«The Macular Degeneration Foundation Guides Low Vision Aids & Technology – A Guide: The fourth in a series of guides produced by the Foundation. It ...»
Low Vision Aids
The Macular Degeneration Foundation
Our vision is to reduce the incidence and impact of
Macular Degeneration in Australia.
The key objectives of the Foundation are
education, awareness, research, support services
The Foundation is a charity which relies on donations
and support from government, business and the
community to help continue our vital work.
All donations of $2 or more are tax deductible and are gratefully accepted.
The Macular Degeneration Foundation Guides
Low Vision Aids & Technology – A Guide:
The fourth in a series of guides produced by the Foundation. It is helpful to read this guide in conjunction with all other guides produced by the Macular Degeneration Foundation.
Low Vision - A Guide:
A practical introduction to living with low vision
Family, Friend & Carer - A Guide:
For people providing care to a person with low vision
Slips, Trips & Falls - A Guide:
Provides practical advice on avoiding falls Contents Introduction
What is Low Vision?
Common Causes of Low Vision
The Impact of Low Vision
Moving Forward with Low Vision
Mapping the Journey on Low Vision Aids and Technology
Low Vision Aids and the Basics
Aids and Technologies
Daily Living Aids
Low Vision Aids
Examples of Low Vision Aids and Technologies
National Service Directory Low Vision Service Providers
Low Vision Aids & Technology – A Guide 1 Introduction Low Vision Aids & Technology - A Guide provides information on the different types of aids, equipment and technology which can assist those with low vision in many different settings from home to work.
Using aids and technology can help to maintain independence and quality of life. This can range from simple hand-held optical magnifiers to more technology based options such as electronic magnifiers, reading machines and computer software.
Advances in technology such as mobile phones and computers have changed the way we communicate in both the spoken and written word. One great advantage of new technology is the benefit to those who are blind or have vision impairment.
Critical to getting the best outcome from using aids and technology is recognising that each person is different, has specific individual needs and that solutions exist to meet those needs.
Services are available to help determine what is needed, where and how aids or technology can be obtained and how to access training and ongoing support.
The prime objective with the use of aids and technology is always to maintain quality of life and independence for whatever task or activity is undertaken in the workplace, the home or social settings.
Being informed, accessing appropriate services, having a positive approach and remaining open to learning new ways of doing things are key elements to great outcomes in the use of aids and technologies.
This guide answers key questions often asked by people with low vision, their family and carers. It also provides examples of how aids and technologies have helped many people with a vision impairment to achieve the goal of maintaining quality of life and independence.
The guide is a resource for those on the low vision journey to help navigate the aids and technology pathway.
2 Low Vision Aids & Technology – A Guide
What is Low Vision?
A person is said to have low vision when their eyesight is limited or impaired and cannot be adequately corrected with surgery, conventional glasses or contact lenses.
Low vision can affect people of all ages and can have an impact on many aspects of a person’s life. It may cause problems with reading, using the computer, dialling the telephone, watching TV, recognising faces, seeing stairs, crossing the road and daily living and leisure activities such as cooking, walking and active sports.
Low vision is often a loss of sharpness or acuity but may also present as a loss of field of vision, light sensitivity, distorted vision or a loss of contrast.
Low vision is measured by distance visual acuity. When a person has normal vision their visual acuity is rated 6/6 or 20/20. This rating indicates that a person who has normal vision can read the letters on an eye chart which is designed to be seen at a distance of six metres or twenty feet away.
A person is said to have low vision when they see fewer letters on the eye chart from this distance. For example 6/18 means that the patient can see at 6 metres what a person with normal vision is able to see at 18 metres.
The primary cause of vision loss is eye disease, although it may also occur as a result of birth defects, injury or a medical condition.
Low Vision Aids & Technology – A Guide 3
Common Causes of Low Vision The most common causes of low vision in western countries are Macular Degeneration, Glaucoma, Diabetic Retinopathy, Retinitis Pigmentosa, Cataract and other retinal dystrophies. These eye diseases affect vision in different ways. The impact of each disease is connected to the amount of loss in visual acuity, visual field and contrast and this will vary from person to person.
1. Macular Degeneration Macular Degeneration (MD) is Australia’s leading cause of blindness. The disease causes progressive damage to the central part of the retina known as the macula, resulting in central vision loss. The most common form of Macular Degeneration is frequently referred to as Age-related Macular Degeneration or AMD. MD affects one in every seven Australians over the age of 50 and the incidence increases with age.
There are two types of MD: Dry MD and Wet MD. Dry MD is the most common form of the disease; it results in gradual loss of central vision. Wet MD is characterised by a sudden loss of vision and is caused by abnormal blood vessels growing into the retina.
2. Glaucoma Glaucoma is the name given to a group of eye diseases in which the optic nerve at the back of the eye is slowly destroyed. This damage is usually due to a blockage of the circulation of the water (aqueous fluid) in the eye, or its drainage, leading to an increase in pressure inside the eye. In other cases, it can be caused by poor blood supply to the nerve fibres, a weakness in the optic nerve or a problem in the health of the nerve fibres.
How a person sees the
world when they have:
1. Macular Degeneration
4. Diabetic Retinopathy
5. Retinitis Pigmentosa 1. 2.
4 Low Vision Aids & Technology – A Guide Glaucoma destroys a person’s vision gradually, starting with the peripheral (side) vision. People can have glaucoma and be completely unaware of it, as there is usually no pain or early warning signs associated with the most common form of glaucoma. Early detection is critical as any sight lost is irreversible.
3. Diabetic Retinopathy The most prevalent cause of visual impairment in people who have diabetes is diabetic retinopathy, a condition in which changes occur in the tiny blood vessels that nourish the retina. In the early stages of diabetic retinopathy, small blood vessels weaken and leak fluid or tiny amounts of blood, which distort the retina. In the more advanced stage, blood vessels in the retina are blocked or closed completely and areas of the retina die.
4. Cataracts A cataract is a clouding of the normally clear and transparent lens of the eye.
When a cataract develops, the lens becomes as cloudy as a frosted window, and light cannot be properly focused on the retina, resulting in an unclear image. Cataracts can be removed by having cataract surgery, and this is dependent on the individual and the eye specialist’s advice.
5. Retinitis Pigmentosa Retinitis pigmentosa is a degenerative, hereditary disorder that is often first characterised by night blindness, followed by loss of peripheral vision. It can eventually lead to total blindness. Retinitis pigmentosa is one of many retinal dystrophies and is the leading cause of youth blindness in Australia. It is second only to diabetes as a cause of blindness for those in their twenties and thirties. Retinitis pigmentosa in most cases is hereditary. However, in some instances there is a gene mutation that leads to the disease when there is no family history.
3. 4. 5.
Low Vision Aids & Technology – A Guide 5
The Impact of Low Vision Low vision can affect quality of life and independence. The impact may be small and manageable or it may be more difficult and require more time, support and patience. The impact of low vision will vary from person to person and can depend on a whole range of factors.
Everyone responds differently to vision loss - from acceptance and accommodation to apprehension and even, for some, depression. It is very important for anyone with low vision to seek help immediately from their doctor if they have any concerns, especially feelings of helplessness, anxiety or depression. Don’t wait; act immediately as help and support is available.
Upon developing low vision, it may take time to adjust to new circumstances.
Tasks, which may seem a real difficulty, can become just another element of daily life with some slight adjustments to everyday activities. Learning new skills and adapting old ones to new circumstances can help support living an independent life.
Low vision service providers can assist with gaining a better understanding of levels of sight, and how to continue to do everyday activities and tasks at work, home and out and about in the community.
6 Low Vision Aids & Technology – A Guide
Moving Forward with Low Vision Moving forward starts with taking control of the situation. This involves acquiring knowledge, understanding the potential impacts of any diagnosis and knowing the options available to deal with any challenges.
Different eye diseases or conditions will result in varying effects on vision so it is important to pursue support services and aids and technologies which cater to individual requirements.
One of the most important things you can do to take control is to attend a low vision assessment as this is the starting point for information, help and guidance.
Taking control can also involve:
Learning effective coping strategies to help overcome challenges Setting realistic goals, and actively learning new skills Working through decisions regarding employment, activities, future plans and lifestyle Working through critical issues in a calm and supportive environment Obtaining support and advice on staying engaged with social and recreational networks Confidence building in managing everyday activities Learning new communication skills with family and friends in order to maintain autonomy and independence Learning new skills and technologies Obtaining orientation and mobility training Re-organising the home and adapting an old environment to a new set of needs
8 Low Vision Aids & Technology – A Guide 1 Information and guidance Information and guidance on the pathway you can follow can be obtained from a variety of sources such as the Macular Degeneration Foundation, ophthalmologist, optometrist, low vision rehabilitation service, orthoptist or occupational therapist.
Question Could I utilise low vision aids and/or technology to improve my quality of life and level of independence?
2 Personal assessment It is important to determine your greatest individual needs. It is a great starting point before an assessment to think about what it is you really want to do that you are finding difficult and is important for your independence. Is it daily living with cooking and housekeeping, or reading for your work commitments or are you an avid gardener?
It may be that you simply want to be able to move freely and safely in your home? This personal assessment will help match aids and technology for your individual requirements.
Question What do I want to do better or undertake that I am not doing now? What is my biggest frustration?
3 Prioritising the personal assessment list Sometimes the list of needs can be quite exhaustive. Prioritising the top three can make the starting point a little easier. You can always come back to the next lot of priorities, but sometimes stepping the way through the list is more manageable and you can build upon success as confidence increases.
Question What are my highest priorities?
Why are they important to me?
Low Vision Aids & Technology – A Guide 9 4 Low vision assessment A low vision assessment is an important first step in taking control. It provides for a comprehensive assessment of vision in order to find the starting point and the best pathway for maintaining activities and independence suited to individual needs.
Some people do purchase low vision aids or technology without a low vision assessment. While the purchase may help the situation, without a formal assessment, the best outcomes cannot be assured. The hearingimpaired have expert advice on the right hearing aid; the same should apply for a low vision aid.
During an assessment, advice is provided on aids, equipment and technology that can help to maximise vision to manage everyday tasks in the workplace, home and community. Some services also provide support through individual counselling and support groups.
Low vision assessments are provided by low vision agencies across Australia, as well as several major hospitals, universities, and also some optometrists.
10 Low Vision Aids & Technology – A Guide
A low vision assessment may include:
• Testing for current vision