SmartSight™
Making the Most of Remaining Vision
Is it difficult for you to read the newspaper, see price tags or set dials? Are you
bothered by glare? If you answered "yes" to any of these, then SmartSight is
for you. Making the most of the vision you have is smart. You may benefit
from tips about lighting and from the tools, techniques and resources of vision
rehabilitation. Losing vision does not mean giving up your activities, but it
does mean applying new ways of doing them. SmartSight can help.
Patterns of Vision and Vision Loss
Central vision is the vision we use when we look directly at something. It
gives us the greatest detail for reading print or recognizing faces. Macular
degeneration (AMD) affects central vision, but spares peripheral vision.
Diabetic retinopathy can affect central or peripheral vision.
Peripheral vision is the vision we use to see everything around the edges.
While not detailed, like central vision, it is important for getting around.
Glaucoma affects peripheral vision first. Strokes can affect one side of the
peripheral vision. Using peripheral vision for details requires magnification.
Contrast sensitivity is the ability to distinguish between objects of similar
tones or color intensity, such as milk in a white cup, a blue sock from a black
one, or facial features. All eye problems can decrease contrast sensitivity.
Depth perception is the ability to judge the position of objects in space.
New vision loss in one eye can affect depth perception.
Visual processing: Like a camera, our eyes have a lens that focuses light
onto the retina (like the film in a camera), and an optic nerve that carries the
images to our brain. Our brain "develops" the images into what we experience
as vision. Impairments in any of these elements affect our vision in different
ways.
The Experience of Vision Loss
It always comes as a shock to learn that your vision loss is irreversible.
Acknowledging the anger and frustration of new vision loss and getting
help working through these feelings are important. Pushing these feelings
inside can result in depression, noted by fatigue and lack of interest.
Address this problem with treatment and counseling, and make the
changes needed to stay active.
You Are Not Alone
We all need support in times of loss. A good support group helps you
realize that your value to yourself and others does not depend on your
vision. You are worth what it takes to make the most of the vision you have.
The Phantom Visions of Charles Bonnet Syndrome (CBS)
About 20 percent of people with vision loss see lifelike images they know
are not real: flowers, people, patterns, etc. This is called Charles Bonnet
Syndrome. It is not a loss of mental capacity; it is just part of vision loss
for some.
Making the Most of Remaining Vision -- Making Things Brighter
Improve lighting. Use a gooseneck lamp with an indoor floodlight bulb, warmcolored
fluorescent tube, or a bulb emitting a white light. Carry a penlight.
Reduce glare. Indoors, cover polished wood tables and shiny counters;
wear yellow or plum clip-on or fitover glasses. Outdoors, try dark yellow,
amber or plum glasses and a visor.
Increase contrast. Use a black ink, gel or felt tip pen instead of a ballpoint.
Put coffee in a white cup, oatmeal in a black bowl, white soap in a dark
soapdish. Use plain tablecloths so items don't get lost in the pattern.
Making Things Bigger
Move closer. Sit close to the TV, and up front at performances.
Enlarge. Get large checks and large-print playing cards, bingo cards, crosswords,
phone dials, TV remotes, calendars, keyboards and books.
Magnify. Magnifiers come in many powers and types, suited to different people
and different tasks: hand-held types for price tags and menus, for example,
and stand-types and CCTVs (closed circuit TVs) for sentences.
Finding and Using Your "Next-Best Spot": Scotomas and PRLs
"Scotoma" means blind spot. The Preferred Retinal Locus (PRL) is the "nextbest
spot" when there is a blind spot in the center. It may be on one side or
above or below the original "center" of your vision. To find yours, imagine that
the object you want to see is in the center of a large clock face. Move your
eyes along the clock numbers and notice when you see the center object
most clearly. Use that same viewing direction for other objects.
Organizing
Separate black clothes from blue. Designate spots for the items in your
refrigerator, and for your keys and wallet. Minimize clutter.
Labeling
Mark thermostats and dials with high contrast markers from a fabric store;
mark medications with markers or rubber bands; safety-pin clothing labels.
Substituting: Let's Hear it for Ears!
Get books and magazines on tape free on loan. Also look for talking watches,
clocks, calculators, glucometers and computers (check the Resources at the
end of this document).
Participating
You are loved because you are you, not for your eyes. Don't isolate yourself.
Keep playing golf; your friends will watch your ball. Keep your social
group or volunteer job. It might require lighting, large print cards, a magnifier
or a ride. Ask. There is nothing independent about staying home to avoid
asking for help.
Driving
If vision loss threatens your driver's license, do not despair. Seek creative
solutions. To assess your driving, ask yourself: Do cars appear unexpectedly?
Do drivers honk at you? Are you having fender-benders? If your answer is
"no," you are probably safe. Pick your times and routes carefully and
consider yellow, amber or plum sunglasses for glare. If you answer "yes,"
consider the following transportation alternatives:
Transportation Alternatives: Creative Solutions
Use the many transportation alternatives that exist so you can continue
going places. Hire a driver, share your car, arrange for a taxi, buy gas for a
friend who drives, use senior and public transit systems. Try a three-wheel
bike or battery-powered scooter at walking speed. Walking is wonderful if
you are able. Set the pace for your peers by using these alternatives now.
The future will offer even more solutions.
For Family and Friends
Your loved one with vision loss needs to be empowered to do as much as
possible independently. Recognize the great challenge of vision loss, but
donŐt take over their tasks. Instead, help identify the adjustments they need
to make to maximize their independence, and trade tasks as appropriate.
Vision Rehabilitation
Vision rehabilitation can help you make the most of your vision. Comprehensive
services include a low vision evaluation and rehabilitation training.
To locate services near you, contact Southwestern Eye Center. Ask
if services include:
- A low vision evaluation by an ophthalmologist or optometrist
- Prescription for devices. Are some devices loaned before purchase,
or returnable?
- Rehabilitation training: reading, writing, shopping, cooking. Training for lighting
and glare? Home assessment? Mobility? Resources and support groups?
- Are services free, billed to Medicare or other insurances? If not, what is
the charge? (Note: Medicare covers most services, but not devices.)
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