Low vision awareness is about recognizing the diversity of vision we might find in our community or workplace. Blindness and low vision are not visual conditions that are either on or off. Low vision affects people in different ways, so it might be that someone with low vision has less peripheral vision, like looking down a cardboard tube, which can be caused by glaucoma, or it might be a very soft focus in the center of the visual field that can't be corrected. Imagine, for example, a smudge of grease in the center of your glasses, like you might experience with macular degeneration or diabetic retinopathy. As editor Aaron Preece mentioned in the February 2022 issue of AccessWorld, low vision, in general, is a condition in which eyesight is not able to be corrected with glasses, contacts, or surgery. While it can be something that affects a person from birth, it is often a condition that is acquired later in life from aging, a disease process, or injury.
If you develop low vision later in life, it's likely that you may lack awareness regarding low vision or blindness, and may be uncertain about how to navigate the various daily living and employment tasks that were previously taken for granted. Unless you have a close friend or family member who is blind or has partial sight, you might even assume that all these activities must come to an end with low vision.
Rosemary Mahoney’s 2014 Op-Ed, “Why Do We Fear the Blind,” is both haunting and accurate in its descriptions of the fear and stereotypes we may associate with blindness and low vision. Ironically, it is these implicit biases that many of us carry into our acquired low vision that may, in fact, make the adjustments to daily living tasks or employment more of a challenge than the vision loss itself.
I am reminded several times a week in phone calls from people with recently acquired low vision what a poor job as educators and professionals we are doing when it comes to sharing the message that life goes on with vision loss, and there are many accommodations that are not only available for low vision but often built right into the devices we hold in our hands.
This is my story as well, so it is familiar. My vision loss began impacting my ability to read and see the computer screen over 25 years ago, at a time when I was working in a job that I loved and found challenging. It was a classic case of “you don't know what you don't know,” and I didn't know until I lost my job and floundered for several years that there were accommodations, like screen magnifying software, text to speech, video magnifiers for enlarging print, and many other tools. Like one of those fearful people Mahoney described, I thought I understood that blind people used white canes to get around, lived with family members who helped provide for them and read braille. How could they be designing websites, using the internet, writing columns, taking photographs, and all the other things I did as part of the job, I ‘knew’ I was going to lose when my vision made all of these activities impossible to do? How would I have known otherwise, without some sort of introduction?
Let's take a look at some of the tools that are available to accommodate reduced vision.
Computers
“Which computer is the best for people with low vision?” This is a question I hear a lot, often from a well-meaning friend or family member or someone new to low vision.
Unless you know someone with low vision, you may know nothing about accessibility features on both Windows and Mac computers (and Linux, also, for that matter). Screen magnification and screen reader software are built right into the operating systems on each. Of course, there are also third-party apps, like JAWS, ZoomText, Fusion, GuideConnect, and NVDA, that can be purchased and installed for more features than what is found on either the Mac or a Windows PC.
The real question here is which computer platform is the one you are accustomed to using? After all, there will be a bit of a learning curve with the accessibility features, so why add to this, by switching operating systems?
These features will be found in the computer settings, under Accessibility or Ease of Access. On Windows, just press and hold the Windows key, then press U to open the Ease of Access menu. Here, you will find many ways to customize Windows for the user with low vision. On the Mac, open the Accessibility Shortcuts Menu by pressing and holding the Command and Option keys, then press F5 (on a laptop the Fn key might also need to be pressed as well). On both Windows and Mac, users will find settings for screen magnification, text-to-speech screen reading, contrast, brightness, and more. To learn more about these features, check out Hadley’s workshop series, Customizing Windows for Low Vision and the Mac Low Vision Series.
The closest things to “computers for the user who is blind or low vision” are the refurbished computers assembled by the non-profit, Computers for the Blind (CFTB). These Windows laptop and desktop computers include a number of accessibility features, like larger monitors, large print keyboards, and software designed for users with low vision or blindness, to make the computer more accessible. Because they are refurbished, the computers are very affordable and offer some additional support for users just getting started.
Smartphones
Second only to the question about which computer is best for a user with low vision is a similar question, “Which phone is best for users with low vision?” There are some specialty phones, specifically targeting the low vision or blind user. Like the computer, the most popular smartphones, Apple’s iPhone, and the Android phones, all have accessibility features built right into the operating system. Users can literally take one of these phones, go into the settings, and customize contrast, brightness, font size, screen magnification and text-to-speech screen reading.
On either phone, open the Settings apps and look for Accessibility to explore these features. Just a heads up that, like the screen readers used on the computer, the Android screen reader, called TalkBack and the Apple iOS screen reader called VoiceOver, require a different set of gestures to use the phone, so there is a bit of a learning curve. That said, with the screen readers on, users have complete access to the phone as text on the screen is read out loud. For some basic tutorials on using the low vision and screen reader features on a smartphone, check out the Hadley workshop series on Android and Apple devices.
Again, the question, "Which phone is best for the user with low vision," is usually asked by someone with no idea, that like computers, most phones have accessibility features built in, both screen magnification and a screen reader.
As mentioned earlier, there are specialty phones available, like the BlindShell Classic, Raz Mobility SmartVision 3, and RealSAM Pocket. Both the SmartVision 3 and Blindshell Classic 2 have a keypad, which many users want, in large part because they have a hard time imagining using the smooth glass surfaces of the Android and Apple smartphones with finger gestures. The RealSAM, on the other hand, is an Android phone under the hood, but its software allows the phone to be used almost entirely by voice.
Without the opportunity to work or interact with someone who is blind or has partial sight, it is often difficult for the newcomer to vision loss to imagine how these smartphones, so visual, with a small screen, can be used entirely and efficiently without vision. While these specialty phones offer the reassurance of the tactile dialing pad, spoken menus, and voice commands instead of gestures, they may not offer the full range of features the more "conventional" smartphones provide—and to be fair, features that not all users will need or even care about.
Reading the Small Print
Reading print with low vision can be a challenge. Often this is solved with the adaptations found on a computer or smartphone, assuming, of course, you are a computer or smartphone user. With the advent of popular, and often free, OCR (optical character recognition) software, like Seeing AI, Google Lookout, or Speak!, reading printed material, like mail, directions on a package, or a magazine article, has become much easier. Just take a picture of it, and the smartphone's OCR app processes it and starts reading it out loud with pretty decent accuracy.
Low Tech Magnification
For those who don't use these devices, handheld magnifiers and reading lights can make print more readable. Both are available from retailers like LS&S Products and MaxiAids in a wide variety of styles and strengths.
Before picking up the phone to call either retailer and order that magnifier, though, do yourself a favor and get an assessment from a vision rehab professional through your eye doctor or the local blindness agency. Without trying some of these out, there's every chance you will pick one that isn't the right model or power for you, and your money will be wasted. If you need help finding where to get an assessment, look up your state in the APH Connect Center Directory of Services or call the Connect Center at 800-232-5463.
Electronic Video Magnifiers
Electronic video magnifiers are very popular, in both handheld and desktop models, and offer far more features than optical magnifiers. OCR has also been added to many of the new electronic video magnifiers, so it is not necessary to be a computer or smartphone user to take a picture of print and have it read out loud.
Talking Books
Perhaps the greatest opportunity for reading with low vision is available through the National Library Service (NLS) Talking Books program (by phone 888-657-7323). The Talking Books program is both free and frequently overlooked. NLS provides a free Talking Book player and mails out audiobooks on digital cartridges that work with the Talking Book player. Cartridges are on loan, like a library book, and all postage is paid, so there is no cost to the patron. For those who are computer or smartphone users, there is a way to download these same books and magazines over the internet using the NLS BARD service.
So many print readers who are discovering print more difficult to read may express doubt that audiobooks and magazines could take the place of reading print visually. For them, Bookshare (by phone 650-352-0198) may provide a great solution because individuals with a verified print disability can join and download books to a computer or smartphone and use an app like Voice Dream Reader, Dolphin Easy Reader, or the new, free Bookshare Reader app to make reading with vision loss more flexible. Each of these apps allows users to enlarge the print on the screen significantly if reading visually is the objective, and they each have a built-in screen reader to read the text out loud and highlight the print as it is being read. Bookshare often has the latest books and now has well over a million titles available.
Redefining Awareness
Low vision awareness is far more than acknowledging the rising incidence of vision loss. It is recognizing our ability to adjust with the many tools at hand—computers, smartphones, audiobooks, and more. It is about sharing the resources and services that bridge the transitions to alternative skills for work, play, school, and daily living activities with reduced vision. Low vision awareness is about reimagining those implicit biases Mahoney described and understanding that our eyesight does not define who we are or our abilities.
