If you have low vision it means that even with regular glasses, contact lenses, medicine or surgery, you find it challenging to do everyday tasks such as reading your mail, shopping, cooking, recognizing faces and writing. While an estimated 14 million Americans currently live with impaired vision, only 120,000 are totally blind, according to NIH’s National Eye Institute.

As the average age of the population grows older and life-expectancy lengthens, the number of vision-impaired people is expected to increase dramatically. Visual impairment is one of the most expensive conditions in the United States, costing more than $139 billion annually (2013) in medical costs, lost productivity, services, income loss, government disability programs, tax deductions and education expenses.

In addition to the personal loss of independence, people with vision loss experience both physical and psychological problems. They often have depression or a sense of helplessness when they are first faced with a visually impaired future. People with low vision have more accidents, experience emotional difficulties including social withdrawal and isolation, and report a lower quality of life.

Low vision can be the result of disease (such as glaucoma, macular degeneration, cataracts or diabetes), trauma or birth defect. Annually, there are about 2.5 million people newly diagnosed with macular degeneration, the leading cause of vision loss in older people.

Many people with vision loss, especially older people, tend to accept their condition and not seek help. If you know a person with vision loss, urge them to get a complete eye and vision evaluation by a medical professional every year. If indicated, ask for a referral to a low-vision rehabilitation facility or occupational therapist that specializes in vision help.

Symptoms of impaired vision

Vision impairment is not the same as blindness. A person with vision impairment may initially notice they are having trouble reading or lights don’t seem as bright as they used to. In more advanced cases, he or she may notice one or more of these problems:

  • Blurriness, even with glasses/contact lens
  • Loss of side (peripheral) vision
  • Distortion of objects or print on a page
  • Blind spots
  • Loss of contrast (print seems to fade out)
  • Sensitivity to glare or light
  • Loss of ability to see colors

What’s vision rehab?

Low-vision rehabilitation can help restore safety, independence and functional abilities, as well as reduce the national costs of this impairment. Most people with vision loss gain numerous benefits from low-vision rehab.

Low vision rehabilitation has been described as physical therapy for your vision. It’s not a cure for vision loss, but an educational process that requires practice, patience and motivation. This type of rehab develops and trains the person to use alternative strategies to get the most out of their remaining vision and maintain their independence.

People with low vision must change how they perform their daily activities by moving from visual practices to nonvisual ones. Low-vision rehab trains them how to successfully make these changes. The most important reason to go through vision rehab is to improve both physical and psychological health.

Vision rehab specialists focus on managing daily activities such as cooking, grooming, shopping, keeping financial records and using adaptive equipment like magnifiers or talking computer software.

Depending on the person’s level of impairment and personal goals, rehab can include counseling to help with personal adjustment and changed family dynamics, as well as marital or family counseling. For severe vision loss, rehab may include orientation and mobility training, occupational therapy, learning Braille or using animal guides.

Self-help guide

If low-vision rehabilitation is not available to you, Prevent Blindness has published a lengthy guide full of tips to help you regain independence even with limited vision. “A Self Help Guide to Non-Visual Skills,” compiled and edited by Dan Roberts, is available in English or Spanish, and also on a CD. It is free and can be read online or downloaded here. A hard copy, large-print version can be ordered from the same website.

The guide starts with a comprehensive self-evaluation of the individual’s needs and goals. There are 21 lessons that explain how nonvisual senses can be used to substitute for eyesight. It also includes directories of low-vision device distributors, technology products and software.

Be sure that caregivers are included in the needs and goals evaluation, as well as when reviewing the lessons from the guide.

The guide can help restore up to 99 percent of common daily activities such as personal grooming and dressing; shopping, cooking and eating; moving about/travel; house cleaning and laundry; reading and writing; and socializing and communication.

Each lesson lists simple and practical tips, and technology devices that are currently available. For example, in the dressing activity lesson, it suggests tying shoes together in pairs or slip one inside the other. Technology solutions include a “color identifier” device that, when pointed at shoes or clothing, speaks the color. The safety lesson suggests keying all the door locks identically so you only need one key. When shopping, its recommends folding currency in different ways to indicate the values; a technology solution is a talking bar code identifier.

Technology has made reading dramatically easier for vision-impaired people. Basic text-to-speech software, built into most computer systems, will read your screen to you. Other software uses a scanner that reads printed materials. Stand-alone text-to-speech systems are also available that don’t require a computer. Books on tape are available free from:

  • Arkansas Regional Library for the Blind and Physically Handicapped. Visit their website or call toll free 1-866-660-0885.
  • Talking Books program of the Library of Congress. Visit their website or call toll free 1-800-424-8567.

Free telephone search services make it easy to get reservations, weather reports, find a business and many other uses:

  • Tell Me, 1-800-555-8355
  • Google Voice Local Search, 1-800-466-4411

Additional resources to help pay for vision care and rehabilitation include:

  • EyeCare America provides comprehensive eye exams and care for up to one year, often at no cost to eligible people age 65 or older. Phone 1-877-887-6327 or visit http://eyecareamerica.org
  • VISION USA provides free eye care to eligible uninsured, low-income workers and their families. Phone 1-800-766-4466 or visit http://www.aoa.org/visionusa.xml
  • Lions Club International is a service organization whose local clubs sponsor training programs can help you buy corrective eyewear or obtain eye health care. Find a local club at  http://www.lionsclubs.org/EN/find-a-club.php
  • Mission Cataract USA provides free cataract surgery to people of all ages who have no other means to pay. Visit http://www.missioncataractUSA.org
  • InfantSEE® is designed to ensure early detection of eye conditions in babies. Member optometrists provide a comprehensive eye and vision assessment for infants within the first year of life regardless of a family’s income. Phone 1-888-396-3937 or visit http://www.infantsee.org
  • Sight for Students provides free eye exams and glasses to low-income and uninsured children 18 years and younger. Phone 1-888-290-4964 or visit http://www.sightforstudents.org
  • New Eyes for the Needy provides vouchers for the purchase of new prescription eyeglasses. Visit http://www.neweyesfortheneedy.org
  • Patient Access Network helps eligible underinsured patients afford the copayments for pharmaceutical treatment for age-related macular degeneration. Phone 1-866-316-7263 or visit http://www.panfoundation.org
  • Medicare Benefit for Eye Exams – Medicare beneficiaries with diabetes can get a dilated eye exam to check for diabetic eye disease. Beneficiaries with glaucoma can get an eye exam every 12 months to check for glaucoma. Patients pay 20 percent of the Medicare-approved amount after the yearly Part B deductible. Visit medicare.gov