What Now?

Learning that you, your child, or someone you care about is losing vision can leave you with a lot of questions.

What happens next? Who should we talk to? What kind of help is available? Can a blind child attend a regular school? Can an adult continue working? Can an older person remain independent? What kinds of technology, training, recreation, and services are available?

The good news is that blindness or low vision does not automatically mean giving up school, employment, recreation, travel, technology, or independence. It usually means learning some different ways of doing familiar things.

This page is designed as a starting place. You do not need to understand blindness terminology before reading it. When a specialized term is used, we will explain what it means.

You can read the whole page or go directly to the section that best fits your situation.

First: Understanding the Eye-Care Professionals

One of the first confusing areas for many families is understanding the different kinds of eye doctors.

Optometrist

An optometrist is an eye-care professional who examines vision, measures how well a person can see, and commonly prescribes glasses or contact lenses.

Some optometrists specialize in low vision. Low vision means that a person has useful remaining sight, but ordinary glasses do not completely correct the vision.

A low-vision optometrist may recommend devices such as magnifiers, special glasses, electronic magnification systems, or other tools that help a person make better use of the vision they still have.

Ophthalmologist

An ophthalmologist is a medical doctor who specializes in diseases and medical conditions of the eye.

An ophthalmologist can diagnose eye diseases, prescribe medicine, and perform eye surgery when needed.

Some ophthalmologists specialize in a particular part of the eye. For example, a retina specialist concentrates on conditions involving the retina, which is the light-sensitive tissue in the back of the eye.

An easy way to remember the difference is this:

An optometrist usually concentrates on vision testing and helping you use the vision you have.

An ophthalmologist is a medical doctor who treats diseases and medical problems involving the eyes.

Depending on the condition, a person may need both.

If Your Child Is Blind or Visually Impaired

When a child has little or no usable vision, one of the most important things to remember is that the child is still learning about the same world as every other child.

The difference is often in how the information reaches them.

A sighted child may learn something by watching someone else. A blind child may need to touch it, listen to it, explore it physically, or have someone describe what is happening.

That does not mean the child cannot learn it.

Learning Through Touch and Sound

Young blind children frequently learn by touching objects and listening carefully to what happens around them.

This may be especially noticeable during meals, play, and exploration.

For example, when a young child explores food with their hands, they may be learning its size, shape, temperature, texture, and location.

As the child grows, parents and teachers can gradually introduce the same social skills expected of other children, including using eating utensils appropriately.

Simple adaptations can make learning easier. A spoon or fork with a flatter handle, for example, may make it easier for a child to understand which direction the utensil is facing.

The goal is not to prevent exploration. The goal is to help the child move from exploration toward greater independence as they are ready.

Medical Care and Medicine

If a child has a medical condition that requires medicine, eye drops, blood-sugar testing, or other regular care, parents should first follow the instructions of the child's medical professionals.

As the child becomes older and demonstrates the ability to understand the task, accessible tools and techniques may allow them to take more responsibility for their own medical care.

The timing will be different for every child.

School and Education

Many blind and visually impaired children attend their local schools alongside sighted students.

They may use materials such as Braille, large print, audio books, screen-reading software, magnification, electronic Braille displays, or other accessible technology.

A student with a disability may qualify for an IEP, which stands for Individualized Education Program.

An IEP is a written educational plan developed for a student who qualifies for special education services. It describes the student's educational needs, goals, services, and accommodations.

Parents are part of the IEP process and should ask questions whenever something in the plan is unclear.

As the child grows, it is helpful to encourage them to understand their own accommodations and begin speaking for themselves whenever possible. That self-advocacy becomes increasingly important in high school, college, employment, and adult life.

Learning to Travel Independently

A blind child can also learn how to travel safely and independently.

The professional field that teaches these skills is called Orientation and Mobility, often shortened to O&M.

Orientation means understanding where you are and where you want to go.

Mobility means moving from one place to another safely.

An Orientation and Mobility instructor may teach skills such as using a white cane, crossing streets, locating doors and stairs, using public transportation, understanding building layouts, and traveling through unfamiliar areas.

Children can begin learning age-appropriate travel skills long before adulthood.

Technology

Technology has opened enormous opportunities for blind students.

Computers, smartphones, and tablets can speak information aloud through a screen reader. Some users read the same information through a refreshable Braille display. People with low vision may use magnification, enlarged text, increased contrast, or other visual adjustments.

These tools can help with schoolwork, communication, reading, appointments, identification of objects, navigation, entertainment, and many other activities.

Learning accessible technology early can become an important part of a child's independence.

Recreation

Blind children should also have opportunities to play, explore, compete, and simply have fun.

Many ordinary activities can be adapted with surprisingly small changes.

Board games can use raised markings or Braille. Balls can contain bells or other sound sources. A basketball goal can be identified by sound. A horseshoe stake can be located by tapping it before the player throws. Electronic games can use audio instead of depending entirely on graphics.

There are also organized sports specifically designed or adapted for blind athletes, including goalball, swimming, track and field, cycling, and many others.

The important question is usually not, "Can a blind child do this?"

A more useful question is, "What information or adaptation would make this activity accessible?"

If You Are a Working-Age Adult Experiencing Vision Loss

Losing vision as an adult can be very different from growing up blind.

You already know how you normally perform everyday tasks, so the frustrating part may be discovering that the methods you have used for years no longer work as well.

Blindness training is designed to help you learn alternative techniques.

Adjustment and Rehabilitation Training

You may hear the words rehabilitation or blindness rehabilitation.

In this context, rehabilitation does not necessarily mean recovering lost eyesight.

It means learning skills that allow you to continue doing everyday activities without depending on sight in the same way you did before.

Training might include:

• Using a white cane.
• Cooking and identifying household items.
• Managing money.
• Organizing clothing.
• Reading with audio, Braille, or magnification.
• Using a computer or smartphone.
• Traveling independently.
• Performing job-related tasks.
• Learning techniques for personal care and home management.

Different agencies provide different combinations of these services.

Vocational Rehabilitation

If your goal is employment, you may be eligible for help through your state's vocational rehabilitation program.

Vocational rehabilitation, often shortened to VR, is a government program that helps eligible people with disabilities prepare for, obtain, or maintain employment.

Depending on the person's needs and eligibility, services may include evaluation, training, education, assistive technology, job preparation, or help adapting a workplace.

Programs and funding rules vary by state and by individual situation, so it is important to ask your local agency exactly what services are available to you.

College and Additional Education

Blind and visually impaired students attend colleges, technical schools, universities, and professional programs.

Colleges generally have an office responsible for disability-related accommodations. The name of the office varies from school to school.

Before choosing a school, it can be helpful to speak with that office and ask how accessible textbooks, websites, classroom material, testing, and technology are handled.

Students should also become comfortable explaining what accommodations they need and what accessible tools work best for them.

Employment

Blind people work in many different occupations.

The methods or equipment used may be different, but the goal is the same: performing the essential duties of the job.

Some people use screen readers, Braille displays, magnification, scanning software, accessible mobile apps, labeling systems, or other adaptations.

If an employer needs to make a workplace adjustment because of a disability, you may hear the term reasonable accommodation.

The Americans with Disabilities Act, commonly called the ADA, is one of the federal laws dealing with disability discrimination and workplace accommodations. Questions involving a particular employer or legal situation should be discussed with an appropriate disability-rights professional or legal resource.

If You Are 55 or Older and Experiencing Vision Loss

Vision loss later in life can affect reading, cooking, medication management, transportation, finances, hobbies, communication, and many other everyday activities.

It can be tempting to begin giving those activities to someone else.

Sometimes assistance is necessary, but there may also be an accessible technique that allows you to continue doing much more for yourself than you first expected.

Independent-Living Skills

Training for older adults may include:

• Organizing and identifying medicine.
• Using talking or large-print devices.
• Cooking safely.
• Labeling appliances and household items.
• Managing money.
• Reading mail.
• Using a telephone or smartphone.
• Learning computer skills.
• Traveling safely.
• Using audio books and accessible reading services.
• Continuing hobbies and community activities.

Some state programs provide services specifically for older people who are blind or visually impaired. Eligibility and available services differ by location.

Technology Is Not Just for Younger People

You do not have to become a computer expert to benefit from accessible technology.

A smartphone can read text aloud, identify objects, make telephone calls by voice, keep appointments, set reminders, provide directions, read books, and communicate with family.

A computer can enlarge information or read the screen aloud.

The goal is not to use every available feature. The goal is to learn the features that make your own life easier.

Staying Involved

Losing vision should not automatically mean giving up church, clubs, family activities, travel, hobbies, sports, or community involvement.

You may perform an activity differently, but continued participation is often possible with planning, accessible information, transportation arrangements, or a few simple adaptations.

Specialized Services for Veterans

Veterans who are blind or visually impaired may qualify for specialized services through the Department of Veterans Affairs.

VA blind rehabilitation programs may provide evaluation, training, technology, independent-living instruction, orientation and mobility, and other services depending on eligibility and individual need.

A veteran should contact the VA directly to determine which benefits and services apply to their particular situation.

Learning to Travel with a Human Guide

Another useful skill for both children and adults is learning how to travel with a sighted person.

You may hear this called the Human Guide technique or Sighted Guide technique.

It is a method in which the blind person holds the guide's arm in a particular way so the guide's body movements naturally communicate turns, steps, narrow spaces, and other changes in the environment.

It is more effective than grabbing, pushing, or pulling a blind person.

Orientation and Mobility professionals can teach this technique along with independent cane travel.

Assistive Technology

Assistive technology simply means technology that helps a person perform a task that might otherwise be difficult because of a disability.

For someone who is blind or visually impaired, that may include:

• Screen-reading software that speaks what appears on a computer screen.
• Screen magnification.
• Refreshable Braille displays.
• Talking devices.
• Electronic magnifiers.
• Smartphones with built-in accessibility features.
• Apps that identify text, objects, colors, money, or surroundings.
• Accessible GPS and navigation tools.

The important thing is not owning the newest equipment.

The important thing is finding the tools that solve the problems you actually have.

Recreation and Social Activities

Recreation is an important part of life at every age.

Blind and visually impaired people participate in board games, card games, bowling, golf, swimming, cycling, running, horseback riding, movies, computer games, outdoor activities, organized sports, and many other forms of recreation.

Sometimes no adaptation is needed.

Other times a simple change is enough.

For example, a game may use sound instead of a visual target. Bright contrast may help someone with remaining vision. Raised markings may make something easier to locate by touch. Audio description can make movies and television programs more accessible.

There are also organized adaptive sports programs throughout the United States and around the world, including events represented in the Paralympic Games.

If there is a particular sport or activity you enjoy, look for an adapted version before assuming that vision loss has ended your participation.

Where Can I Get Help?

There are several different kinds of organizations that may be able to help.

State Blindness or Rehabilitation Agencies

Each state has agencies responsible for different disability and rehabilitation services.

The names vary. Some are called a Department of Rehabilitation Services, Commission for the Blind, Vocational Rehabilitation Agency, or something similar.

The programs offered may depend on age, employment goals, income, disability, or other eligibility requirements.

Private Blindness Training Centers

Private and nonprofit organizations may offer blindness skills training, technology instruction, independent-living training, recreation, support groups, or other services.

Some services may be funded through state agencies, grants, insurance, donations, or private payment.

Consumer Organizations

There are national and local organizations led by blind and visually impaired people themselves.

These organizations can be especially useful because they provide the experience of people who actually live with blindness every day.

They may offer mentoring, advocacy, conventions, local chapters, scholarships, information, training, and opportunities to meet other blind people.

Community Organizations

Local civic organizations, churches, charities, libraries, senior programs, and community groups may also offer assistance, transportation, equipment, activities, or connections to other services.

Where Should I Start?

You do not have to solve everything at once.

If blindness or vision loss is new to you, begin with a few basic questions.

First, make sure you understand the medical condition as clearly as possible. Ask your eye-care professional what is happening with the vision and whether treatment, glasses, low-vision devices, or other medical care may help.

Second, find out what blindness or low-vision services are available where you live.

Third, identify the most important problem affecting everyday life right now. It might be reading, transportation, cooking, school, work, using a computer, identifying medicine, or something else.

Start there.

You can add other skills as you need them.

Blindness affects how information is received, but it does not remove a person's ability to learn, work, participate, contribute, and enjoy life.

Sometimes the greatest first step is simply discovering that another method exists.

Additional Resources

Listening Acuity maintains a separate Online Resources page containing organizations, training resources, products, services, and other information related to blindness and visual impairment.

Rather than trying to remember every organization listed here, use the Resources section of Listening Acuity whenever you need to look for a particular type of assistance.

The important thing is to know that help is available and that you do not have to learn everything at once.