The start of 2023 has been a rocky one with Sacheta and I being hurled into the low vision world like never before. She has always had low vision thanks to glaucoma, but it has reduced further due to damage to her optic nerve. I am not going to talk about the causes behind the damage but the technical adaptations that we have had to make and are still making. My idea behind writing this post is to help others in our situation.
The first thing to know about low vision is that the characteristics of sight that a person has, are radically different therefore what works for me will not work for you. The settings and adaptations are unique and may change from day-to-day or from month-to-month. This is something that you will have to figure out on your own. There may be rehabilitation professionals who may help with some of this but as of this writing, I have not found any in India who have substantive knowledge in this regard. Moreover, there is a huge emotional component which remains unaddressed.
Sacheta has always had low vision but its characteristics have altered significantly.
The change in the kind of light
Sacheta used to prefer strong white light. We have LEDs across the house.
She now prefers a mix of white and yellow lights. Strong white light hurts her eyes.
Extreme contrast sensitivity
People who have glaucoma suffer from contrast sensitivity. In her case, even moving between rooms now is a huge issue where her eyes take time to adapt to the change in the levels of light.
The conundrum of natural light
Sacheta sees better in natural light, but bright sunlight virtually destroys her vision for about 6 to 7 clock hours. The vision becomes blurry and effectively non-functional.
A lack of depth perception
Given the above changes, she has difficulty in gauging depth therefore detecting stairs specially those going down is a challenge and the same applies to judging distances.
Sacheta now carry’s three pairs of glasses. One pair are her regular glasses, one pair is tinted glasses- to better handle indoor light-level transitions and the final pair are dark glasses. She keeps changing glasses as needed.
We did consider photochromatic lenses but those would not help in her situation because they only darken in the presence of strong sunlight.
A brighter monitor
Sacheta is just about able to use the screen of her laptop. She used a big screen in any case, but we have had to invest in a brighter monitor. As of this writing, we have finalized the LS27AG300N monitor.
We did consider monitors from BenQ but have settled on the Samsung monitor because of greater brightness. BenQ may have worked and for all we know work better, but eye comfort technology reduces brightness which makes it difficult for her to see text on the screen.
The 27 inches width was determined by Sacheta. We could have gotten wider monitors but that is what worked for her.
Increasing the use of screen reading technology
Sacheta has begun to learn the The nvda screen reader and is using it heavily in Microsoft Outlook and in Microsoft word.
The same applies to Google Talkback.
She does not use them like a totally blind individual would, but they reduce eye strain significantly because she does not need to read text in detail. She mouses to where she has to go and the fact that the screen reader speaks text under the mouse helps her to know where she is. She is still learning how to go mouse less. She continues to use the windows magnifier.
The good news is that nvda works seamlessly with the windows magnifier and there is a winMag add-on that adds functionality to nvda that supports various features of the windows magnifier and avoids key clashes such as when navigating within tables.
We have also tried various visual options like inverting colors, inverting the color of only the mouse pointer and various high-contrast themes. The Aquatic theme worked the best for her.
One thing to watch out for is that when you do color inversion or change the theme, many icons look different. This became uncomfortable for Sacheta hence she changed the theme and inversion settings to their defaults.
However, when she is doing work that involves a lot of reading of text, she does change the theme but once again, it is a matter of choice.
Talkback has been a little easier to grasp because there are fewer keystrokes, and she has learnt the basic gestures for navigation. Using the magnifier is also possible and does not involve any change in gestures. One thing that helped her learn the gestures was the tactile book and directions from the excellent personnel at IIT. She is also making heavy use of the google assistant to interact with her onePlus 9 pro phone. She also uses talkback on our Sony Bravia television.
Using the cane
She has begun to carry the standard white cane. This is to help when she cannot see steps in bright sunlight and to also signal to the rest of the world that she may need assistance.
Cooking is a significant part of our lives and Sacheta has not let this reduction in vision stop her. She has made lighting changes to the kitchen such as installing different lights above the kitchen slabs. One more thing we are planning to try is using spacefelt tags for labelling food etc.
We have tried the CCTV cameras from vision aid and would also like to try the following solutions which are not available in India.
Oxsight Onyx glasses
We have other solutions such as the vOICe as well and ara but we propose to try them a little later. The speed of change needs to be regulated.
A note on lifestyle changes
While I have documented technology solutions in the above post, implementing these involves significant lifestyle changes. Do not underestimate this aspect. E.G., if we go out and the light levels are unusual, Sacheta and I do take significantly more help from people around us than before. This loss of independence takes getting used to.
In addition, she has to be extremely careful when travelling in a car during the day because bright sunlight will cause her vision to become non-functional if she exposes her eyes to bright sunlight.
There are several hospitals who have low vision units, but they were not able to provide any solutions beyond magnifiers and some experimental video glasses. We received tangible help from the following entity.
ASSISTECH group of IIT Delhi