You know coping with vision impairments is a topic of the times when it’s covered in the Real Estate section of the New York Times. Be assured, you are far from alone. The likelihood of experiencing some type of visual impairment becomes more prevalent with age and the numbers affected will double over the coming decade. So it’s a good idea to get your house in order.
If you have begun to make adjustments to accommodate vision loss, you know small changes can make a big difference. Comfort begins at home. No need to do a total renovation or spend a fortune on home improvements. Here are some ways to elevate the accessibility of your home environment today.
A minimalistic living room with color contrast.
COLOR CONTRAST AND TEXTURE
Use light color plates on dark color placemats
Use contrast cutting boards and colored ceramic kitchen knives
Contrast furniture with rugs, pillows, throws
Contrast colors for doors, moldings, and cabinets
Contrast and texture on edge of steps
Place textured dots on appliance settings
USE SMART SPEAKERS
Set kitchen timers and alarms
Check the time, weather, news
Listen to music, audiobooks, podcasts
Order household items online
Turn on lights and adjust the thermostat
GO MINIMALIST, LESS IS MORE
Keep a clear path through rooms
Remove hazardous rugs and furniture
Get rid of clutter
Edit and organize closets, cabinets, and drawers
LIGHTEN UP
Choose lighting that suits your needs
Maximize natural light and minimize glare with updated blinds or shades that adjust well
Taking charge and making adjustments to compensate for vision loss is empowering. There’s plenty more about this on OE Patients and we’ve linked it below, along with the NY Times article mentioned at the top.
Learn how to make the iPhone easier on your eyes using VoiceOver & Speak Screen for text to speech, Dictation to replace typing for speech text, and Siri for voice commands.
Accessibility Resources for People with Visual Impairments
Alexa, Google, and Siri are the virtual assistants that make life easier for everyone, especially people with vision loss. We’ll talk about 20 things they can do if you ask.
Accessibility Resources for People with Visual Impairments
In a recent video from the American Academy of Ophthalmology, Drs. Mary Lou Jackson and Mark Bona take a brief look at an interesting selection of low vision technology. Here is the list of products they mention with our summary and comment. The video is linked at the end of this post.
Handheld Victor Reader Stream
Victor Reader Stream: $369
This was the go-to digital reading device for people with low vision or blindness in the pre-iPhone era. Still recommended by low vision specialists for it’s simple and tactile interface.
Seeing AI app reading an address on an envelope.
Seeing AI App: FREE
This very new and very popular iPhone app from Microsoft is available on the App Store. It reads text instantly and on the go, identifies products, colors, currency and more.We talked about the first release and the upgrade on OE Patients posts titled:
We agree video magnifiers offer a powerful boost to a wide range of low vision patients. Read what we say on OE Patients in the post titled: Magnifiers Are A Must.
A man using eSight glasses to read a document.
eSight: $5,950
A head-mounted video magnification device. Here’s what we said about it in OE Patients post titled: eSight Up Close
Jordy, optical viewing device.
Jordy: $3,620
A head-mounted video magnifier recently reintroduced as a lower priced competitor to eSight. Jordy also converts to a desktop magnifier with the purchase of an optional dock.
Aira: $89 – $329 per month
Aira (pronounced I-ra) is a new service, for a monthly fee offers access to a sighted agent, summoned by a tap on the Aira smart glasses and connected by a live video feed. The agent will provide on the spot detailed guidance when needed. This is an innovative concept and we are very interested to see how people with low vision take to it.
A totally accessible touch screen was brought to us by Apple nearly a decade ago.The iPhone 3s was delivered with a fully functioning VoiceOver screen reader, right out of the box.It was our first experience with truly inclusive design, nothing to add on and no added cost.This was indeed a pivotal moment, a game changer!
For me, it was a dream come true.Already past the point of reading any size text on a small screen, I was feeling left behind. So I seized the opportunity to learn to navigate the iPhone with a screen reader.It seemed a pretty steep learning curve, but really not all that different for anyone learning to use a touch screen for the first time.
After several bouts of avoidance and fear of failure, I rediscovered the key to learning anything; Practice, practice, practice.Learning VoiceOver is a matter of repetition.It was time to get rid of the backup flip phone (as my 9-year-old nephew advised) and stop prolonging the process.
Today, I am fluent in VoiceOver for iOS, it is embedded in my muscle memory, the result simply of repeating the gestures each and every day.I realized that my ability to learn this was more dependent on how many times I touched the screen each day, not any real skill.The point being, if I did it…so can you.
Having said all that we know that transitioning from visual to audible function also has its challenges.If you cannot read your phone screen visually with a fair level of comfort, it may be time to give VoiceOver a try.Consider how amazing it would be to have everything you can’t see, read to you right out of the iPhone, or more discreetly through an earbud (or Air Pod).Once you’ve adjusted, it feels like you’re reading everything again, like you once did.Try it.
The easiest way to turn VO on and off, as you learn, is by asking Siri.There is also a triple click shortcut that can be activated, or the long way through Settings, General, Accessibility, VoiceOver, On/Off.
It all boils down to learning a very manageable set of VO gestures and practicing every day for at least 1 hour.It will all become second nature in a few short weeks and you’ll never regret a minute of your effort as you move around the iPhone (iPad, iPod Touch, Apple Watch) with ease.
Below are the resources you need to succeed.
YouTube “VoiceOver” Tutorials
iFocus Tutorials from the Hadley Institute are beautifully produced and very user-friendly. Play these videos on a big screen, or just listen, while you practice on your iPhone. Repeat as many times as needed.
And Apple Accessibility Support is available 24/7 by phone to answer your questions and help you learn. To contact them, call 877-204-3930.
It’s worth the work — just do it!
Please note that this article was not paid for, affiliated with, or endorsed by any third-party companies. The views and opinions expressed in this article are solely those of the author’s.
It is one of those things you hope never happens to you, and then it does. “Am I Going Blind?” (NY Times Feb. 23, 2018) is Frank Bruni’s intense and honest account of the life-altering experience known as vision loss. In his case, a stroke of the eye took a “chunk” of sight from one eye as he slept.And it might come back for more.
In the months that ensue, he navigates an altered dimension.There is the cycle of doctors, diagnostics, and treatment (or lack thereof).The seemingly endless stream of questions that sometimes are left hanging in the air.He resists the pull of fear or anger.Despite the increase in typos, he finds careful determination is key to adjusting as he works. He discovers the best antidote to weakness is strength.
He draws inspiration from others. David Tatel, a Federal Appeals Court Judge, who lost his sight 40 years before and coped successfully by never dwelling on it.Peter Walsten, Senior Politics Editor for the Washington Post, is not deterred by a lack of central vision.He tells Frank to remember, “it’s not your brain that’s affected, it’s your eyesight.”Joe Lovett, a filmmaker who documents his slowly progressing glaucoma in “Going Blind,” advises respect for the “blessings of the here and now’ because you cannot live in fear of “future losses.”
He is grateful for all the sights he can take in today and states, “My eyesight is in jeopardy.But I see some things more clearly than ever.”The fact is, he knows seeing clearly has little to do with visual acuity.I think it would be safe to say we can look forward to Frank Bruni’s clarity on the op-ed pages for a long time to come.
The article is recommended reading for anyone living with vision loss. It reminds us that life goes on.
A visual impairment that causes an acuity of 20/70 or less (in the better eye) and is not correctable with standard prescription glasses, or medical treatment, is considered ‘low vision.’Although the term seems self-explanatory, it is not universally known, used predominantly by professionals in the field of vision rehabilitation and ophthalmology.
People with low vision can benefit from higher powered magnification that may take the form of glasses, handheld devices, stand magnifiers and desktop video magnifiers. These specialized magnifiers range from 3x to 30x.A low vision evaluation with a specialist is a good opportunity to see what works best for you.
Patients are not typically referred for vision rehab services until they are legally blind (20/200 in the best eye), because that is when fees for services are covered. So living with a progressive vision loss is your best advantage to get into the habit of making adjustments long before legal blindness.
Getting organized is key to living successfully with low vision. It may not be as easy to look for things as it once was.A neat and tidy environment will compensate in substantial ways.Think about how nice it is to open a drawer and find exactly what you’re looking for because it is right where you left it. With low vision often it is easier to put our hands on something before our eyes see that it’s there.
Let’s face it, everyone feels better when they’re organized. It gives us all a better sense of security. Like all good things we do for ourselves, order is something we have to work at and get into the habit of maintaining.
Here are some tips for re-organizing:
Declutter
This can be a difficult exercise for many people, but it is the absolute most important first step. Get rid of the stacks of catalogs and unopened junk mail you are never going to look at. Arrange for some help from a friend or a professional. Let it go. Purge! This eliminates a major safety hazard and it’s truly cathartic.
An organized drawer with folded clothing.
Clothing
Overstuffed, disorganized closets are totally unpleasant and way too difficult to find anything in. Get rid of the clothes that don’t fit or haven’t been worn in a while. It’s always good to be able to move hangers easily to find what you’re looking for. Set up the closet as you like, by category, color, season. Keep things neatly folded on shelves or as preferred. Get shoes in order on door organizers or on racks, keeping them out of your path to prevent stumbles. Dressers also crave coordination, as does the coat closet. Might be wise to get some help here to look over the clothes and make sure they’re looking good.
Cooking utensils neatly placed in a drawer kitchen organizer.
Kitchen
A place filled with cabinets and drawers is just asking to be organized. Cooking utensils and silverware should be neatly arranged so you can put your hand on the item you’re looking for. Consider using brightly colored utensils or contrasted dishes for better visual ID.Organize food pantry items as preferred and keep everything in it’s designated place. Keep favorites up front. Use textured bump dots for touch identification on frequently used appliance settings.
Bathroom
This is usually a small room that houses many small products where order is essential. In the bathroom, less is always best. Pare down to the everyday items. Keep cabinet shelves tidy. Do your best to remove clutter from surfaces. Put away or discard items not used often.
Eliminating chaos among your things will help you every single day. Explain to family members, and remind them from time to time, the importance of keeping your world organized.
Accessibility is a term that knows no bounds, defining the ease of use of technologies, services, and environments. At one time associated mainly with disability, its prominence now is largely driven by universal design and the aging population. Smart developers know that for a product to be successful it must be easily adoptable by people of every age. No dumbing-down required.
The new age of accessibility is a game changer for people with vision loss in particular. We are no longer relegated to the stigma, or the expense, that “special” technology has traditionally carried. Using the same popular devices everyone else is using has incredibly healing and renewing properties, and gives us back some sense of normal. It is ultimately about inclusion.
The most disappointing thing about these amazing developments is that far too many people are unaware that accessibility exists, and they continue to needlessly struggle with daily tasks! We can all help to change that. Screen settings and speech applications can significantly benefit all patients experiencing any and every degree of vision loss. They just need to know it’s available.
In 2008, Apple delivered the iPhone with Accessibility Settings built into every phone, at no extra cost, which expanded usability to people with low vision or no vision. The move marked a pivotal shift in mainstream accessibility and Apple became the undisputed leader in this important evolution.
The iPhone became the most adopted device, ever, among people with vision loss. It is also the most multiple-use device ever available for vision. Today the iOS options under Accessibility Settings for Vision include VoiceOver, Zoom, Magnifier, Larger Text, Bold Text, and Increased Contrast. These settings, along with Siri’s AI (artificial intelligence) and Dictation features, are not just beneficial for people with serious visual impairments…they’re good for everyone!
In 2010, the 21st Century Communications and Video Accessibility Act (CVAA) was signed into law, mandating equal access to digital, broadband, and mobile devices for people with visual impairments or blindness. This is why all smartphones and tablets now have accessibility features included. It is also why all cable providers now offer customers the option to enable talking TV guides and menus. We now have an abundance of choices. Although all are not created totally equal, we can expect Android phones and tablets are accessible. Amazon’s Kindle eReaders and Fire tablets are accessible. Google, Microsoft, and Apple all make universal access a standard.
Accessibility apps also play a meaningful role in improving function for people with visual impairments. There are apps that are magnifiers and flashlights; apps that take notes and send reminders; apps that convert text to speech; apps that help you take a well-focused photograph; and apps that read signs and locate transportation.
This range of useful options isn’t limited to just cell phones and tablets — Microsoft Windows PC and Apple’s Mac computers can also be depended on for magnification, speech, dictation, and voice commands. People often give up computer use once the screen becomes too difficult to read. They don’t realize that they can adjust the technology to their needs, every step of the way. This is particularly important for people at work. The great majority of low vision users can continue to work, uninterrupted, with a little help from their IT Department to set it up to suit their particular needs.
Taking an even bigger leap forward, Apple launched a dedicated Accessibility Support phone line to assist their customers with visual, hearing, motor, and learning impairments. The Verizon Wireless Accessibility Center followed. Next came the Microsoft Disability Answer Desk. Comcast, the leader in cable accessibility, offers dedicated phone support. Recently, Google announced that they, too, are preparing to launch a special support line. Amazon does not yet offer dedicated support, but they do have staff well versed in accessibility for Kindle, Fire and Echo accessibility.
It is a life-changing innovation, and this is just the beginning — the best is clearly yet to come. Intuitive and predictive technology, interacted with by voice, is the next big frontier. Smart speakers like Amazon Echo and Google Home are already popular and accessible for people of all ages and acuities. A powerful reminder that we are more alike than we are different.
For more than a decade, descriptive audio tracks have been available on widely released feature films. Now the devices used to access these audio tracks are also widely available. This accommodation was once at the discretion of the theater, but now it is a requirement.
And what a difference it can make for moviegoers with visual impairments.Sitting up close to the screen is usually a good move, and the added narration can help ensure you don’t miss a thing.
Beginning in January 2017, movie theaters across America now have descriptive audio devices, readily available, for all guests wishing to use them. The theater is also required to have a staff member on hand to assist customers requesting these devices, and that is a very good thing because different theaters may use different devices, and if you are not used to them it takes a time or two to acclimate.
The policy for accessible movies accommodates people with hearing impairments as well, with separate devices that provide closed captioning. This tends to create some minor confusion because the device for people with hearing impairments looks like it’s for the eyes and the device for visual impairments looks like it’s for the ears. Just be sure you are clear that you wish to “listen to the descriptive audio track.”
People sitting and excited, watching a movie in a movie theater.
Depending on the theater, you may get a set of headphones or you may encounter a device that allows you to connect your own personal headphones or earbuds.Thanks to the digital age in which we live, the movie tracks automatically synch with the film track. Voila!
What happens next is truly wonderful.A lovely voice begins to speak into the quiet spaces of the film, describing scenes or activity without ever interrupting the dialogue or talking over the music. Important details no longer slip by, the voice keeps you abreast every step of the way. You begin to “see” the picture you might have otherwise missed.
You should also know these descriptive tracks can also be accessed in the privacy of your own home, TV, computer, tablet or smartphone.
The start of a fresh new year is filled with promise. Anything and everything is possible. It’s a good time to evaluate your goals and objectives for the year ahead.
OE Patients was created to provide practical tips and encouraging advice to keep you addressing the challenges of vision loss and moving forward.We strongly recommend a conscious renewal of your resolve to not give up doing the things you need to do and love to do.
Coping with a visual impairment can be daunting until you discover there are solutions. We advise always to explore options, and never to give up easily. Here are 4 categories you should not give up, each followed by the tried and true solutions found in the pages of OE Patients.
Don’t Give Up On Technology
Continuing to use a mobile device or computer with a visual impairment can be unpleasant at times. But living without the use of technology today will be even more difficult. The very solutions you need, to adjust visual settings or access speech, are built into the software’s accessibility settings.We’ll continue to give lots of advice on Accessibility & Technology in the coming year.Here are links to some of the articles already posted:
We acknowledge that adjusting to vision loss while contending with the demands of a job can feel overwhelming. There are accessibility solutions built into your computer that can be exactly what you need to continue working productively. Make a friend in IT and get some help. Strongly consider discussing your visual impairment with your supervisor or Human Resources, it is in the employer’s best interest that you succeed on the job. Strengthen your resolve with a look back at these articles on this topic from OE Patients:
Reading is always affected by vision loss. It is important to learn early on to make the adjustments that will keep you reading. Consider the lighting, text size, contrast, and magnification.At some point, you may decide to move part of your reading to listening. A good audiobook is every bit as enjoyable as a real page-turner.
Reading has a very broad spectrum and it comes into play over and over throughout any given day. You may need to find new ways to read signs, packaging, documents, and mail.Here are some options to look at:
It all really ultimately comes down to independence, and it should never be given up without a fight! Stay tuned to these pages and we’ll keep giving you the power.
The first gene therapy for a rare inherited retinal disease has been approved.The treatment is specific to the RPE65 gene mutation which causes progressive vision loss in children and adults, resulting in legal blindness, and sometimes even total blindness.
The therapy, brand name Luxturna, is approved for a small group, approximately 1,000 to 2,000 patients in the US. It consists of the injection into each eye with a normal correcting RPE65 gene. The cost of this treatment expected to be in the high six figures.
The hope is, this progress potentially opens a door to treatments for many more gene mutations causing inherited retinal diseases and progressive vision loss.
Here is the United States Food & Drug Administration’s bulletin:
The U.S. Food and Drug Administration today approved Luxturna (voretigene neparvovec-rzyl), a new gene therapy, to treat children and adult patients with an inherited form of vision loss that may result in blindness. Luxturna is the first directly administered gene therapy approved in the U.S. that targets a disease caused by mutations in a specific gene.
“Today’s approval marks another first in the field of gene therapy — both in how the therapy works and in expanding the use of gene therapy beyond the treatment of cancer to the treatment of vision loss — and this milestone reinforces the potential of this breakthrough approach in treating a wide-range of challenging diseases. The culmination of decades of research has resulted in three gene therapy approvals this year for patients with serious and rare diseases. I believe gene therapy will become a mainstay in treating, and maybe curing, many of our most devastating and intractable illnesses,” said FDA Commissioner Scott Gottlieb, M.D. “We’re at a turning point when it comes to this novel form of therapy and at the FDA, we’re focused on establishing the right policy framework to capitalize on this scientific opening. Next year, we’ll begin issuing a suite of disease-specific guidance documents on the development of specific gene therapy products to lay out modern and more efficient parameters — including new clinical measures — for the evaluation and review of gene therapy for different high-priority diseases where the platform is being targeted.”
A close up of a long white cane on a street with yellow lines.
Vision loss can elevate feelings of insecurity, on many levels. Actively making adjustments helps maintain or regain the confidence to continue doing the things you need, and want, to do. That includes getting around safely.
Taking a fall is unpleasant at any age.Getting back up, in one piece, is not always easy. What you don’t see can definitely hurt you. The long white cane is a very useful tool in preventing falls.
The white cane is still believed by many to indicate total blindness. But everyone should be aware, this is a tool that significantly improves mobility for people with low vision.And it is increasingly being utilized by older adults with all kinds of visual impairments.
Although it can restore confidence and independence, the white cane remains a difficult step for many to take. The reluctance commonly felt about using the cane, is almost always replaced by the sheer empowerment it offers.
Use of a cane will greatly reduce the risk of injury. It provides feedback about the path ahead, changes in elevation, and alerts to obstacles. It will help you orient to conditions of darkness or bright glare. The cane will also inform others of your visual impairment.
A professional Orientation & Mobility Specialist should always be consulted for proper training in the use of a long white cane. Contact your local vision rehabilitation center or ask your physician for a referral.
Long white canes are lightweight and easily retractable. They fold up to a small bundle that fits into a tote or backpack. And they open up again with the flick of a wrist.
Don’t allow fear to curtail your freedom. The upside of cane use will far outweigh the downside.
