Services for Persons with Vision Loss
Various services are available for individuals undergoing a change in their vision. These services may serve to retain or find employment, assist in adjusting to vision loss, learn the use of new communication systems or assistive technologies, or improve ability to navigate safely inside and outside of your home. It is important to know the options available to you. You can learn more about these resources by clicking on the topics below.
Every state has a federally funded Vocational Rehabilitation (VR) program to help persons with disabling conditions, like vision loss, learn new skills and return to work. Many state VR programs have services specifically designated for individuals who are blind and visually impaired. The state receives federal government funds, from the Rehabilitation Services Administration, to provide these services at the local level. This is not welfare or public assistance. It is primarily a program to help people keep their job or return to work at a new job and become more independent.
People with vision loss will go through an assessment process and determine what their skills and abilities are and, with a vocational rehabilitation counselor, develop a plan for rehabilitation that will enable the person to return to work. This might include vocational training, learning adaptive skills, and/or learning to use adaptive technology.
Once an individual successfully completes rehabilitation and training in the use of Assistive Technology (AT) like computers with speech output or screen magnification, the vocational rehabilitation staff will help prepare individuals for the job seeking process. When appropriate, staff will identify and work with potential employers to help them understand how the job candidate who is blind or visually impaired would be able to perform a job. They can assist the job candidate with interviewing skills, resume writing skills, and other preparation for that first meeting with an employer. In a majority of the state rehabilitation agencies, it is the vocational rehabilitation counselor who works with the client on this last phase.
Some agencies have an additional staff member known as a job developer who helps with the process of resume writing, job seeking, and preparing for interviews. To find a VR office in your state, go to http://www.ntac.blind.msstate.edu/information-and-resources/ncsab/ or check the internet by searching under the name of your state and “Vocational Rehabilitation Services.” Services Vocational Rehabilitation agencies provide for people with vision loss include the following.
If an individual has vision that cannot be improved with normal glasses or contacts, the eye doctor may refer the patient for a special eye examination called a “low vision evaluation.” A low vision evaluation is different from just getting glasses. It focuses on functionality and on making the best use of remaining vision. The low vision specialist uses different charts to check visual acuity and may come up with a different result. Often different people with the same condition and visual acuity see very differently and have different visual functional capabilities. The low vision clinician will seek to identify these differences and find ways to facilitate visual functioning.
A low vision exam will not restore the individual’s vision to where it was before, but with the use of magnification devices and various strategies, it will allow the individual to function better with the remaining vision. Some people experience a tremendous improvement, others a small improvement. Patients can ask their eye doctor or vocational rehabilitation counselor to refer them to a low vision specialist who performs the low vision examination.
The low vision specialist may be able to prescribe optical devices, such as magnification or telescopic devices, or non-optical devices, such as special lighting or large print items, that may make doing near tasks (like reading) easier. They also arrange for training in the use of various low vision devices. In some states, there is a bioptic driving program to help people with low vision to return to driving, with the use of specialized aids and training. See the website Driving with Bioptics for more information.
Low vision exams and devices can be expensive and in some cases, VR can assist eligible consumers with this expense. Some eye doctors may not make this referral, but VR can arrange for these services if they are appropriate.
Orientation and Mobility (O&M) is an area of instruction that describes the ability of a person who is blind or severely visually impaired to move safely through the environment with dignity and confidence. Orientation describes a person's understanding of where they are in space and helps them find their way through an environment to a destination. Orientation includes the understanding of directionality (north, south, east, and west) and comprehension of the intricacies of the environment. Orientation answers the questions, “Where am I?”, “Where am I going?”, and “How am I going to get there?”
Mobility in the context of vision-related concerns describes the ability of a person to move safely and comfortably through the environment. Traditionally people who are blind have used either human guides, dog guides or white canes to assist them in mobility travel. Mobility answers the question, “How am I going to safely get where I want to go?”
There are a variety of electronic travel aids or “wayfinding devices” that can assist individuals with vision loss to safely travel through complex and unfamiliar environments. These include devices like GPS systems, laser canes, and audible street lights.
For more information see http://www.ntac.blind.msstate.edu/information-and-resources/omp/
Known by several different names, instructional services to help adjust to vision loss are provided by Vision Rehabilitation Therapists (a.k.a. Rehabilitation Teachers, Independent Living Instructors, Braille Instructors, etc.) who provide instruction in compensatory skills and assistive technology that will enable persons with vision impairments to live safe, productive, and independent lives. Vision Rehabilitation Therapists work in areas that enhance the vocational opportunities, independent living, and educational development of persons with vision loss, and may include working in center-based or home-based settings.
Specific areas of instruction involved in Vision or Blind Rehabilitation Services include:
- Communication Systems (Braille, handwriting, recording skills, use of electronic reading systems, use of assistive technology and computer access technology)
- Personal Management (grooming, hygiene, clothing organization, medical measurement, and socialization skills)
- Home Management (organization and labeling, repair and home maintenance, budgeting and record keeping)
- Activities of Daily Living (cooking, cleaning, shopping, safety, and money organization and management)
- Leisure and Recreation (hobbies, woodworking, crafts, and sports)
- Psychosocial Aspects of Blindness and Vision Loss (adjustment and acceptance of vision loss)
- Medical Management (assessment and instruction regarding adaptive medical equipment, medicine identification and organization)
- Basic Orientation and Mobility Skills (sighted guide, and safety techniques)
For more information about vision rehabilitation or blind services, http://www.visionaware.org/.
Rehabilitation counseling services are provided by a rehabilitation counselor who works with consumers with visual impairments to assess and coordinate vocational rehabilitation services. The rehabilitation counselor plays an important role in working with the consumer to prepare for and obtain gainful employment. Activities include:
- Evaluating medical reports to determine eligibility
- Reviewing reports with the applicant and interpreting educational and employment data
- Creating with the consumer a rehabilitation plan for employment that is consistent with the individual’s strengths, resources, priorities, capabilities, and interests.
Work also involves purchase and provision of services needed for the consumer to achieve the plan for employment, including such services as physical and mental restoration, educational and vocational training, computer and adaptive equipment, and job readiness, placement and retention services.