VisionAware

It’s surprising to a lot of people that something as basic as adequate lighting can be so effective at helping those with vision loss to continue their everyday activities with little or no assistance. Reading, writing, cooking, housework, gardening—your ability to perform all of these and a great many other tasks will greatly benefit by making appropriate lighting choices.

Lighting

There are four basic types of lighting scenarios to consider:

When and where it’s available to you, sunlight (or natural light) is always your best bet. Nature’s light works best because it is “full spectrum,” meaning that it contains all the visible colors of light in equal amounts. This results in a warm, pleasing light that fully illuminates any environment.

Pros: The best, most natural light source that exists; brings out excellent contrast; good for all outdoor and indoor tasks.

Cons: Not always constant or reliable (clouds don’t respect your schedule); hard to control—changes in the amount of light can be sudden and dramatic, which can cause pain and other problems for eyes that have difficulty adjusting to lighting changes; can produce outdoor and indoor glare and shadows.

Tips:

• Lattices, adjustable blinds and sheer panel curtains are great for reducing sunlight without shutting it off completely.
  
  
• Sunglasses or hats with visors limit the amount of light that enters the eye.
  
  
• Keep windows as clean as possible.
  
  
• Minimize glare by using window tinting, blinds, or curtains. You can also reduce glare by working with your back to the window.
  
  
• Change the times at which you do certain tasks, e.g., chop vegetables at 2 pm rather than 5 pm.

Bottom line: Natural light is always your best alternative so long as you have the means to control it.

At its most successful, artificial lighting should replicate natural light’s full color spectrum (and its warm tone) as much as possible. Fortunately, you have several viable options:

 Overview of Lighting Video

Fluorescent Lighting

If you attended public school or spent time waiting in line at a government agency, then you may harbor a negative impression of fluorescent lighting. For a long time fluorescent bulbs were dull, flickery things emphasizing the darker end of the color spectrum (green, blue, violet).

Fluorescent lighting has come a long way. Full spectrum or warm fluorescents are now available in several wattages (10, 14, 20, and 25) and are used in ceiling fixtures and other areas, such as under kitchen cabinets. Compact fluorescent bulbs fit into regular lamp sockets and provide illumination that is comparable to incandescent light without the heat.

Pros: Provides cool, evenly spread illumination—better than incandescent for general room lighting; does not create shadows; inexpensive and energy efficient, provides cool lighting.

Cons: Science hasn’t completely licked the flickering problem, which can produce a “strobe” effect; eye strain and headache are possible if bulbs aren’t properly covered; cannot be dimmed as easily as incandescent light.

 Use of Fluorescent Lighting Video

Incandescent Light

Probably the most common and familiar lighting choice for the home, incandescent bulbs generally produce a “hot” light that emphasizes the red/orange/yellow end of the light spectrum, although full spectrum incandescent lights are now available (see info below). Bulbs are available in clear and “soft white” finishes and are used primarily in table and floor lamps and ceiling fixtures

Pros: Produces a highly concentrated light that is best for “spot” lighting for close work tasks such as reading and sewing. Light is very stable (no fluorescent “flicker”) and can be easily controlled with a rheostat or dimmer switch.

Cons: Not recommended for general room lighting—it creates shadows and glare spots. As wattage increases, so does the amount of heat, making prolonged close work problematic. Also, bulbs create areas of bright light within a relatively dark room—an issue if your eyes can’t easily adjust to abrupt light changes.

Tips:

• Position several incandescent fixtures in a room to create a more even light throughout.
  
  
• Use shades to reduce pinpoints of light.

 Use of Incandescent Lighting Video

About “Full Spectrum” Bulbs Full spectrum bulbs simulate natural sunlight by emitting fewer ultraviolet and infrared rays than conventional bulbs, which reduce the emission of yellow light. The effect is a more vivid “true” color with increased contrast. Full spectrum bulbs are available in supermarkets, but a type called chromalux can be ordered through specialty catalogs. Full spectrum bulbs are also available in several different wattages.  Use of Full Spectrum Lamps Video

Halogen Light

Halogen bulbs emphasize the red/yellow/green end of the light spectrum and create an even more concentrated light than regular incandescent bulbs. This type of light can be found in floor lamps, track lights, and recessed ceiling fixtures. In general, halogen light is not recommended for people with vision loss.

Led Light

LED lights are usually on the cooler side of the color spectrum and can be very bright. LEDS are best for doing close-up work such as doing crafts or reading. Lighting an entire room with LEDS can be too intense.

LED video: Use of Light Emitting Diode (LED) Lighting – VisionAware

Combination Lighting

No single lighting option is adequate for every task. You may want to experiment with a mix—incandescent bulbs for close tasks and fluorescent bulbs for general room lighting. This option utilizes the best features of both types of lighting to create a full spectrum light in any room. Lamps with combined fluorescent and incandescent bulbs  or LED bulbs are available from lighting supply stores and specialized resources.

• Experiment with several types of lighting. Some people may prefer incandescent, some fluorescent, and some a combination of both.
  
  
• Experiment with different placements of lighting.
  
  
• Cover or shade bulbs. Choose a covering that reflects the light off the ceiling or walls before it hits the eyes; reflective light produces excellent light while also reducing glare.
  
  
• Use stronger light bulbs or 3-way bulbs to provide no-glare lighting.
  
  
• Put lamps in places where you do close work. For example, put a gooseneck lamp in your reading-writing area. Many companies make softer light bulbs that simulate natural daylight and can be very helpful to someone with low vision.
  
  
• Install extra lights in the bedroom closet and other frequently used closets and cabinets throughout the home.
  
  
• Put special lighting over all stairways (where serious, even fatal, accidents are most likely to happen).
  
  
• Make sure the lighting level is consistent throughout your home to eliminate shadows and dangerous bright spots. Install rheostats, or dimmers.
  
  
• Be certain you can easily reach light switches from doorways and from your bed.
  
  
• Use night lights in the bedroom, hallway, and bathroom.

Adjustable task lamps are equipped with an adjustable arm and flexible head that allow you to point light where you need it. They can be floor- or desk-standing or wall-mounted. When using adjustable lamps, keep the following points in mind:

• The bulb should be recessed into the shade to reduce glare and to avoid accidental burns.
• When using an adjustable lamp, position the shade below eye level with the light directed onto whatever you’re working with.
• The light should shine onto the task from a 45-degree angle so that excess light shines away from your eyes.
•  Focus an adjustable lamp directly on the task
• You can place the lamp as close as 6 inches (15 cm) from the task. Reposition the lamp if the light is too bright or glare is reflecting into your eyes.
• To be safe, always use adjustable task lamps in conjunction with general room lighting. When you move away from the task, you should be able to see where you are going.
• When you move away from the task, you should be able to see where you are going.
• Use of Adjustable Lighting Video Be sure to assess your visual comfort with each type of light bulb before you buy. Many people with low vision prefer a full spectrum fluorescent desk lamp since it is a cool light, or a desk lamp that’s wired for a 60- or 100-watt full spectrum light bulb.

Lighting and Magnification

Remember:

• Magnifiers can amplify task lighting when you need to see fine detail. When using a lamp with a hand or stand magnifier, be sure to place the lamp so that the light is shining underneath the magnifying lens. This prevents light from shining onto the lens and causing painful glare.
• You can purchase hand and stand magnifiers through specialty product sources, though higher magnification is generally not available to the public without a prescription. It is recommended that you consider having a low vision examination to determine what type of magnification will help you perform specific tasks, and if needed, to obtain higher magnification.
• People with some eye conditions, such as retinitis pigmentosa, experience night blindness and need additional, higher-powered lighting.

Portable Lighting

Portable lighting (for example a flashlight) can be very useful for looking inside cupboards and closets, navigating dimly lighted areas, or finding keyholes in the middle of the night. Small pocket flashlights are also great for nights out on the town, providing an effective, unobtrusive means for reading restaurant menus and theater playbills. Keep one flashlight in the kitchen and one in your pocket or handbag at all times. Another portable option is hands-free lighting, which can be mounted on a headband like a miner’s lamp. Take a look around any bingo hall and you’ll see several players with lighted headbands. This is also an excellent option for card players (your hands are free to deal) and music enthusiasts (whether you play an instrument or sing in your church choir). Clamp-on book lights provide hands-free lighting for reading. 

Portable Lighting Buyer’s Guide:

• LED or halogen bulbs give a bright, white light but the beam of light can be quite narrow. Fluorescent portable lights are also available, but may not produce enough light for your needs.
• Try not to get a light that is too heavy to hold in one hand for extended periods of time.
• Battery changes should be quick and easy. Avoid lights that require a screwdriver to open the battery holder.
• Always try out the light before you buy to make sure that you can use it without problems.

Recessed Lighting

Recessed lighting is one of the best ways you can modify your environment for living with vision loss. Recessed lights are cylindrical cans that are inserted into the ceilings (usually by a licensed electrician) and can be placed strategically to illuminate hallways, kitchens, bedrooms and study rooms. Recessed lights can use flood or spot bulbs. These are dimmable and provide you with a high degree of flexibility. An 85-watt flood bulb in a recessed light offers excellent ambient light while the use of halogen spot bulbs can illuminate specific work areas such as desks, stoves, and eating areas without causing glare. Recessed lights are available in a large variety of sizes and styles.

Track Lighting

Nearly as effective as the recessed option – and much more affordable – is track lighting. Track lighting consists of a ceiling-mounted rail or track fitted with a series of small, adjustable light fixtures. The lights can be pointed in any direction and are very effective at illuminating desks, dining areas, and other work areas. Track lights can use both incandescent and low-voltage halogen bulbs. Track lighting fixtures tend to produce a narrower beam than recessed lights. However, since track bulbs use less energy, you can add more lights where the need is greatest. Please note, however, that halogen lights are very hot, can be dangerous, and may not be allowed in many settings, such as assisted living facilities.

(Information for this section was adapted from Use of Lighting from Vision Australia, and Lighting and Vision from The Dr. Bill Takeshita Foundation.)

As you evaluate the different types and sources of light within your home, it’s also important to check for glare.

Glare

Glare is reflected or uncontrolled light that shines directly into your eyes. Although it is very bright, the light produced by glare does not usually help you see more clearly; instead, it can interfere with your visual comfort, physical safety, and independent performance of everyday activities.

Glare is caused by light that is too bright, making it harder to see, rather than easier. Glare also happens when certain types of vision problems cause the light entering the eye to bounce around instead of coming to focus. Reflective surfaces are another cause of glare, such as highly polished floors, metal objects, mirrors, and tiled or enameled floors and walls.

Glare can make it difficult to see things like your TV screen.

If you move your TV, or adjust blinds or curtains, to avoid glare, the TV screen becomes easier to see.

In many homes, the bathroom is “Glare Central.” The problem is particularly acute when you enter a brightly lit bathroom from a dark hallway or other dim environment.

Eight simple steps you can take to reduce glare in any room:

• Install dimmer switches.
  
• Clean but do not polish floors and other surfaces
• Avoid using wax on the floor; use a flat finish.
  
• Consider replacing harsh-glare surfaces with softer ones—carpet instead of tile, wallpaper instead of enamel, etc.
• In places where glare is unavoidable, use sunglasses, large, brimmed hats, umbrellas or visors.
• White sheet paper can produce a harsh glare—to make reading easier, try placing transparent yellow acetate sheets over white pages.
• Sunlight can fill a room with light without producing glare.
  
• Mini blinds are excellent window coverings because they can be adjusted during the course of the day to eliminate glare.
  
• To make the television easier to see, simply turn the screen away from the sun or a lamp so the light source is behind the screen.

Minimizing Glare Video

Better Lighting for Better Sight

The video series Better Lighting for Better Sight contains information about critical factors that can enhance vision, including different types of lighting, positioning of lights, contrast sensitivity, and control of glare.

Bryan Gerritsen, M.A., CLVT, a certified low vision therapist, lighting specialist, and recognized leader in the area of low vision, is featured in the videos. The videos provide suggestions that may be helpful to professionals and family members in helping the person with vision loss choose the right light for the task.