Diabetes - vision loss; Retinopathy - vision loss; Low vision; Blindness - vision loss

Low vision is a visual disability. Wearing regular glasses or contacts does not help. People with low vision have already tried the available medical or surgical treatments. And no other treatments will help. If you have been told that you will go totally blind or to the point where you can't see well enough to read, it may be helpful to learn Braille while you are still able to see.

People with vision worse than 20/200, with glasses or contact lenses, are considered legally blind in most states in the United States. But many people in this group still have some useful vision.

When you have low vision, you may have trouble driving, reading, or doing small tasks like sewing and crafts. But you can make changes in your home and in your routines that help you stay safe and independent. Some of these methods and techniques require at least some vision so will not be helpful for total blindness. Many services are available for you to get the training and support to function independently. One of these is the Braille Institute of America.

The type of low vision aids and strategies for daily living you use will depend on your type of vision loss. Different aids and strategies are better suited for different problems.

The main types of visual loss are:

• Central (reading or recognizing faces across the room)
• Peripheral (side)
• No light perception (NLP), or complete blindness

A normally-sighted family member or friend may need to help you set up some types of visual aids. Some options include:

• Magnifiers
• High power reading glasses
• Devices that make it easier to use cell phones and computers
• Watches made for low vision, or talking watches and clocks
• Telescopic glasses that may aid distance vision

You should:

• Increase the overall lighting in your home.
• Use a table or floor lamp that has a gooseneck or flexible arm. Point the light directly on your reading material or task.
• Although using incandescent or halogen bulbs in lamps can give good focused light, be careful with these lights. They get hot, so do not use one too close to you for too long. A better and more energy-efficient choice may be LED bulbs and lamps. They produce high contrast and do not get as hot as halogen bulbs.
• Get rid of glare. Glare can really bother someone with low vision.

You will want to develop routines that make life with low vision easier. If your home is already well organized, you may need to make only small changes.

Have a place for everything.

• Keep things in the same place all the time. Put items in the same drawer or cabinet, or on the same table or counter space.
• Put things back in the same place every time.
• Store things in different size containers, such as egg cartons, jars, and shoe boxes.

Become familiar with common things.

• Learn to recognize the shape of items, such as egg containers or cereal boxes.
• Use a phone with large numbers, and memorize the keypad.
• Fold different types of paper money in a different way. For example, fold a $10 bill in half and double fold a $20 bill.
• Use Braille or large print checks.

Label your things.

• Make labels using a simple form of Braille called uncontracted Braille.
• Use small, raised dots, rubber bands, Velcro, or colored tape to label items.
• Use caulking, raised rubber, or plastic dots to mark certain settings for appliances, such as temperature settings on the furnace thermostat and dial settings on the washer and dryer.

You should:

• Remove loose wires or cords from the floor.
• Remove loose throw rugs.
• Not keep small pets in your home.
• Fix any uneven flooring in doorways.
• Put handrails in the bathtub or shower and next to the toilet.
• Place a slip-proof mat in the bathtub or shower.

You should:

• Group your clothes. For example, keep pants in one part of the closet and shirts in another part.
• Organize your clothes by color in your closet and drawers. Use sewing knots or clothing pins to code for color. For example, 1 knot or pin is black, 2 knots is white, and 3 knots is red. Cut rings out of cardboard. Put Braille labels or colors on the cardboard rings. Loop the rings onto hangers.
• Use plastic rings to hold pairs of socks together, use these when you wash, dry, and store your socks.
• Use large Ziploc bags to separate your underwear, bras, and pantyhose.
• Organize jewelry by color. Use egg cartons or a jewelry box to sort jewelry.

You should:

• Use large-print cookbooks. Ask your health care provider or nurse where you can get these books.
• Use caulking, raised rubber, or plastic dots to mark the settings on the controls of your stove, oven, and toaster.
• Store food in specific containers. Mark them with Braille labels.
• Use a high contrast place mat so you can see your plate easily. For example, a white plate will stand out against a dark blue or dark green place mat.

You should:

• Keep medicines organized in a cabinet so you know where they are.
• Label medicine bottles with a felt tip pen so you can read them easily.
• Use rubber bands or clips to tell your medicines apart.
• Ask someone else to give you your medicines.
• Read labels with a magnifying lens.
• Use a pillbox with compartments for days of the week and times of the day.
• Never guess when taking your medicines. If you are unsure of your doses, talk with your provider, nurse, or pharmacist.

Learn to get around by yourself.

• Get trained to use a long white cane to help.
• Practice with a trainer who is experienced in using this type of cane.

Learn how to walk with someone else's help.

• Follow the other person's movement.
• Hold the person's arm lightly above the elbow and walk slightly behind.
• Make sure that your pace matches the other person's.
• Ask the person to tell you when you are approaching steps or a curb. Approach steps and curbs head-on so you can find them with your toes.
• Ask the person to tell you when you are going through a door.
• Ask the person to leave you at a specific place. Avoid being left in an open space.

American Foundation for the Blind website. Blindness and low vision - resources for living with vision loss. www.afb.org/blindness-and-low-vision. Accessed February 22, 2024.

Andrews J. Optimizing the built environment for frail older adults. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 132.

Braille institute website. Guide techniques. brailleinstitute.org/resources/guide-techniques. Accessed May 23, 2022.