Updated January 30, 2007

Tools and Techniques for Visual Impairment

by Connie Kleinbeck, R.N., B.S.N., C.D.E.

Diabetes is the leading cause of new blindness for American adults between the ages of 20 and 74. The American Diabetes Association (ADA) estimates that 12,000 to 24,000 people in the United States lose their vision to diabetic retinopathy each year. But retinopathy is not the only eye disease associated with diabetes. Having diabetes also raises the risk of developing cataracts, glaucoma, and several other eye conditions that can cause severe visual impairment.

While in many cases severe vision loss can be prevented through attention to blood glucose and blood pressure control, the sad reality is that many people with diabetes are living with significant visual impairment. However, life doesn’t stop because of vision loss, and the good news is that there are many resources and tools to help people with visual impairment manage their diabetes and get on with their lives.

Resources
Low-vision and blindness agencies are available in every state. Your physician, diabetes educator, or another of your health-care providers may be able to refer you to a low-vision or blindness rehabilitation center or agency or to an occupational therapist to help you learn to use the remaining vision you have, learn nonvisual techniques as necessary, and remain as independent as possible.

If you cannot get a referral from one of your health-care providers, the information office of your state government can provide contact details for your state’s blindness rehabilitation agency, and it may also have information about private agencies and veterans’ services in your area. The American Foundation for the Blind also maintains a list of services for blind and visually impaired people organized by type of service and area. (Call [800] AFB-LINE [232-5463] or visit www.afb.org for more information.)

Services offered by low-vision and blindness agencies generally include instruction in daily activities such as cooking, cleaning, taking medicines, identifying clothing, and shopping. Instruction also covers the use of adaptive devices, lighting, magnifiers, and computers, as well as orientation and mobility training. Employment accommodations and training may be offered. Some individuals may learn to use Braille. Many of the instructors who work in low-vision and blindness agencies are certified by the Academy for Certification of Vision Rehabilitation and Education Professionals in low-vision therapy, orientation and mobility, and vision rehabilitation therapy.

Orientation and mobility training can help a person to move safely in or out of his home. Training may include the use of a white cane, guide dog, or sighted guide. Learning and using good orientation and mobility skills will have lifelong implications for a person’s ability to participate in social, recreational, educational, and employment opportunities.

Rehabilitation services specific to diabetes are available in some areas, too. The American Association of Diabetes Educators has a Disabilities/Visual Impairment Specialty Practice Group. The educators who belong to this group have a special interest and expertise in helping individuals with visual impairment or other disabilities learn diabetes self-management skills. (See “Resources” for contact information.)

The National Library Service for the Blind and Physically Handicapped has a free library program for people who cannot use standard printed materials. Braille and audio materials (talking books) are circulated to eligible borrowers in the United States by postage-free mail. Special cassette players are loaned free of charge to those who borrow talking books. The book collection is similar to what one might find at a public library, and many magazines can be borrowed, as well. An application for services must be completed before books are loaned. (See “Resources” for contact information.)

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Connie Kleinbeck is a Certified Diabetes Educator at Truman Medical Center Hospital Hill in Kansas City, Missouri, and a member of the Disabilities/Visually Impaired Specialty Practice Group of the American Association of Diabetes Educators.

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