  

Feelings of Shame  

• Believing that the disability in some way was caused by their own behavior or that they are being punished for something they have done
• Believing that society will view them as less than they are because they are now disabled  

It is important to keep these issues in mind and to address them when appropriate.  Anticipating needs and creating an atmosphere of acceptance and support will help promote better outcomes for people experiencing vision loss (as well as for those with other life changing conditions).  How well someone adjusts, though, is often determined by their basic personality and general outlook on life, their coping skills, their motivation to persevere and learn new things, and their continued involvement with daily activities.  

Those working with those with vision loss need to keep in mind that their road to adjustment will most likely not take a straight path and that the process can sometimes take years.  Patience, empathy, a sense of safety, and an environment that is designed to include them in mainstream activities are critical to maintain the morale and hopefulness for those struggling to adjust to their new life with low vision.

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