Impaired vision: What can help in everyday life?

One aspect of impaired vision is the sharpness of the images you see – also known as your visual acuity. This tells us how good our eyes’ “resolution” is. That is determined by checking how far away two points have to be from one another for us to be able to see them separately from a certain distance.

People with normal vision can clearly distinguish two points that are 1.5 millimeters apart when looking at them from a distance of 5 meters (visual acuity of 1.0). That means that if they stand 5 meters away from an eye chart, they can see which way around a c-shaped symbol with a 1.5-millimeter opening is. Young people in particular often have a better visual acuity than 1.0 and can identify the symbol from even further away. The closer you have to go to identify it, the lower your visual acuity.

People are considered to have impaired vision if they have a maximum visual acuity of 0.3 even when using corrective eyeglasses or contact lenses for both eyes. That means they have to be 1.5 meters away from the eye chart to be able to see the opening in the c-shaped symbol. In everyday life, that means they might be able to read the titles in books or magazines, but not the smaller main text.

People who have a visual acuity of 0.05 or less are considered to have a severe visual impairment. Those with a visual acuity of 0.02 or less in both eyes are considered to be blind.

Other types of vision problems can be classed as a visual impairment too, though – such as a severely restricted field of vision. Your field of vision is what you can see when you look straight ahead without moving your eyes. With each eye, it is normally possible to see a total area of up to 150 degrees to the left and right, and up to 135 degrees upwards and downwards. Diseases such as a detached retina or stroke can restrict the field of vision. People with a field of vision of 5 degrees or less in all directions have a visual impairment, even if their visual acuity is normal. If people have both a narrow field of vision and poor visual acuity, even minor restrictions lead to visual impairment.

Restricted eyesight can have far-reaching effects on many areas of life. It might make it more difficult to find your way around and move about outside your home, for instance. Depending on how severe the visual impairment is, you might lose some of your independence and need help from others.

It usually takes a while to accept the new situation and get used to the changes. It can take some determination and creativity to be able to do certain activities, with the help of others or with technical aids. And a lot of everyday tasks simply take more time, even with the help of various aids.

Depending on how severe the impaired vision is, it may no longer be possible to do certain things like reading a book, driving a car or looking up at the stars. Some people find it very hard to accept their new situation for a long time. It can then help to get psychological support.

Talking to those around you about how your impaired vision affects your life can often lead to more understanding and support from them. Many also find it helpful to speak with other visually impaired people – for example, in a support group. There they can talk about things like their experiences with the following aids:

• Magnifying aids such as monoculars (hand-held telescopes), binoculars, magnifying glasses and magnifying spectacles can help to read things like street signs, house numbers and public transport timetables.
• The magnifying or zoom function on smartphones or tablets can also be used to enlarge text or objects.
• Navigation apps can help you find your way around without street signs.
• Digital devices like computers or e-readers allow you to see things bigger and with better contrast, or they can read text out to you.
• Dictaphones or the recording function on smartphones can be used instead of writing notes and lists.

Please note that some of the following information describes the situation in Germany specifically. You may find that things are different in other countries.

Depending on your situation, you could make use of the following kinds of support:

• Aids: Various aids such as screen readers, orientation tools or special canes (often called white canes) can be useful. Mobility training can help you learn how to find your way around using a white cane and other senses. In Germany, if a medical aid that is classed as a "Hilfsmittel" is prescribed by a doctor, you can apply for the costs to be covered by your public health insurance provider.
• State allowance for the visually impaired or blind (Sehbehindertengeld/Blindengeld): In Germany, blind people can apply for monthly financial assistance. In some regions, that's also possible for people with severe visual impairment. The amount paid depends on the region. You usually have to submit the application to your social welfare office (Sozialamt) or your local council, depending on where you live in Germany.
• Long-term care insurance (Pflegeversicherung) support: This includes things like a nursing care allowance (Pflegegeld) and financial assistance to make necessary changes to your home. The type of financial support you can receive depends on the level of nursing care you need. In Germany, that is assessed by experts from, for example, the medical advisory service (Medizinischer Dienst).
• Assistance for the blind (Blindenhilfe): Blind people also receive monthly payments that depend on their income and assets. If you already receive a state allowance for the blind, that is taken into account here too. The nursing care allowance (Pflegegeld) is also partially deducted. Depending on where you live in Germany, the application for assistance for the blind is usually submitted to your social welfare office or your local council.
• Severely disabled person’s ID card (Schwerbehindertenausweis): Above a certain degree of disability (determined based on the level of vision loss in both eyes), you can apply for a severely disabled person’s ID card that offers certain compensations. These may include things like reduced entry fees, the free use of some public transport, and special rights in the working world. You can apply to your local social security authority (Versorgungsamt) for the ID card.

A visual impairment often means that you can no longer work like you used to. Many of those affected are then worried about losing their job. But there are some changes you can make to help you carry on working.

People with a severely disabled person’s ID card have a right to certain support services so that they can continue working. If you don’t have a severely disabled person’s ID card but a degree of disability of 30 or more, you can apply to get equal status with severely disabled people (Gleichstellungsantrag). You can only do this if your own job is at risk because of your disability or you can't find work. This equal status entitles you to many kinds of support that people with a severe disability are also entitled to. They include financial support

• to adapt your workplace to your disability – for example, using technical aids like magnification software, screen readers or large print keyboards,
• to get to work – such as with a transport service, and
• for regular assistance at work – from a certain person who helps you with professional tasks, perhaps by reading things out to you.

People with a severely disabled person’s ID card and those with an equal status also have special protection against being fired or made redundant. The German pension insurance fund's (Rentenversicherung) rehabilitation advisors can provide information about what types of support are available in your specific situation.

Another solution is sometimes to switch to a different profession which is more compatible with the visual impairment. Employment agencies (Arbeitsagentur) and vocational advancement centers (Berufsförderungswerk) can provide advice about vocational training, continuing education and changing your profession. People who can hardly work or no longer work at all might be entitled to an invalidity pension (Erwerbsminderungsrente). The German pension insurance fund (Rentenversicherung) can provide further information about this.

Visually impaired people may have a lot of questions and concerns. Those living in Germany can find local information and advice services through a search function on the website of the German Federation of the Blind and Partially Sighted (DBSV: Deutsche Blinden- und Sehbehindertenverband). The website also has a list of psychotherapists who are experienced in therapy with visually impaired people. There is a search function for support groups, too.

For more specific matters, you can also contact the following places:

• Independent Patient Advice Service Germany (Unabhängige Patientenberatung Deutschland) – for information about your rights as a patient, for example
• Your own health insurance provider’s telephone or online information and advice services – for instance, to apply for aids, home help or nursing care support
• The German statutory pension insurance fund’s (Deutsche Rentenversicherung) information services – for things like information on making your workplace accessible or invalidity pension payments
• Social security authorities – to apply for a severely disabled person’s ID card, for example
• The German Federal Employment Agency (Bundesagentur für Arbeit) – for things like equal status applications and advice about changing profession
• Integration and inclusion authorities (Integrationsamt/Inklusionsamt) – to ask about assistance at work, for example
• Counseling centers run by local authorities or welfare associations such as Caritas or Diakonie – for things like advice about financial difficulties
• Psychosocial support and information centers (psychosoziale Beratungsstelle) – for help with psychologically distressing situations and emotional crises