Solve low vision challenges in nontraditional ways

Take-home

Improvements in accessibility of computers, e-readers, and smartphones are all allowing people with low vision to utilize magnification and voice technology quickly, easily, and inexpensively.

By Bethany Fishbein, OD

In today’s world, people with low vision are being diagnosed earlier, and their vision loss is being arrested at better levels of acuity, thanks to new therapies. There are a tremendous number of patients with newly diagnosed low vision who expect to keep working, studying, traveling, and generally living well with vision in the 20/50 to 20/100 ranges.

Fortunately, patients with low vision have more options for magnification available to them than ever before-and interestingly, many of the things that are most beneficial for people with low vision are not low vision aids at all. Improvements in accessibility of computers, e-readers, and smartphones are all allowing people with vision impairments to utilize magnification and voice technology quickly, easily, and inexpensively.

For someone with low vision to read a book or newspaper, traditionally there were several options. Large-print books and newspapers are effective but limited by poor availability of materials and heavy, cumbersome books. Handheld and stand magnifiers are great tools for spotting tasks, like seeing a label or price tag, but must be constantly focused and provide a limited viewing area. Telescopes are useful for some, but many patients complained of being able to read only one word at a time.

Digital magnifiers, such as closed-circuit television (CCTV) systems, allow patients to combine wide viewing areas with higher levels of magnification. However, these magnifiers are limited by their cost and lack of portability. Handheld digital magnifiers provide portability, but are limited in their range of magnification and limited focal distance.

Breaking with tradition

Many of today’s patients with low vision have enjoyed great success with nontraditional vision aids-simply the magnification and accessibility features provided by today’s computer, e-reader, and smartphone technology. Applying this technology, people with low vision are able to magnify anything they choose easily with affordable devices that are already carried by a great percentage of the population. Because these devices are so commonplace in home, school, and work settings, there is no stigma attached to their use, as there might be with a magnifying glass or CCTV.

E-readers, although not designed for this purpose, happen to be extraordinary and inexpensive low vision aids, at prices starting less than $100. There are different brands and models, each with slightly different features. What they all have in common is the ability to download nearly any reading materials, such as books, newspapers, magazines, and textbooks, onto an easily carried device.

Once the material is downloaded, the reader can adjust the font size to a suitable magnification. On some devices, the reader can access enhanced contrast or reverse polarity. On others, there is a “voice” option that will read the text to the listener. These devices are useful for patients of all ages. Young people with low vision use them to access college textbooks and notes. Even people who are not computer-savvy find the devices easy to use, occasionally circumventing the need for computer literacy by having family members who download reading materials for them.

Tablets, such as the iPad, also open up many possibilities for people with low vision and can serve as reading aids, as well as providing magnification for distance and near. Similar to e-readers, patients can download reading materials onto their tablet and utilize increased font size and contrast enhancement to allow them to read quickly and easily.

In addition, many tablets and smartphones are equipped with cameras. Users can point the camera at distant objects-think street signs, wall-mounted menus, or chalkboards-and zoom in to magnify the objects on the tablet’s screen. They can also capture and enlarge near items, such as menus. Users of tablets and smartphones also download magnification apps, often for little or no cost, that provide lighting and digital magnification to use for near tasks.

Seeing outside the box

People with low vision are also finding great benefit in the accessibility options on new laptop and desktop computers (particularly Apple products). In many cases, these eliminate the need for separate magnifying or screen-reading software. With touchscreens in particular, computer users find magnification and contrast enhancement quite literally at their fingertips. Smartboards and conferencing software can be used to allow a visually impaired student or employee to view presented material on their own laptop as it is presented on-screen.

Although there is still use for traditional magnification-high-add spectacles, hand-held and stand magnifiers, telescopes, microscopes, and digital magnifiers, such as CCTVs-new technology cannot be ignored. Low vision practitioners should be familiar with e-readers, tablets, smartphone apps, and computer technology that may allow their patients to read more quickly, easily, and comfortably.

As low vision practitioners, it is our obligation to educate patients about the best solutions for their visual needs, even when these solutions are not traditional optical products. It is appropriate to have an e-reader and tablet available for demonstration, and have information for your patients interested in purchasing these devices.

Bethany Fishbein, OD, and her husband, Jonathan Fishbein, OD, own the Low Vision Center of Central New Jersey in Somerset, NJ. They help patients maintain their independence and use their remaining vision effectively. Bethany is also director of low vision services and an associate consultant for The Power Practice in Hawthorne, NJ.