Blindness is considered one of the most devastating disabilities that can affect an individual, striking people of all ages and walks of life. The term legal blindness is, however, a deceiving one. The generally accepted definition of legal blindness is either central visual acuity of 20/200 or worse in the better eye with the use of corrective glasses; or, central visual acuity better than 20/200 in the better eye with visual field deficits in which the widest diameter of peripheral fields is 20 degrees or less. The definition of low vision used to generate estimates of veterans with low vision is central visual acuity equal to or less than 20/70 but greater than 20/200 in the better seeing eye with the use of corrective glasses.
In the United States the number of veterans diagnosed with low vision (those individuals who have a significant, uncorrectable visual impairment from 20/70 to 20/190, but who are not legally blind) is currently estimated to be more than one million veterans (De l’Aune, 2002). The most common causes of low vision are age-related as well.
The impact of blindness is very individualized and includes a wide range of eye conditions, from the older veteran whose vision gradually worsens due to macular degeneration or some other age-related eye problems, to the serviceperson who is totally blind from traumatic injury. Veterans who must cope with a significant loss of vision require individualized, specialized care and treatment suited to their specific cause of blindness. Physical and medical condition, age, ability to cope with frustrating situations, learning ability, and the overall needs and lifestyle of the veteran are important considerations.
A person confronted with blindness may feel limited and frustrated in performing everyday activities previously taken for granted. Tasks such as dressing, eating, writing, reading, and traveling may become difficult to perform independently. Communication with other people by ordinary means is often hampered, as is the ability to keep up with the daily news and current events. Social interaction, recreation, and hobbies may also be limited or curtailed as a result of vision impairment.
Frequently a person may be forced into premature retirement because of vision loss, often resulting in loss of income and financial security. As a result of the numerous negative outcomes, it is not uncommon for the newly blinded individual to undergo a period of personal stress. Individuals facing blindness and vision impairment may lose self-esteem, or believe the future holds little promise. Spouses, families, and loved ones may experience pressure, strain or uncertainty.
As with any physical disability, family and caregivers should be aware of the psychological and emotional demands placed on patients with low vision, in addition to their physical challenges. For more information, contact your eyecare specialist