By Linda Hepler, BSN, RN
If you're caring for a family member with impaired vision due to glaucoma, cataracts, macular degeneration or diabetic retinopathy, there are many things you can do to help.
A good place to start is by learning as much as you can about the limitations imposed by this eye disease so that you can assist your loved one to function safely and productively at home.
Lighting and Glare Control
People with glaucoma require higher light levels, yet they have problems with glare, such as light shining into the eyes or reflecting off of shiny objects, like a Formica countertop. Contrast sensitivity (the ability to see different shades of the same color) is also affected.
Tips for Proper Lighting
- Position lighting directly onto tasks such as reading, cards, or hobbies with a small gooseneck or clip on lamp. Under-counter lighting works well for the kitchen or other work areas. Specialized lamps/bulbs to increase contrast and reduce glare are available through low vision supply companies.
- Avoid large discrepancies in lighting, such as a bright lamp shining into a dark room. As task lighting is increased, the surrounding room lighting should also be increased. Keeping lights on during daytime hours helps to equalize lighting from indoor and outdoor sources.
- Reduce glare by covering reflective surfaces when possible and making sure that the person is not seated facing the window, especially when reading or working at a task. Encourage her to wear tinted glasses and a visor when reading or working outside.
Magnification is an essential tool for those with low vision, and magnifying devices range from the very simple to increasingly complex technology.
- Large print books, checkbooks, calendars, calculators, remote control units, clocks and watches, appointment books, and playing cards.
- Small pocket magnifiers for reading a restaurant menu or a price tag, large illuminated stand magnifiers for reading and performing other tasks at home.
- Electronic magnification units, which use a camera to capture an image on a printed page and project it onto a built-in monitor, a television monitor or a computer screen. These units can be used to read bills and write checks, look at books, newspapers and photos, read labels on food or medicine and fill an insulin syringe. Available through low vision supply companies, they can be chosen with preference for image size, degree of contrast, and color or black and white. They range in size from large models to small portable devices.
- Telescopic systems to magnify distance objects, such as the television. These may be handheld or mounted in eyewear called "bioptics."
- Adaptive equipment for computer use, such as screen enlargement software, large lettered keyboards and near telescopic systems.
Low Vision Devices
To help people with low vision remain as self-sufficient as possible, try using some of these independent living aids. There are countless ways to compensate for low vision when trying to set the temperature on the oven, match clothing, or determine the contents of a container. Two main types of living aid systems are tactile and visual. Tactile systems are helpful for those with limited or no vision, or for those whose visual ability changes from day to day. Visual systems make use of any remaining vision to identify and organize things.
- Rubber bands placed around objects to distinguish them from other things, such as a rubber band placed around the juice container to tell it apart from the milk container. Rubber bands can also be placed around a pill bottle to help with taking medication; two rubber bands around a twice-daily pill can be removed one by one as the pill is taken.
- Felt or raised plastic dots or sandpaper cutouts used to mark things, such as the most common temperature used on the oven or set on the thermostat.
- Labels made of white index cards with large print using a dark-colored, bold tip pen to identify things such as clothing, DVDs or tapes.
- Colored stickers or tapes to distinguish objects. For example, canned soups labeled with a bright orange sticker and canned vegetables with a blue sticker.
Most people with low vision can benefit from combined tactile and visual systems, as well as from learning to identify and organize using other senses, such as smell or sound. Spices can be identified with a sniff, and food can be turned or removed from the oven when it stops sizzling or smells cooked.
Canes and even dogs can be used to help persons with low vision to navigate safely. There are numerous other techniques to assist with mobility, such as using a clock face to orient oneself to a room. For example, the sofa is at the 3 o'clock position and the television is at 9 o'clock. People with low vision can also use other senses to find their way around, whether it's the ticking of the grandfather clock in the hallway or the hum of the refrigerator in the kitchen.
Low Vision Specialists
The best way a caregiver can help a person with decreased vision as a result of glaucoma is to engage the services of a low vision specialist. These professionals have the knowledge and experience to help find personal solutions for specific needs. Vision rehabilitation can help with mobility training as well as methods to organize, mark and label things, and resources for and proper use of low vision aids.
Many vision rehabilitation programs even offer mental health services to help with the anxiety or depression that often accompanies loss of vision.