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Winter 2002 Table of Contents
Versión Español de este artículo (Spanish Version)

The Case for Low Vision

By Dennis Dickinson, Itinerant Teacher of the Visually Impaired
for Gilmer ISD, Ore City ISD, Harrison County, and Upshur County

Individuals with low vision, by any estimate, constitute the vast majority of the visually impaired population. However, more than half a century after this has been acknowledged, there remains a controversy regarding the way they should be treated by educators and rehabilitation professionals. Actually, I should not say "they," for this article is written by such an individual. I am a middle-aged person with low vision. In addition, I am the spouse of a visually impaired person, the father of two adopted children, a low-vision driver, and have been an educator of students with visual impairment for over 25 years. I readily acknowledge that these credentials do not entitle me to speak on behalf of all members of the low vision population. However, I do feel that I represent many within this population who simply wish our voices to be heard.

The low vision population is by nature an extremely diverse group. At its extremes, it includes people with light perception as well as those who can read paperback books and newspapers without using any aid or device. I would submit that despite this diversity, the low vision population has certain unique characteristics that set it apart from both the "fully sighted" and "blind" populations. These characteristics are:

  1. Individuals with low vision do not have the same abilities as people with "normal" vision.
  2. Individuals with low vision do not have the same characteristics as totally blind individuals.
  3. Individuals with low vision have unique needs that set them apart from either population.

As a member of this group of individuals, I also believe that there are three unique needs that should be addressed by educators and rehabilitation professionals.

UNIQUE NEEDS OF THE LOW VISION POPULATION

Our vision should be accurately measured.

To put it succinctly, "LOW VISION IS NOT NO VISION!" The definition of legal blindness is a visual acuity of 20/200 in the best eye with best correction or a visual field of 20 degrees or less. While this definition sounds precise, it is often subjective. An eye specialist who uses an eye chart that does not measure acuities between 20/100 and 20/200 may give "the benefit of the doubt" and declare the patient "legally blind" in order to give the person access to more services. Thus, a person who reads regular print with no aids risks being placed in the same category with people who have a far lesser degree of visual functioning. Why, in an environment where time is measured in milliseconds and gasoline sales are measured in thousandths of a gallon, do we still consider "counts fingers" a viable visual measurement? Why do we continue to cling to an out-of-date standard? Unfortunately, mistakes and misunderstandings still occur. The definition of "legal blindness" is not even the same in all countries. It is simply an arbitrary designation arrived at by people with 20/20 vision to determine eligibility for government services.

An oft-repeated truism in the field of visual impairment is that a fully sighted person gets 80 percent of his or her information about the world visually. In the case of a low vision person, he or she is still receiving a vast majority of their sensory input by visual means. The point at which 80% becomes 50% or 5% is not something that is easily determined. Attempts to state a "percentage" of vision loss frequently fail to take into account factors other than visual acuity. In my opinion, if an individual demonstrates good visual functioning, this individual's vision should be given the "benefit of the doubt" when considering educational and rehabilitation programming. Certainly it does not deserve to be ignored as if it were of no importance.

It should be obvious that a simple measurement of visual acuity is not sufficient to make blanket decisions regarding a person's education or rehabilitation. Other factors should also be considered, especially when they can have such a profound effect upon programming. Visual field, the effects of various lighting conditions, and the nature of the eye condition including prognosis, age of onset, and cognitive functioning are important components of visual functioning. While most of these items have long been included on the State of Texas Eye Report Form, experience has shown that all these factors are seldom addressed. Even though there are many fine eye specialists and low vision clinics that can give great assistance to persons with low vision, more precise and accurate vision evaluations are needed to ensure that accurate decisions are made.

Our vision must be respected.

It has been well documented that an individual's visual functioning is dependent on a great variety of factors. In addition to visual acuity, visual field, and the nature of the eye condition, factors such as lighting, color vision, and visual experience also play a significant role in an individual's ability to use visual information. This is why educators perform Functional Vision Evaluations and Learning Media Assessments; to determine, on an individual basis, the visual abilities of each student. The Learning Media assessment makes further recommendations concerning the learning media that will be most effective and the modifications that will enable an individual to function at maximum potential. Admittedly, these assessments are not perfect. No evaluation that depends on observation and a limited amount of contact with a student could possibly make such a claim. That is why the assessment is repeated at least every three years, and it is not relied upon as the sole factor for making educational decisions. It is considered along with medical information, evaluation by educational diagnosticians, teachers and other education professionals, and parental input.

Ultimately, the person best qualified to speak about visual needs is the individual with low vision. In the case of young children and people with multiple disabilities, the determination must be made by observation, caregiver interview, professional judgment, and other means. However, in the field of education, it is a decision based upon the characteristics of each individual. It is our function as educators to help the student become increasingly aware of not only his or her visual condition, but also the adaptations necessary to function in a fully sighted world as a productive member of that society. It is the individual's responsibility to demonstrate what role the visual impairment will play in his or her life. When we make assumptions about what a visual impairment means, we run the risk of limiting what the person may ultimately be able to accomplish.

An individual with low vision should have access to a wide variety of tools.

The literacy tools of a fully sighted person are print reading and writing. The literacy tools of a totally blind person are Braille reading and writing. Both populations will likely use computer technology, listening skills, and other sensory input to supplement these tools. The person with low vision may use either or both of these literacy options. In addition, this person may use a variety of other tools including enlarged print, magnifiers, telescopic aids, screen-enlarging software, and other devices to enhance communication skills. Denying any of these sources, especially print access, to those capable of using them, limits an individual's potential. I am sure no one in the education or rehabilitation field, or the consumer of such services, wants this outcome.

I write this as a member of the largest numerical component of the low vision population. I refer to those whose acuity is above 20/200. I do not think I stretch the point when I say that most of us regard ourselves as basically visual people. Frequently we fail to identify ourselves with the "legally blind" population. Frankly, it is our goal to blend in with the rest of society as much as possible and to attract as little attention as possible. Consequently, we too often fail to speak out on issues which effect programming for persons with visual impairment. It is not my aim to criticize any particular agency or individual. Rather, I simply call for the recognition of individuals with low vision as a distinct population with abilities and needs that distinguish it from both the totally blind and fully sighted populations. As a distinct group, this population deserves to have programming decisions that are based upon its unique characteristics and needs. More precise vision evaluations, respect for the individual's use of all the sensory channels open to him or her, and access to an increased availability of the necessary tools for literacy and life would go a long way toward meeting the unique needs of the low vision population.


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