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M. Mackeben; Use of remaining vision by "legally blind" seniors . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4349.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To explore whether and how people with severe visual impairment (visual acuity = 20/200 – 20/1000,) use remaining vision to solve tasks of Activities of Daily Living (ADL). Methods: A survey was conducted among 22 seniors (65 – 89 years of age) using a 45–item questionnaire. Visual acuity (v.a.) was measured at 3m and 40cm distance with best available correction. Items included medical background, living conditions, means of solving ADL tasks and areas of greatest difficulty. No subject fulfilling the v.a. criterion in the better eye was excluded. If mobility or transportation was a problem, interviews were conducted in subjects’ home (13/22). Results: The main finding of this study is that all subjects reported that they use their remaining vision to solve ADL tasks. Consequently, all said that closing their eyes or being in darkness would make solving ADL tasks extremely difficult. * Most frequent cause (19/22) of impairment was age–related maculopathy. Not all (17/22) were aware of using eccentric viewing. * Items found frequently: No problem seeing motion (22/22), uses cane (13/22), uses books on tape (18/22), can read print with optical or electronic aid (20/22), watches TV (19/22), takes notes in writing (18/22). * Items found rarely: Reads Braille (2/22), uses a computer (4/22), cooks meal beyond heating up (5/22), clean house thoroughly (3/22), records voice to take notes (4/22). * Most reported difficulties: Reading (due to eye strain and fatigue, 22/22), grooming (20/22), finding objects (19/22), independent mobility (17/22). * Factors most associated with satisfactory independent functioning: Higher education (16/22), living alone (at home or retirement home, 16/22), good lighting (16/22), had cataract surgery with IOL implant (14/22). Subjects use a variety of techniques and aids to solve ADL tasks (scanning eye movements, eccentric viewing, spectacles, telescopes, hand–held magnifiers, and CCTV magnifiers). Only half (11/22) reported using their sense of touch to supplement their vision. Conclusions: Seniors at or past the visual acuity limit for "legal blindness" benefit from their remaining vision and use different aids and learned techniques to deal with their impairment.
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