WHO IS LIKELY TO HAVE LOW VISION?

As a rule of thumb, the following people are

likely to need low vision services and must be

referred wherever possible:

• All children who have undergone bilateral

cataract operations, both those with

pseudophakia and those with aphakia

• People with diabetic macular oedema whose

vision remains poor despite laser treatment

• People with age-related macular

degeneration

• Children with oculocutaneous albinism

• People with optic atrophy, whatever the cause

• Any person who still has difficulty performing

their daily activities because of their vision,

even after treatment and refraction.

What does low vision look like?

People with low vision are affected in different

ways. They may suffer from some or all of the

following:

• Severely reduced visual acuity

• Blurred vision

• Visual field loss: central or peripheral

• Loss of contrast sensitivity

• Increased light sensitivity.

Many people with low vision suffer from blurred

vision (Figure 1), for example if they have

scarring on their corneas.

People with optic atrophy or age-related

macular degeneration will have loss of central

visual acuity (Figure 2), which means that tasks

requiring good central vision will be difficult. For

example, reading, writing, threading a needle

and sewing, putting on make-up, recognising

people, seeing where their food is on the plate

and whether they have finished eating, seeing if

their clothes are clean, finding their own pair of

shoes. If they have a full field of peripheral

vision then mobility will be less of a problem.

Someone with glaucoma or retinitis

pigmentosa will have constricted visual fields,

i.e. loss of peripheral vision (Figure 3). This

makes it difficult to move around without

bumping into objects on the floor. People may

have difficulty finding things they have dropped.

Reading may still be possible, but difficult.

Loss of contrast sensitivity (Figure 4) can

have a very big impact on someone’s visual

function, making it difficult to recognise faces or

find food on a plate of similar colour.

Increased light sensitivity makes it very

difficult for people to see detail or make sense

of what they see if they are in bright light, or

glare (Figure 5).

Figure 1. Blurred vision. People with

blurred vision (right) have difficulty

seeing details, both at distance and

nearby; they often have problems with

glare. Printed materials and colours

might seem faded.

Figure 2. Loss of central vision. “Is

the man sitting down my husband, and

is there a seat for me?”

Figure 3. Loss of peripheral vision.

“How many other people are there in

the room?”

Figure 4. Loss of contrast sensitivity.

With normal contrast sensitivity (left),

it is easy to recognise faces. With

reduced contrast sensitivity (right)

this becomes more difficult.

Figure 5. Increased light sensitivity.

This is how a street scene in bright

sunlight would look to someone who

has increased light sensitivity.

We hope that these experiences of people with low

vision will highlight what is

important in a low vision service.

Before they received low vision

care, the adults said they had

been unable to do their

desired activities, such as

driving or reading. They were

worried about their vision and

had negative feelings,

including stress, depression,

anger, and frustration. They

had also felt dependent on

their family, and that they were

a burden to the family. The adults had

also struggled to accept their condition as

being irreversible.

School-age children and young adults

said that they had been unable to attend

school, had to drop out, or had faced

great difficulties in their schooling, such

as being unable to take examinations.

Some of them had been treated as blind

and taught to use Braille.

Testimonies 

Engr. K. C, stated that, Low vision services helped her

to set realistic goals. “The visual

rehabilitation helped me a lot,

mostly to be aware of my

limitations, to accept them

and to know up to where I can

develop and set my goals.”