Why Glasses May Not Help

Individuals with many different eye disorders may lose vision to the point that glasses will not help them to see better.  Glasses are used to change the focal distance of the eye, correcting near-sightedness or far-sightedness.  The correct power of glasses typically depends on the amount of near or far-sightedness.  Making glasses “stronger” by increasing the power of the lenses will not improve the clarity of the vision.  In eyes with severe damage to the cornea, retina or optic nerve the image transmitted to the brain from the eye may be so blurry, dim or distorted that normal glasses do not help.  If you suffer from such vision impairment using special optical devices and technologies might significantly improve the quality of your life.  These devices are known as “low vision aids.”

Low vision aids have improved considerably since their introduction several decades ago. New devices may enable patients with serious vision loss to function almost as well as they did before they lost their vision. However, because everyone’s vision is different, and their visual tasks and needs vary, low vision rehabilitation should be seen as a joint effort between the patient and the low vision professional, and even a family member or two. This is where the staff at the Vista Center for the Blind and Visually Impaired (“Vista Center”) can really help. 

Understanding which low vision aids may help enhance your remaining vision should be seen as a process because there usually is no “quick fix” to the problem.  You might find that using 5 or 6 different low vision aids will be needed to help with your different visual tasks.   For example, do you need help with small print or large print?  Do you need help reading at home or in public (like reading a price tag in a store)?  Do you need more help in dark conditions like a restaurant, or in bright conditions like direct sunlight? These are just a few of the issues with which a low vision professional at the Vista Center could help.  You may have to try more than one method before you find a low vision aid system that’s right for you.  In addition to low-tech devices like magnifiers, there are a wide array of high-tech items such as CCTVs, text to speech synthesizers and computer screen readers to help make you as independent and successful as you wish in whatever you want to accomplish.

Not every low vision aid is appropriate for everyone, but many low vision devices use magnification to improve a patient’s visual acuity. Magnification, a “+” powered optical lens held some distance away from the object (such as a word on a page) makes that object look bigger. By making the “+” power stronger and stronger, greater and greater magnification can be achieved. As a person’s vision declines from disorders like macular degeneration, stronger and stronger magnification is required to make the letters on the page larger and easier to read.  However, there is always a trade-off to the increased magnification such as shorter working distance or reduced field of vision.

Usually, the first low vision devices offered to patients with low vision are spectacles with high “+” lenses. They look like normal spectacles and keep the hands free for writing, holding reading materials and performing other activities.  Prism half-eye spectacles provide correction for individuals with visual acuities ranging from 20/40 to 20/200. Beyond the half-eye series is a higher-power series – Microscopic lenses. One advantage of these lenses is that patients with visual acuities ranging from 20/200 to 20/800 usually can read normal-sized -print. Finally, microscopic doublet lenses offer superior optics and a wider field of vision.  Unfortunately, not everyone can use or tolerate high-plus spectacles and microscopic lenses. The higher the power, the closer you must hold reading material to your eyes. As power increases, depth of field becomes more critical.  You may function better with a different low vision aid, such as a hand or stand magnifier.

For patients who are uncomfortable with the close working distance required for spectacles, there are hand and stand magnifiers. Both types provide a wider field of vision than spectacles, and they’re available with the option of a built-in illumination source. Xenon and LED lights offer higher contrast than traditional incandescent lighting, making it possible for some patients to read printed materials.

There are many different types of high technology low vision aids.  These aids can involve text to speech synthesis to create audio output in a variety of situations, or enhanced viewing through electronic magnification.  These devices range from hand held CCTVs and scanning devices, to computer accessibility devices and programs, to devices worn by individuals with low vision to enhance what vision they have left.   Which high technology devices might be appropriate for you will depend on a number of factors. Working with a low vision professional at the Vista Center will be the best way to determine which high technology devices may be right for you. 

Creating an appropriate low vision strategy for you can take a while to perfect and involves diligent work – not only during the examination, but also afterwards when you are “practicing” to gain maximum benefit.  You must work together with a low vision professional to come up with solutions that work best for your situation.  As your needs and vision changes, low vision rehabilitation will also change to help adapt and make improvements to maintain as much of your “quality of life” as possible.