What is low vision?

Low vision corresponds to a loss of vision sufficient to limit the activities of daily life. Note: this is not total blindness. At least 80% of people affected have a residual "useful vision" that can often be improved with special devices.

Low vision can manifest as an impairment of central vision or peripheral vision. 

1. Central vision 

Difficulty reading, writing, performing precision tasks, perceiving colors, or recognizing faces is noted. Macular degeneration and diabetic retinopathy are the most frequent causes. 

2. Peripheral vision 

Side vision is affected. This can result in tunnel vision, making it difficult to move around without bumping into objects. Advanced glaucoma and retinitis pigmentosa are examples of this.

Causes

The causes are numerous, but currently the deterioration of central vision is dominated by the degenerative damage to the macula. This age-related macular degeneration (A.M.D.) corresponds to the pathological aging of the macular retina. 

The main conditions leading to low vision:

Glaucoma: this is a condition of elevated pressure inside the eyeball. This hypertension causes a progressive deterioration of the visual field. Chronic glaucoma is a fairly common, painless, often hereditary condition that can only be detected during a medical examination by an ophthalmologist. This condition can lead to permanent blindness if left untreated. Treatment is medical in the first instance and may require surgical treatment at a certain stage. Acute glaucoma, which is rarer, is painful. It is a medical emergency (blurred vision with headaches, pain, nausea, …).

AMD: Age-Related Macular Degeneration. This condition has become the leading cause of poor vision in Western countries and mainly affects people over 65. There are 1,250,000 people affected in France. AMD does not cause blindness but disrupts detailed vision (reading, for example). It progresses toward a loss of central vision.

Diabetic retinopathy: this is the leading cause of blindness before the age of 50. Ophthalmological monitoring of diabetic patients is essential. Treatment, aside from managing diabetes, is carried out primarily with laser (photocoagulation). The visual field is reduced and disturbed by spots.

Pigmentary retinopathy: a condition affecting approximately 30,000 people in France. In the majority of cases, the diagnosis is made between the ages of 20 and 40. This retinal condition is progressive, leading to blindness through an inexorable reduction of the visual field. Sensitivity to light is very strongly felt.

Cataracts: loss of transparency of the crystalline lens (or opacification of the lens) leading to a decrease in visual acuity. It is a common condition that occurs after the age of 60 or 65 (progressive loss of acuity, blurred vision, yellowing of vision). Treatment is exclusively surgical.

Visual aids

Rehabilitation programs and special tools allow visually impaired people to see differently. Neither fully sighted nor blind, there are more than 1.5 million visually impaired people in France. Their vision ranges from 1 to 4/10 after correction. The majority of people affected by this disability are over 65. 

Making the most of one's minimum visual capacity. But even when limited, vision still exists. Even when imperfect, it functions. A visually impaired person retains more or less significant visual capacities that must be optimized and cultivated. Low vision rehabilitation is a valuable aid. A concept still poorly known to many ophthalmologists, it does not allow one to recover visual capacities but rather to see differently. It teaches how to use compensatory strategies.

Vision is a multisensory cerebral process that draws on all the senses. And it is not reduced to the sole functioning of the eye.

Rehabilitation thus involves developing the use of touch, smell, and hearing. At a pace of a few sessions per week, or through inpatient care, the person follows a varied program: orthoptic rehabilitation (eye-hand coordination...), occupational therapy (muscle tone, mastery of trajectories), safe mobility training (detecting and avoiding stationary obstacles, climbing stairs...) and activities of daily living (reading, games...). This rehabilitation is practiced at all ages. With one condition: being motivated. Only the visually impaired person can decide to participate. 

Essential visual aids. 

Many tools also help visually impaired individuals. Magnifying glasses, the oldest system used for image enlargement, are today very practical and adapted to various uses: handheld or stand-mounted, bridge-mounted or on a stand, articulated, with a lighting system.

They can also be integrated into eyeglasses. Video magnifiers, more recent, allow reading of all handwritten documents. Electronic magnifiers include a camera, an optical system, and a screen. They can enlarge text up to 50 times its original size.

Some are portable, others can be connected to a computer. There are also telephones with large keys; talking watches, food scales, or talking bathroom scales; playing cards, books, and newspapers in large print, etc. 

Seeing poorly does not mean not seeing at all. Low vision should not be a barrier to an independent life.