As a volunteer at a visual rehabilitation center in Boston,
Elaine knows that people with limited vision don't have to lead limited lives.
Her life certainly hasn't been limited, despite the fact that she has
severe loss of vision in both eyes -- one from a retinal detachment, and the
other from macular degeneration.
Visual rehabilitation services and low-vision aids don't have
the high-tech flash of laser eye surgery, and they can't offer hope of a cure
for what ails a failing eye, but "they can do a great deal -- they did for
me, and they do for many people. A lot of them are elderly, as I am, and it
makes such a difference in their lives to realize that there's something else
to do besides just sit," she says.
Some people are thrust into the role of caregiver abruptly. After a loved one has a sudden illness, he or she may obviously need a lot of help.
But often, caregiving is a gradual process with few clear dividing lines. How do you know when you've really become a caregiver? When is it time to start taking more control over a relative's life -- and to start taking control away? And how will your new responsibilities caring for someone else affect the rest of your life?
The National Eye Institute defines low vision as "a visual
impairment, not correctable by standard glasses, contact lenses, medicine, or
surgery, that interferes with activities of daily life."
Common causes of low vision include diabetic retinopathy, a
common eye disease in people with advanced diabetes; glaucoma, where an
increase in eye pressure causes damage to the nerves of the eye; and
age-related macular degeneration, where the retina, the layer in the back of
the eye that processes light, begins to deteriorate. According to the NEI,
about 14 million Americans have low vision affecting their ability to cook,
read, drive, and socialize. People at higher risk for loss of vision include
blacks and Hispanics age 45 and older, and members of other ethnic groups over
Learning to Cope
Severe visual loss, whether sudden or gradual, can be
devastating for many people, because it implies helplessness and a loss of
"I refer many patients to therapists because of their need
to cope more effectively with what they have and with trying to plan for the
future," says Andrea Heinlein, MSW, a social worker at Boston's
Massachusetts Eye and Ear Institute who helps patients with low vision find
special services and resources that can help them function to their
An important but little-appreciated aspect of low-vision
services is training in activities of daily living: teaching patients how to
continue doing what they have always done -- cooking, cleaning, shopping,
"If you live alone as I do, the kitchen and trying to cook
is a problem, because you could get burned or you're going to have a mess,"
Cole says. "They were able to show me what to do just in everyday living.
One of the technicians came and saw me at home, and saw how I lived. She showed
me everyday stuff: how to pour hot water into a cup for coffee without getting
burned, how to reach into an oven without getting burned, how not to spill --
small techniques that make life much easier for a person who has any vision
Ann Marie Turo, OTR/L, an occupational therapist who works with
low-vision patients at Massachusetts Eye and Ear, says patients with loss of
vision in the central visual field, as occurs with macular degeneration, can
use a technique known as decentered viewing, in which they are trained to use
their peripheral rather than central vision to see images. Astronomers use a
similar technique to pick up fine details in telescopic images of distant faint