30 March 2012 FEATURE practice F E A T U R E Understanding the impact of sight loss T he impact of vision loss can be under-estimat ed by many within our society. Those of us that work within this client group are fully aware of the impact of vision loss on someone’s independence and ability to complete tasks of daily living. With an agei ng populati on many peopl e will experience age-related vision loss conditions, so it is important to educate those who work with this client group about the impact of vision loss and ensure that people with vision loss are identified and have access to the services they need from a well-trained workforce. Vision is our primary sense, which helps us interpret the world around us. It is estimated that up to 80 per cent of information is gathered through our sight. For this reason, if the sense is impaired in any way a person’s ability to collect the information normally acquired from the environment is greatly reduced. Sight is essential for most activities and any loss of vision can reduce an individual’s independence and quality of life. There are many eye conditio ns that can impair someone’s sight, but the most common two in the aging population are cataracts and age-related macular degeneration (ARMD). A cataract is the clouding of the normally clear lens of the eye. This happens over time and is commonly linked with the aging process. ARMD is a progressive disease of the retina, which results in the loss of central vision – used for detailed tasks such as reading and writing. Initial symptoms of ARMD can be dark patches or empty space within the centre of someone’s vision, distortion where straight lines may appear wavy or bent, and difficulty in reading or other activities that require fine vision. Distinguishi ng faces can also become a problem. With either of these conditions people may experience issues with reduced acuities, reduced night vision, sensitivity to glare, poor colour sensitivity, or a need for increased light when performing daily activities. Any of these symptoms are an indication that the individual may have an eye condition that could cause vision loss. Vision impairment will impact on each person in a different way, but there are some common difficulti es: ● ● reading a book, a newspaper, mail, instructions on food packets, telephone dictionary, an address book, or a bill; ● ● when writing, a person with vision loss may report that letters end up on top of each other or words run off the line; ● ● seeing the number buttons on a telephone; ● ● seeing a clock or watch face when trying to read the time; ● ● identifyin g coins; ● ● locating the key hole when unlocking a door; ● ● judging water l evels in a cup whe n preparing a hot drink; ● ● seeing the temperature dial for the oven when cooking; and ● ● mobilising around the home when moving from a light to dark area, due to difficulty adjusting to different light levels. OTs assist with a number of strategies that can be implemented to assist someone in increasing or retaining their independenc e, while working with other professionals such as optometrists and orientation and mobility instructors. Strategies commonly used include making things bigger, by: using large print personal diaries and phone books; photocopying or a computer to enlarge recipes, the TV guide and music; moving closer to the object; using a black marker pen and bold lined paper for writing; and using a magnifier for reading or for other detailed activities. Also making things bolder, by: using black on white, or white on black background for good contrast, for example a plain dark table cloth/mats and white crockery when eating, using a blue chopping board when preparing vegetables, as this provides good contrast and there are no blue food items, and large knitting needles that are a different colour to the wool, for example red knitting needles and blue wool. Strategies for making things brighter include: improving general and/or specific task lighting; ensuring people use lights throughout the day and night; ensuring that light provision within a room is even, to assist that person with navigating their environment and to reduce the risk of falls; using different types of lights, such as halogen, fluorescent and LED to identify what is best for an individual; wearing UV shields or placing diffusers over lights to reduce glare; and thinking about lighting to enable a person to complete a task independently. The use of other senses is also important. With touch, p eople could be encouraged to use tactile markers, for example sticking Velcro on either side of a key hole, or on microwave buttons. With hearing, people can use talking and audible devices, such as talking clocks and watches. Taste is used to identify food. Finally be organised and consistent. Always keep items in the same place and keep doors open or shut consistently. ● ● Claire Farrell has spent 12 months working with the Royal Society for the Blind in South Australia Sight is one of our primary senses and its loss can result in difficulties for a person’s independence and quality of life. Claire Farrell shares a number of strategies that can be put in place to assist an individual to maintain their independence within their own home environment © i S t o c k p h o t o Features.indd 30 24/02/2012 12:39