An Overview of Low Vision Devices and Technology
by Dan Roberts
Can a blind person see? Most thoughtful people now understand, or can be led to understand, that a blind person can indeed “see”. Just not with the eyes. Modern science has shown that it is our brains that see by interpreting the light signals sent from our retinas. And even without such light input, the brain can still create pictures, like when we dream in the dark of night. Or when we imagine, because the word itself means “to form a mental image”.
So if our brains work properly, and our eyeballs do not, our challenge is learn other ways to activate those images. Early humans knew that. They knew that when darkness fell they would have to depend upon their nonvisual senses to navigate, relate to one another, perform their nightly routines, and understand their environment. It was either that or sleep all night. But who can sleep until dawn when that Paleolithic baby in the next cave has colic?
I’m thinking that one of the first low vision assistive devices was probably a fire torch. With a torch, Mr. and Mrs. Paleo could see better in the dark, which made their days longer and more productive. And today, a million years or so later, I’m happy to announce that we not only have torches of the electric variety, but we have at least 25 types of devices specifically designed to help us see. And not just in the dark, either. People whose eyes don’t even work well in the light have a huge buffet of substitutes and supplements for eyesight. But there are so many choices that it’s difficult to know what’s out there and which will work best for us. Or even whether or not we actually want or need most of them.
So I’ll present these gadgets in four categories, beginning with the earliest and simplest to the most modern and advanced. This might aid us in making effective decisions about how best to satisfy our needs. And at the very least, we’ll know what is available to us if and when we need more help. The four categories are:
- Surgical implants
Non-optical devices enhance or replace vision without use of a lens. Some have been around for a long time, such as:
The mobility cane, probably the earliest low vision device: a long stick that allows us to feel and hear ahead of our footsteps.
Large print and graphics, the first attempt at magnification, now applied to books, phones, calculators, clocks, playing cards, and other games.
Daily living aids like magnification mirrors, raised stick-on dots and tactile labels, bold tipped writing pens, tactile and highlighted writing paper, writing templates, liquid level meters, and needle threaders.
With the advent of electricity, torches evolved into flashlights and lighting of all kinds, the most useful of which is bright task lighting for reading and other close-up needs.
Books on tape were made possible with the invention of audio tape. They are still available in that format, but CD and digital technology is swiftly taking over. The Talking Books program, sponsored by the National Library of Congress, makes more than 50,000 titles available at no cost through local libraries.
Before moving on to higher technology non-optical devices, let’s not forget the good old-fashioned land-line telephone. For many people, this continues to be a trustworthy and effective device for the price. It may not help you directly to see better, but you can call low vision support help lines for information, you can connect to a reading service to hear the latest news, and you can order free company catalogs containing nearly all of the devices mentioned in this presentation. There is even a free live support group called TeleSupport that meets monthly by telephone. To contact the NFB-NEWSLINE® telephone reading service, call 1-866-504-7300. To learn about TeleSupport, call 1-888-866-6148. For low vision hotline phone numbers of various organizations, visit www.mdsupport.org/information/md-portal . To find dealers in low vision devices, visit lowvision.preventblindness.org/resources-2.
All of the non-ocular devices I have mentioned so far require the sense of hearing to substitute for eyesight. But the same kinds of devices are also available using the sense of touch. Tactile devices have been around since the Braille coding system was introduced in 1827. The first device for producing those patterns of raised dots was called a Brailler, and it is still in use today in a variety of incarnations. To show how far technology is going, here is a brief rundown from Instablogs TV of five state-of-the-art Braille devices that are in various stages of development and marketing: www.youtube.com/watch?v=NAlHTgGCqYk .
Optical devices use lenses to enhance vision. The first lenses were developed in the 13th century, beginning with prescription lenses for improving visual clarity.
Then came protective lenses, which block or reduce hazardous light frequencies that can damage the eye. This is done with tinting. Lenses can also be polarized, a special process that reduces horizontal glare. Protections such as these can also be incorporated into prescription glasses to serve double duty.
Manual and hands-free magnifiers are for seeing close up. These are most effective with lighting built in.
Telescopes are for monocular, or one-eyed, distance viewing, and binoculars are for stereoscopic distance viewing. Both can be adjusted as needed to accommodate your acuity. Both can also be built into prescription glasses for hands-free use.
Desktop magnifiers, also called closed circuit televisions, or CCTVs, come in many makes and models, sizes, price ranges, and capabilities. They enlarge anything within range of their cameras and display the images on a screen.
Digital devices use computer technology to greatly expand the capabilities of some optical devices. Portable and desktop magnifiers, for example, can now be operated electronically, allowing you to manipulate the image by changing the magnification power, background color, text color, brightness, and contrast. Some of them will also allow you to freeze the image, and the more advanced ones will adjust, or “wrap”, text to fit the screen, which eliminates the need for constant shifting of the printed material. The same technology has been applied to video magnification glasses, which are wearable 3D units that perform like hands-free digital magnifiers.
Recent technological advances have propelled us into a whole new realm of non-optical devices. Development of digital voice recording and speech synthesization brought us electronic books (e-books) and talking products like timepieces, calculators, scales, thermometers, glucose testers, TV remotes, pill containers, and cooking aids.
Then speech synthesization was integrated with digital scanning technology to bring us text readers, color identifiers, and currency identifiers. And the military combined digital speech with satellite guidance research to build Global Positioning Systems (GPS) that are now portable enough to help us find our way on our daily walks or while traveling around the country.
Now, pack all that technology into something about the size of a cigarette case (remember those?), and you’ve got a smart phone, also known as a personal digital assistant (PDA). A larger version of the smart phone is the computer tablet. These are essentially the same as smart phones, but with the advantages of larger screens and some limited functions of a laptop or desktop computer. These devices have touch screens instead of keypads, but physical keypads can be attached to them.
Smart phones and tablets can help you see in many ways. A guy can find a date, call her by simply speaking her name, buy her flowers, put on a tie of the right color, locate a nice restaurant, and pay for a taxi and dinner–all with little or no eyesight. And it won’t be long before he might be able to pick her up in his self-driving automobile.
With that same device, you can also take notes or send a written message by simply speaking into it. And you can have it read your notes and messages to you. You do have to pay for a cellular Internet service in order to communicate with others or surf the Web, but that doesn’t have to cost much more than what you’ve been paying for basic telephone service.
The newest thing to come down the pike are perception enhancing glasses that see for you, then describe through the earpiece who or what they see. The device is called OrCam, and it’s one of a kind right now. A similar product, however, may be on the market in about five years. The main difference is it’s use of ultrasound to detect objects (even window or door glass), and the addition of artificial intelligence for recognizing places, signs and objects.
Now, here is a unique idea that may or may not catch on, but it’s interesting enough to mention here. Again, you need to have a cellular Internet service. It’s a volunteer-based assistance application for a smart phone, called Lend-an-Eye. Learn about it at https://www.youtube.com/watch?v=LlpESaD1p1c&feature=youtu.be .
Surgical devices are Implanted electrical devices, sometimes called “bionic”. They are brand new on the market, and several are still in clinical trials. Those that have reached the market are expensive and few in number.
Here is a discussion about the only retinal implant currently available, called ARGUS II. Anthony Arboni from DNews will tell us about it, and he will also introduce a similar device still under development, called ALPHA IMS:
Another implant that is helping people see is the Implantable Miniature Telescope (IMT). Dr. Randolph Kinkade, OD, describes it at:
We’ve come a long way since the fire torch and the long stick. And we don’t have far to go before cures for blindness and visual impairment are developed. In the meantime, we want to continue finding ways to see what our eyes cannot. This list of 25 is a good start–actually it’s about twice as long as it was 10 years ago–and I’m sure you are already taking advantage of some of the devices. We may be visually impaired, or even have no eyesight at all; but we don’t have to blind.
This overview has focused on low vision assistive technology. It has listed practical devices that can help us see by utilizing our non-ophthalmic senses. Research has shown that, by turning those senses loose, we can achieve 99% of our common daily living activities without eyesight. We can, in other words, still see; and in some cases even better than we could with perfect eyes.
Here is a checklist of all of the devices I have identified. How many of them have you used?
- mobility canes
- large print and graphics
- daily living aids
- bright task lighting
- books on tape or CD
- telephone help lines and reading services
- tactile devices
- prescription lenses
- protective lenses
- manual or hands-free magnifiers
- desktop electronic magnifiers (CCTVs)
- digital desktop or portable magnifiers
- video magnification glasses
- talking daily living products
- talking global positioning systems (GPS)
- electronic books
- electronic text readers
- smart phones or tablets
- perception enhancing glasses
- new concepts like Lend-an-Eye volunteer service
- ARGUS II
- Implantable Miniature Telescope (IMT)
If you are significantly visually impaired, how many of these devices would help you personally to see using at least one of your non-ophthalmic senses? How many have you never tried? If you haven’t tried some of them, was it because of cost? Lack of necessity? Physical or mental disability? Those would be good reasons. But if you haven’t tried some of them due to lack of information, I hope this presentation has been helpful.
If you would like to learn more about the devices listed, you will find links to all of them and their distributors at lowvision.preventblindness.org/resources-2 .
Hundreds of low vision products are on the market, so choosing the right ones can be daunting. Your best approach is to contact a low vision specialist who can evaluate your needs and goals, then help you decide what devices will suit you best. To locate a specialist near you, ask your doctor, or follow the links at lowvision.preventblindness.org/low-vision-rehabilitation-2/locating-a-low-vision-specialist .
For more about living better with low vision devices, view the audio visual presentations at www.mdsupport.org/audiovisual-library/#devices .