Living with Low Vision

How does aging affect our eyes?

Between the ages of 40 and 50, the lens of the eye begins to gradually lose elasticity. This makes it harder to focus for close-up activities such as reading. As you get older, the lens of the eye also becomes thicker and yellower. These changes may affect the way you see colors and contrast. For instance, the color blue may appear darker and harder to tell apart from black or green. As the eye ages, the pupil gets smaller. This means that you need more light to see well, along with more time to adjust to changing levels of light (going from daylight into a dimly lit room, for example).

You may have low vision even though you do not have medical problems such as cataracts or glaucoma. However, if you notice any change in your vision, you should have an eye exam as soon as possible.

What problems does low vision cause for older adults?

• Light and glare
  • You may need environments with more lighting than younger people. For example, what may seem like bright lighting to some may seem very dim to you.
  • You may struggle with glare from large windows that face the sun or when there are very bright indoor lights. These large amounts of light have a partial blinding effect. The older eye also takes longer to recover from glare than younger eyes.
• Colors
  • Rooms and facilities decorated in pastels may seem very dull or gray to you. Older adults who spend a lot of time in these environments may feel depressed by the constant drabness of the colors they see.
  • It is difficult to match clothing when many colors look alike. Older women may not realize the intensity of the cosmetics they are using. They may wear more make-up than expected. This may affect the way people treat them.
  • Medicines come in various colors, but many pills have similar shapes. It may be hard for you to tell one medicine from another based on their colors
  • Problems with seeing colors may make it hard for you to see when your food, especially meat, is done cooking.
  • Changes in skin color may be harder for you to notice than when you were younger. This may mean that you may not see bruises, rashes, or changes in moles and so may not get treatment.
• Depth perception
  • You may have a harder time judging distance than when you were younger.
  • You may have trouble judging the depth of the bathtub or a stair step. This is dangerous because your bones may be more brittle and break more easily if you fall. If you fear that you will fall in an unfamiliar place, you may be less willing to leave your home.
• Contrast sensitivity

  It may be harder to tell lighter colors from darker colors. You may have a hard time recognizing even the people who are most familiar to you. If you cannot see someone’s lips, it may be harder for you to communicate if you are also hard of hearing and so rely on reading lips.

• Visual acuity
  • It may be harder to see detail and to read small print. Phone books and advertisements are often printed in small type. This can make it hard for you to find needed information. Labels on products such as food and medicines use very small typefaces, so preparing meals and taking medicine correctly may become more of a challenge. Any printing that is small may be hard for you to read without help. Rather than ask for help, you may ignore important information sent to you, for example, information about insurance benefits. Then you may get frustrated because you do not understand your benefits.
  • Menus, bibles, sheet music, and playing cards are often printed in small print, making them difficult to read. Rather than deal with the frustration, some older adults may choose to avoid social activities altogether.
  • You may also have trouble reading clocks, watches, telephones, television remote controls, and stove and oven controls. Poor vision may make it hard to do tasks such as mending clothes or sewing buttons.
  • Elderly men may shave less often because it may be hard to see the stubble growing on their face.
• Visual field
  • The area you are able see when you look straight ahead may be smaller than when you were younger. If you have a reduced field of vision, you may not be able to see possible dangers, such as cars pulling onto the road, people, animals, or emergency vehicles.
  • Reading signs while you are driving can also present a challenge. You may need to slow down to read a road sign, but this can put you at risk for an accident in fast traffic.

What can I do to help myself?

Get regular eye exams so you can get help for any vision problems you have. There are aids and tools you can get that will help you read, write, and manage daily living tasks. You can try magnifying aids, audio tapes, electronic reading machines, and computers that use large print and speech.

Less than perfect vision does not have to hamper your lifestyle. Here are some simple changes that may help:

• Write with bold, black felt-tip markers.
• Use paper with bold lines to help you write in a straight line.
• Put colored tape on the edge of your steps to help you avoid a fall.
• Install dark-colored light switches and electrical outlets that you can see easily against light colored walls.
• Ask if large print material is available from Medicare, insurance companies, pharmacies, and the library.
• Use motion lights that turn on by themselves when you enter a room. These may help you avoid accidents caused by poor lighting.
• Use contrasting plates, tablecloths, place mats, and napkins. Use light or dark colored plates, glasses, or cups to contrast with food and beverages. Use a cutting board that contrasts in color with the items that you are cutting.
• Use telephones, clocks, and watches with large numbers, and put large-print labels on the microwave and stove.
• Organize clothes by color or by matching outfits. Use a safety pin to tell black and navy colored items apart. Identify garments by textures and style rather than just color. Alternate light and dark colors in your closet. The contrasting sections will help you locate the color you want.
• Label medicine caps with a bright color code system using nail polish or colored dots.
• Keep lights on during the day so the lighting doesn’t change as much when you move between outdoors and indoors. When arranging a room to be used for reading or working, position seating so that windows are behind you or to your side. Don’t face the windows. If this is not possible, use blinds or shades to control the light during daylight hours. Avoid using a very bright lamp in a dark room.
• Most people use black, dark brown, or gray luggage when they travel. Use brightly colored (red or yellow) luggage so your luggage stands out from the others on the carousel. If you already own dark-colored luggage, tie a brightly colored ribbon to the handle to help you know which suitcase is yours.
• Ask the pharmacist to explain how you should take your medicine. Ask about the dose, best time to take the medicine, and possible side effects. Record the information on a tape recorder.
• Take advantage of medicine organizers available in drug stores. They come in a variety of shapes, sizes, and contrasting colors. Or ask your pharmacist to use different size bottles when filling your prescriptions.