Coping

10 Questions About Low Vision

By Debbie Kogler, LDO
President, Magnifiers & More
440-946-3363

1. Why can’t I get a magnifier to cover the whole page?
Magnification is determined by the curved surface of the lens. The curved surface bends the light to produce an image that is actually larger than it is. The more curved a lens is the smaller the magnifier becomes. Physically the lens becomes thicker and heavier as the magnification increases. The more power a magnifier has the smaller the lens size (viewing area) will be.

2. Are magnifiers or other visual aids covered under Medicare or insurance?
The only vision device that is covered under Medicare is one pair of eyeglasses following cataract surgery. The devices for LV are considered a luxury, non essential item to the insurance company.

3. Why do I need more light now that I can’t see?
The increased need for light is in direct correlation of the aging process. As we age, the amount of light entering the eye becomes less clear; which causes a reduction in our vision, contrast and color perception. The iris, the colored part of the eye, expands and contracts to control the amount of light entering our eye. As with all our muscles in the aging process, the iris loses some of its flexibility and doesn't open as wide. More light is needed to compensate for the reduced ability of the iris to open wide. Also the aging process causes the lens in our eye to begin thickened and cloudy (eventually called a cataract). When light enters the eye, it falls on the retina and causes photochemical and neurological processes that result in seeing. A 75 year old person needs three times as much light as a 20 year old. Light from lamps or fixtures should be positioned directly onto the task you are doing. Use a task lamp instead of an overhead lamp.

4. Why does glare bother me so much more now that I am visually impaired?
Again as we age, we become more sensitive to glare. Glare is the reflection of light not too much light. So you can have glare reflecting off a shiny surface or when light is shined directly into the eye, the healthy tissue in the retina is more sensitive to glare.

5. Do I really need to wear sunglasses now that I am visually impaired?
Yes. Everyone must wear sunglasses. UV light from the sun can cause significant damage to the eye and can cause many eye diseases to progress faster. Sunglasses should have side protection and top protections. You do not necessarily have to have dark sunglass; but they must have 100% UV protection in them.

6. Why can’t I see the faces on TV?
When watching TV we normally use our central most acute vision; which comes from the macula area of the retina. Due to the degeneration of the macula, the cells have started to die off causing the sharp, acute vision to dissipate. This causes us to not be able to clearly see the faces. However, if you sit closer to the TV, even sitting one foot away from the screen, you will be able to see a little more detail. In addition, if you sit at an angle to the TV you will also see better. For example, if you right eye is the better of your eyes sit with the TV about twelve inches off to your right, but keep your head facing straight head. This position will help you to use you peripheral (side) vision.

7. What does it mean to be “legally blind”?
The term legally blind originated from the IRS. This was a classification that the IRS used to determine if someone was eligible for an extra tax credit. In order to receive this tax credit one had to get from their doctor a letter stating that even with corrective lenses, they have less than 20/200 visual acuity or that their visual field is 20 degrees or less, regardless of acuity. 20/200 visual acuity means that one can only see the big E on the eye chart. Individuals who are classified as Legally Blind still have vision they are not totally blind. Remember though that with Macular Degeneration you will never go totally blind.

8. How do I explain to my family what I can see?
Two good examples are, 1) you are at the movie theater and someone sits in front of you and his/her head blocks your direct straight ahead view. You can’t see the movie screen completely. If you move, and look around the person then the movie screen comes back into full view, however with ARMD you can’t move around that big head, it is stuck in your view no matter where you move. 2) When driving you go to use your wipes which are starting to wear out, they start to streak, leaving part of the windshield very smudgy or blurred, you can see somewhat through the window but it is not as clear as when the new wipers are working.

9. Will I have to give up driving?
It will depend on your states requirements. Each state has different visual acuity requirements.

10. Should I join a support group?
Yes! Support groups are one of the best social, emotional, helpful and mental things to do when you have a vision impairment. The understanding and help you can give to each other, getting to listen to each other's frustrations and success, and offering new ideas for managing tasks and social situations are of enormous benefits.

11. Why do I feel so down & out?
When faced with a loss or impairment, such as our sight it is normal for one to feel down & out. You go into mourning. This feeling is part of a defense mechanism that our brain produces. One can experience a variety of emotions. Some individuals deal with these emotions quickly, while others require time and assistance to work through them. Such feelings of isolation (it can’t be happening to me), anger (how dare this happen to me), bargaining (just let me live to see), and depression, (I’m the only one with this why should I bother, I’m no good any more) are very common. For most people the next step is usually acceptance (it’s not as bad as I thought), I can do this (it could be worse). When dealing with vision loss, an individual must be educated on what low vision rehabilitation options will help them during various stages of their disease. Education and training will help one to develop new thoughts about how they can function with a visual impairment.

“It’s not the strongest of persons that survives, nor the most intelligent person, but the one most responsive to change” – Charles Darwin