By Kristen Shifflett, OT, as told to Keri Wiginton
“Will I go completely blind from this?”
That’s the question everyone with age-related macular degeneration (AMD) always asks. And they melt upon themselves with calmness when I say, no, you’ll just need to do some things differently.
If you have geographic atrophy (GA), an advanced form of dry AMD, you may lose some or all of your central vision. That’s the part of your eye you use to look directly at things, like people’s faces or the words in this sentence.
Your medical team may give you shots or other interventions to keep your eyesight as close as possible to where it is now. But no matter how GA affects your vision, lifestyle changes and low vision aids can help you adapt.
Keep in mind that some solutions may seem impractical at first. For instance, you may feel like you’re interrogating someone if you shine a flashlight directly on their face. But isn’t a little awkwardness worth it to see your loved ones a little more clearly?
Here are some tips for how to stay safe, connected, and independent with low vision.
Work With a Low Vision Therapist
I’m an occupational therapist who specializes in low vision rehabilitation. I help people with vision loss learn how to do daily activities on their own. No task is too small to tackle. Everything from the moment you get up to the moment you go to bed is technically in our realm.
A conversation with someone like me early on can help you find ways to make life easier and safer at every stage of vision loss.
I treat many folks with vision impairment who tell me they're functioning well. Maybe they have trouble seeing numbers on their bank statement or kitchen appliances. But those little things can add up.
For example, people often say they press 20 minutes on the microwave when they mean 2. If you tend to set the timer and walk away, a simple bump or locator dot on the button could save you from a house fire.
Low vision therapists don’t just consider your vision problems. We look at what’s going on with your whole body because you may need to tap into your other senses to make up for a loss of sight.
Take reading, for example. If you have trouble seeing fine print, there are many other ways to get information from a book or newspaper, including someone reading to you. But to reach your goal, we may also need to address things like:
- Hearing problems
- Dementia or memory challenges
- Arthritis or other medical conditions
I also get a feel for how comfortable someone is with technology. Some interventions can be a little intense, but I can make the solution as simple or complicated as you can handle.
Create a New Normal
The first thing people want is a new prescription. And while your low vision eye doctor should certainly fit you for the best corrective lenses, “normal” glasses aren’t the end-all, be-all when it comes to improving eyesight for people with low vision.
From reading the mail to doing computer work, external devices may help you see better for everyday tasks. Some examples of low vision assistive aids are:
- Stand or hand-held magnifiers
- Desktop or portable video magnifier (CCTV)
- Stronger reading glasses
- Devices that talk out loud
- Low vision cooking tools
You’ll also want to take advantage of any accessibility features on your smartphone or computer, including tools to make text bigger or boost contrast. Ask a low vision specialist if you’re not sure how to do this.
Once you find a tool or strategy that works for you, practice using it daily. You’ll feel more confident when you complete tasks accurately, like reading and paying your bills, even if using an assistive device takes a little longer.
If you have GA, you want to boost brightness without adding glare. Here are some things to consider when it comes to low vision lighting:
Use task lighting. These desk or floor lamps are a must for any tabletop activity, whether that’s reading, seeing food on your plate, or working on a jigsaw puzzle. One of my favorites is the Stella Go, a portable task lamp that lets you change the color of light and adjust brightness depending on what you need.
Put your light in the best place. You’ll want to position the light low and in between you and the activity, not behind you or over your shoulder. That may cast a shadow and make it harder to read or see whatever you’re doing. Anything with a gooseneck can help you achieve this.
Use dimmer switches. A simple on or off may make the room too bright or dark. Dimmers give you more flexibility with light, and I suggest people with low vision install them throughout the home.
Tips for Social Situations
It’s common for people with low vision to shy away from social events. But there are steps you can take to see better and feel more comfortable when you’re out and about. Ask your low vision therapist for more tips, but here are a few I suggest.
Find a good spot. When you go to a party or restaurant, try to get close to a window. And stand or sit with your back to it. The added sunlight may help you see details better, including people’s faces or the menu.
Bring a buddy. If you’re in a big group situation, like a wedding or party, you might want to have a friend or partner with you to identify folks or guide you through the crowd.
Say hello first. I usually tell people with low vision to extend their hand when they meet someone. You’re less likely to misalign a handshake if you let them come to you.
Tell people about your vision impairment. I know a few people who wear a button that says I have low vision. If someone doesn’t know what that means, at least it’ll give you a new topic of conversation.
Education and Awareness
People are resilient. And you may learn to work around your vision problems so that people can't notice your vision loss. But it's important to take your tools with you everywhere once you feel confident with lifestyle changes or devices at home.
I encourage people to use assistive devices in the real world for many reasons. First, they give you the confidence and ability to do what you need. But they also normalize the use of low vision aids in public.
The larger community doesn't understand the spectrum of vision loss. Most folks think you’re either sighted or blind. But that can change if society starts to understand the diverse needs of those with vision impairment.
Photo Credit: iStock / Getty Images Plus / Getty Images
Kristen Shifflett, licensed occupational therapist and certified low vision therapist with a specialty certification in low vision, Wilmer Eye Institute, Johns Hopkins University School of Medicine.