You may wonder how the phrases in the title connect? Read on! February is both Age-Related Macular Degeneration (AMD) Awareness Month and Low Vision Awareness Month. If you have recently been diagnosed with AMD and experienced some of the frustration and grief that seem to arrive simultaneously with the onset of a vision loss, you will not be surprised to learn that there is a high incidence of clinical depression among individuals recently diagnosed with AMD. In a 2001 study, published in Ophthalmology, researchers found that the rate of depression among those over the age of 60, diagnosed with AMD was 32.5 percent, double the rate for a comparable group of individuals without AMD. This research has been replicated by other studies with similar outcomes.
Vision Loss Can Affect Your Quality of Life
This research points to what we all might consider obvious—vision loss can make it difficult to maintain many of the daily activities we consider important for our quality of life—independent transportation, reading, using the computer, leisure activities, etc. What may be less obvious is the downward spiral vision loss can initiate. If these important activities of daily living are restricted, quality of life is reported to deteriorate. As the quality of life deteriorates, the depression compounds and begins affecting other areas of life not originally affected solely by the vision loss.
One thing that seems to stand out in this research is that a functional decline in the quality of life is linked to subsequent depression, which then contributes to greater functional decline.
Maintaining Functional Quality of Life
If depression is linked to a functional decline in the quality of life, how then do we retain that functional quality of life and avoid the onset of depression? A 2005 study by Horowitz and Boerner identified certain areas of vision rehabilitation over a two year period of time as having a positive effect on reducing depression among the individuals in their research. Among other things, they reported that the acquisition and use of low vision devices during this training played a key role in reducing depression among study participants by 10 percent.
Importance of Knowing What Is Available to Help
It has been my observation that most of the clients referred to me with a recent vision loss have no idea what low vision devices or technology is available for individuals with low vision. Most people new to vision loss probably have no clue that the smartphone in their pocket most likely has both a screen magnifier built into it and text-to-speech (the phone will read much of what is on the screen). The same is also true for the computers and tablets we use every day.
Among other things, AMD can make it difficult to see the screens on the devices we use to stay "connected" to the world. How would you know these "accessibility" features come on Apple’s iPhones and iPads, Android tablets and phones, Macs, and Windows computers? That silly truism we hear all the time, "You don’t know what you don’t know," certainly applies to vision loss. Unless your circle of friends and family includes someone using an iPad with a screen magnifier and VoiceOver (the text-to-speech screen reader), you’ll have no idea that it can make text larger and easier to read or read it for you, using some specialized gestures or by learning new keyboard shortcuts.
Of course, there is a learning curve or some adjustment needed whenever an adaptation, like a screen magnifier, is first used, but it is this type of assistive technology (AT) that enables users to continue using their computers, tablets, TVs, and phones.
In addition to what is already on these devices, there is a whole world of specialized assistive technology devices that can compensate for vision loss. Take, for example, the wide array of video magnifiers or CCTVs on the market. Although they come in different sizes and shapes, they all use a camera of some sort to project a magnified image on a screen—TV, computer, or tablet—to make print easier to read or see distant objects more easily.
Being Open to Alternatives
Retaining the ability to continue doing those daily living skills we’ve taken for granted, like reading, also means developing or invigorating our openness to alternatives. I am always both surprised and empathetic when a client tells me they are not interested in the free National Library Service Talking Books program because "listening to books is not the same as reading books." I said the same things for years, reading less and less because it had become more difficult with a vision loss. Eventually, I got tired of not doing one of the things I loved. The naysayers are correct, it is a different way of reading, but I’m so much happier reading again, with my iPad, Android phone, Talking Book player, Audible on the Amazon Echo, etc.
It would be completely unrealistic to suggest that the challenges faced adjusting to a recent vision loss from AMD, or any other eye disease, could be quickly and easily surmounted with a piece of technology and a willingness to be open to new ways of doing the things we loved doing…the old way, with better vision! The research shows there is a very real chance that it is not the vision so much that will ultimately reduce the quality of our lives, but allowing ourselves to let go of those activities that have been so meaningful to us, feeling loss of control of our lives, and becoming depressed from the perception that our quality of life has diminished.
Start with that phone in your pocket, the tablet your grandchild has, a couple tech articles on VisionAware, a call to your state’s agency for the blind or visually impaired or to a local vision rehabilitation agency to locate a vision rehabilitation therapist to learn a few adaptations for doing the things you love! It’s Low Vision Awareness Month; learn more about what you don’t yet know!
Brody, B., Gamst, A., Williams, R., Smith, A., Lau, P., Dolnak, D., Rapaport, M., Kaplan, R., & Brown, S. (2001). Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration [Electronic version]. Ophthalmology, 108(10), 1893-1900.
Brown, R. L., & Barrett, A. E. (2011). Visual impairment and quality of life among older adults: An examination of explanations for the relationship. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 66(3), 364–373.
Horowitz, A., Reinhardt, J., & Boerner, K. (2005). The effect of rehabilitation on depression among visually disabled older adults [Electronic version]. Aging Mental Health, 9, 563-570.