Low vision affects about 7% of adults ages 65 and older, according to survey results from VisionServe Alliance and the Aging and Vision Loss National Coalition. It may be related to several underlying issues, and its effects go far beyond having to use magnifying devices to be able to read.
If you have low vision, taking full advantage of what sight you do have is vital. Here’s what you need to know to live a fuller, more active life.
What Is Low Vision?
Low vision refers to visual impairment that limits your ability to perform daily activities, including work, travel, and routine tasks, according to Andrea Zimmerman, OD, FAAO, a low-vision optometrist with Lighthouse Guild. “Low vision typically begins at a visual acuity of about 20/40, meaning that you can see at 20 feet what someone with normal vision can see at 40 feet,” Dr. Zimmerman explains. “Anything worse than this is when people begin to experience serious vision difficulties.”
Wide-Ranging Impacts of Vision Loss
Dr. Zimmerman notes that a person’s risk of injury is greater if they have low vision. Common hazards she points to include falling because you step off of a curb you didn’t see, walking into something in the street, having a serious accident due to not seeing traffic lights, and burns sustained while cooking because you are unable to clearly see the temperature dials on the stove or the fluids you’re pouring.
Moreover, “Any chronic medical condition may become worse if a person struggles to read the small print on a drug label or cannot clearly see their medications,” she adds.
You may have difficulty telling the time, using the phone, watching the television, or climbing stairs. “Communicating with others may be harder if you cannot clearly see their face during conversations,” Dr. Zimmerman says, adding that becoming homebound is another possible complication. “People with low vision may have difficulty going out to socialize, shop for food, or attend medical appointments,” she says. “Reduced mobility may lead to social isolation, depression, and anxiety.”
Your brainpower also may be affected: Research has suggested that older adults with low vision participate in fewer cognitively stimulating activities, such as doing crossword and jigsaw puzzles, reading newspapers and magazines, and enjoying crafts like needlework, compared with people whose vision is good.
All of these factors make poor health outcomes more likely among older people with low vision, compared with their peers who do not have the condition. Federal health data indicate that low vision raises the risk of falls, heart disease, stroke, diabetes, depression, hearing loss, social isolation, and poor quality of life.
Your Vision in Older Age
Older adults with low vision typically have underlying age-related conditions that can lead to vision loss. These conditions include glaucoma; macular degeneration, which damages the central vision needed for reading and driving; and diabetic retinopathy, which occurs when diabetes damages tiny blood vessels in the retina (the light-sensitive tissue that lines the inner eye), causing them to leak. All of these problems develop gradually, meaning that they often are diagnosed after they already have caused irreversible vision loss.
“The best way to catch these conditions early is through regular comprehensive eye exams,” Dr. Zimmerman says. “Regular eye checks and early treatment save sight. If they are caught early, glaucoma, macular degeneration, and diabetic retinopathy can be treated to prevent further vision loss.”
Getting Help for Low Vision
If your vision loss cannot be corrected, ask your doctor to refer you for a low-vision evaluation.
“These assessments look at how a person with low vision functions with their impairment and is aimed at preventing harm and increasing independence in everyday skills,” says Dr. Zimmerman. “A low-vision specialist can help you understand where your vision loss is happening—whether it’s impacting your central or peripheral vision or affecting your contrast sensitivity. Once you understand where your remaining vision is, the specialist will work with you to maximize it through different approaches, including the use of assistive devices, specialized glasses, and mobility training to help you with things like reading and navigating the outdoors.”
Low-Vision Aids
An array of low-vision aids and assistive technologies can help you make better use of your remaining vision when it comes to close-up activities. Magnifying devices are among the most basic optical devices and are widely available.
“These can help you with both long-distance vision and up-close activities like reading,” says Dr. Zimmerman. “These devices are demonstrated to people during a low-vision evaluation at Lighthouse Guild, to see if they make sense for that person’s needs.” Examples include simple handheld magnifiers that can be placed over a book or newspaper so that you can see the letters clearly, or a magnifier on a stand that can be positioned right next to you so you can have your hands free for sewing, needlepoint, crochet, or knitting.
Other things that may help are prism spectacle lenses. To understand how these work, consider that light must enter the eye for you to be able to see. “Prism lenses redirect that light from one area to another.” Dr. Zimmerman explains. “If a person has lost peripheral vision, a prism can be placed on the edge of their glasses to move light from their side vision to their central vision, where they are still able to see.”
Color tinted lenses also may be helpful, since they make the difference between light and dark areas more distinct. “By improving contrast they improve clarity, making it easier to see in various lighting conditions,” Dr. Zimmerman says.
Lighthouse Guild also offers assistive technology training that can be useful when it comes to using accessibility features that now are incorporated into many smartphones, such as text-to-speech features. Modern televisions also come with accessibility options, such as audio descriptions that describe what is happening on the screen as you watch. Some newer televisions also have visual options specifically aimed at people with vision impairments, such as contrast and color adjustments that make it easier to identify characters and other objects on the screen. You can use voice commands to turn newer televisions on and off and change channels, and can purchase third-party remote controls with large, high-contrast buttons and/or buttons that incorporate one or more tactile raised dots depending upon their function. Phone use will be easier if you make use of your phone’s voice-activated virtual assistant to make calls and send texts for you.
Orientation and mobility training also is an important tool for people with low vision. A low-vision specialist also can help you understand how to use your senses of smell, touch, and hearing to identify clues in your environment that can help you mentally map your surroundings (for example, the hum of the refrigerator can tell you that you are in a kitchen, and the texture of different types of flooring or ground underfoot can help you recognize other rooms in your home or what kind of terrain you are navigating outdoors). Studies suggest that people with low vision who participate in this type of training remain more independent and active, are less at risk for falls, engage in physical and community-based activities, and tend to remain more compliant with medical appointments.
The takeaway is that low vision doesn’t have to diminish your quality of life—there are strategies and resources that can make a difference to your vision loss.
Resources
- Lighthouse Guild provides information and advice about coping with low vision, as well as supportive services and online presentations and classes focusing on assistive technology for low vision.
- VisionAware has a wide range of online resources to help you navigate low vision, including helpful tips for orienting yourself in your environment and navigating it safely and even finding an item you have dropped.
- Mount Sinai’s New York Eye and Ear Infirmary has a downloadable list of low vision resources.
