Solutions

The first thing we need to cover is visual aid prescriptions. Understanding what the specifications mean helps to guide a persons best match. Terms relating to power and diopter need to be covered.

Magnification power:

Magnifying or reading glasses usually have their magnification power listed as a number followed by an X, such as 2X. The "X" means that is the power rating, or the size of enlargement. A 2X magnification makes items appear to be twice as large, 4X yields four times, etc.

When choosing visual aids, keep in mind that the trade off for the enlarged object is a loss of total visual area. It is best to pick the lowest amount of magnification needed to comfortably view an object so that more area of the object is available at any given time.

Diopters and focal length:

A diopter is the measurement of refractive strength, usually marked as a number followed by a D, such as 10D. A plus or minus sign before the number indicates a positive or negative property.

A lens rated at one diopter (+1D) will focus at a distance of about 40 inches (one meter) from an object. The distance (in inches) of best focus (or focal length) can be calculated by dividing 40 by the diopter value. A +60D lens (such as the average human eye) will focus at 40/60 or 2/3 of an inch (just over 22 millimeters).

Focal length is an important factor because it determines how close an object must be to the lens. A person would want to choose a visual aid with a realistic working distance in mind. Many visual aids have two focal length ratings, one for the distance between the object being viewed and the aid and one for the distance between the aid and the eye. The second value is usually not posted for glasses and contact lenses as it is usually a standard measurement.

Binocular and telescopic ratings:

Binoculars and some visual aids are marked with specifications similar to 8x21. In this example, 8 is the power magnification and 21 is the size of the front lens in millimeters. The size of the lens determines the amount of light which can enter into the system.

Visual aids:

Now that the properties are defined, we shall look at some of the available visual aids. There is a huge variety of styles and options in each one of these groups. The types and abilities are also always changing.

Here we will cover the more common visual aids. Glasses and contacts, magnifiers and binoculars, sunglasses, and finally surgical options to improve vision.

Glasses:

When the eyes are not able to clearly see objects, glasses might be a good solution. Glasses contain convex or concave lenses depending on whether they are treating a near-sighted or far-sighted condition respectively. The power level of the glasses is determined by the severity of the bend of the lens. The lens in glasses are designed to perform the same basic function as the lens of the eye, but the lens of the glasses help to start the focus process to make up for what the eye cannot do.

Bifocals are glasses with two different prescription values on one lens. Usually one part is for help with distance viewing and the other for close work such as reading. It is possible to need different prescriptions for each eye as well.

Contact lenses:

PLEASE NOTE:

Serving the same basic function as regular glasses above, contacts are popular with people who don't want to wear glasses due to appearance or possibility of the glasses falling off. Contacts are placed on the eyes surface and held in place by the eyelids and the eye fluids. Contacts are made to meet prescription specifications just like glasses.

Contacts need to be kept very clean since they rest on the surface of the eyes. Some people may experience allergic reactions or sensitivity to the chemicals used to clean contacts or problems with the eye adjusting to the new addition.

Contacts require much more maintenance than glasses. Most contacts are worn through the day but must be removed during sleep periods. Extended use contacts can be worn longer, but still need regular removal for cleaning. Some people have difficulty putting in contacts and it is possible for contact lenses to fall out accidentally.

Rigid contacts are made of shaped solid transparent material. Since they are not flexible, they can take some time to adjust to. They can also cause eye fatigue and may even scratch the eye or eyelid if they move around. These also inhibit the proper flow of oxygen to the conjuctiva, which can become a problem.

Gas-Permeable contacts are much like the rigid contacts, but are designed to allow oxygen to flow through them. They are also a bit more flexible which allows for a better fit.

Soft contacts are even more flexible and are designed for a more comfortable fit.

Giant papillary conjunctivitis (GPC) can occur with soft contacts. It is an allergic reaction which may involve discharge from the eye and irritation. People affected by this should switch to the gas-permeable contacts or discontinue using contacts altogether. Episcleritis is a sensitivity reaction where the eye becomes red in one area. It occurs with rigid or soft contact lenses.

Magnifying glass:

Magnifiers come in a variety of shapes, sizes, and powers. These are made up of a convex lens (middle thicker than the edges) whose strength (magnification power) is determined by the severity of lens curve. A magnifier is often used for limited periods of time to do a specific task, such as reading fine print in a phone book.

Binoculars And Telescopes:

Like magnifiers, binoculars and telescopes come in a variety of shapes, sizes, and powers. They are different though in that magnifiers are designed for enlarging close objects while binoculars are designed for enlarging distant objects. Most binoculars have magnification powers of 8x to 15x with some models having a range of adjustable power (called zooming). Personal telescopes have magnifications of 250x to 750x and are used for even farther distant objects, such as astronomy viewing.

Most binoculars are hand held devices that require both of your hands to control (one hand needed for focusing or zooming). Now you can also get binoculars that have head-mounting ability or even some which clip on to the frames of glasses and flip out of the way when not in use.

Sunglasses:

Believe it or not, sunglasses are considered to be a visual aid as well as eye protection, especially for people with Aniridia. Sunglasses have shading material that limits the amount of light which is allowed to enter the eye. This provides relief from bright sunlight causing glare or eye fatigue. In addition to help with shielding of bright visible light, many sunglasses now protect from harmful ultraviolet (UV) light which can be present even on overcast or cloudy days. Protecting the eye from ultraviolet light is said to increase its life expectancy for normal functions. Always read the labels on sunglasses to determine the level of UV protection they offer.

Also available are glasses that combine glasses prescription with shading qualities. There is also a style of sunglasses available which changes its shading as the light intensity changes. They provide less shading in lower light environments and more shading in bright light. Be sure to inquire about the reaction time of these before purchase.

Surgery:

While surgical correction methods offer the best cure for vision problems, the subject is far to complex to cover all of them here. Surgery is an issue best left discussed between a patient and doctor.

There are two main types of surgery, incision and laser. Incision surgery is where a doctor operates by hand and uses tools within the eye. Laser surgery involves a machine which uses a laser beam to perform the operation. Laser surgery often requires very little incisions, usually just the conjunctiva and cornea is peeled back for this.

People with Aniridia will often face surgery to correct problems associated with the condition. Kerato-Limbal Allograft (KLA or KLAL) surgery is incision surgery to replace some of the corneal (kerato) stem cells (limbal) with good stem cells from donor cornea. Many people with Aniridia also develop cataracts which is a clouding of the lens. Cataract removal surgery is usually an incision surgery for Aniridics as the surgeon may recommend replacing the damaged lens with an artificial one during the operation. Glaucoma (high internal eye pressure) is another condition which Aniridics face that may be addressed by surgically placing a shunt in the eye drainage canal.

It is VERY important to consult a physician or surgeon who is very familiar with your particular condition(s).

In this section, we will show you pictures of some of the visual aids that are currently available. The picture quality is not the best in the world, but at least you can get an idea of the size of these devices as well as their general physical styles. Along with the pictures, we have included some text for each device to help you to better understand what it does best and its other important properties.

This picture shows eleven different visual aids side by side so that you can compare them by size. The size and design of each device is as unique as its intended benefit, natural limitations, and cost. No visual aid that I am aware of is best suited for all situations or conditions.

The first visual aids we will discuss is a regular pair of binoculars. It might seem trivial to people with good eyesight, but this device helps people with low vision to see things from a distance that others could see without it. It could be used for watching birds and looking at scenery on trips. It will not help to read small print nor would it be useful for most everyday duties.

Pictured here is a colllection of assorted styles of magnifiers. The lower power magnifiers can be used to read material that is just a bit too hard to read without an aid. The higher power devices come in handy for reading from the dictionary or phone book. The one problem with all of these devices pictured is that they require the use of one hand to hold them. You cannot hold a book and turn the page while holding a visual aid in place all at the same time.

One device not in this picture (but is in the picture of all devices together, (bottom righthand corner) is the flat page magnifier. These may come with a stand. It is very useful for placing over the page of a book and being able to read without holding the magnifier in place or having to move the magnifier back and forth as you read.

Pictured here is a colllection of assorted loupes, often called Jewelers loupes because they are commonly used in fine jewelery work. These are available in a range of sizes, styles, and magnification powers. Some of these have multiple lens sections that can be combined to allow many magnification powers from the same device, such as the square white loupe on the righthand side of this picture. Normally loupes have higher magnification powers than standard magnifiers.

Loupes are more useful for reading minimal amounts of material at a time because of the small lens size. For example, you would use a loupe to read parts of your favorite recipe rather than reading the whole newspaper. Some people use loupes for reading thermometers, dial settings (on stoves, washing machines, etc), and have a CCTV (see below) for reading books or other printed material.

The drawback to loupes is that since they are handheld devices there tends to be less light available around the object being viewed. One solution to low light situations is using a lighted magnifier (bottom of this picture). These are normally battery powered devices with a small light mounted to direct light at the viewing object. While they offer a brighter image, they normally are lower power magnifiers.

The Beecher Mirage was one of the first visual aids available that was worn like a pair of glasses. They are still available today from low vision centers. It is said to be similar to opera glasses in power and style. The device is just like a pair of binoculars, except that it mounts on a headband for handsfree usage. This device can be useful for watching TV and movies. The front lens is higher than eye level, which allows you to see your regular view around the small eyepieces where the magnified view appears. Reading caps can be obtained for the Mirage that slip on the front lens and allow for reading instead of distance viewing.

A spotting scope is a monocular (for one eye) device which offers up to 50x power magnification. It is the largest and heaviest visual aid that is covered here, but it also offers over three times the magnification of the second best pair of binoculars here. It would be useful for distance viewing such as bird or wildlife watching or looking at scenery.

Here are two other binoculars which are smaller than what we have discussed above. They offer easier portability and can be used while traveling to read street or business names.

This monocular mounts to glasses (either prescription or clear) and can flip up out of the view with the motion of one hand. Because it mounts to glasses, it offers hands free usage. It is also very light and does not cause much added pressure to the nose in extended wearing.

This is another view of the device mentioned above. One very nice feature of this device is that it allows one hand focus ability, which will also quickly adjust between distance and close (reading distance) viewing. It closely matches the Mirage mentioned above, but is much lighter and less obstructive in the normal view.

This is a CCTV (closed circuit TV) device made to magnify text and objects. There is a camera which points toward a section of the movable tray. The picture on the monitor can be controlled with a few adjustment knobs for focus, magnification, contrast, and even some line reading guides. The device can greatly enlarge small print and will also allow visually impaired people to trim their own fingernails and other difficult tasks. Almost anything which can be placed between the camera and the tray can be greatly magnified with this device. In this picture, the screen shows the lowest magnification setting while viewing dictionary print. This shows 20 lines and 53 characters from this dictionary.

In this picture, the screen shows the highest magnification setting of the CCTV above while viewing the same dictionary print. It shows 3 lines and 7 characters with this setting. For reference, the measurements of a standard character in this dictionary is 1/16" wide. The character was 1/4" wide on the screen at lowest magnification and 3/2" at the highest magnification. This means the magnification power of the device is 4 to 24 times the size of the original object.

There are a number of different types of CCTV systems available today. The type shown above is a tabletop model. Some of these tabletop units feature swivel cameras or trays that can accept different material than the unit pictured above. There are also tabletop units which have the camera mounted on a swivel arm which takes away the limitation of the material needing to be able to fit on a tray. There are also many types of portable CCTV systems that use much smaller LED screens instead of a monitor/TV type of display unit. These portable units can have a variety of camera systems including those mounted on a frame for book reading ability and those that can be slid across material such as you would use a computer mouse.

There are many more visual aids available. This is just a sampling so that you can get an idea of what each type might look like and the tasks they would most likely be useful for.

Not all vision problems can be treated or corrected by visual aids. Therefore, it is only logical to mention other tools or methods which can improve the quality of life.

Braille:

Books on tape:

Check guides:

Computer software:

Many of these places will also carry voice recognition software. This allows the user to speak commonly used commands instead of typing or clicking. These are usually restricted by the number of commands they can store and the ability to detect speech. If you have a cold for instance, they may not pick up the commands.

Guide dogs:

Identity devices:

Brightly colored stickers can also be helpful in identity of products. Some people can identify the sticker but could not read the label. This type of marker system has been used for a variety of products such as buttons on tape recorders (red for record, blue for play, etc) and the controls on microwave ovens (green for start, red for stop, blue for timer setting, etc).

Stamps:

Talking devices:

Tape recorder:

Some recorders use cassette tapes. Digital recorders are widely available today, but usually have limitations on the length of recording time or the way you have to go about storing and retrieving messages.

These are just a few of the many tools available to help. Since technology is always expanding the options, be on the lookout for more options in the future.