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Central Vision Loss Peripheral Vision Loss Loss of Visual Field Acuity Loss Total Loss of Vision Importance of Orientation and Mobility Training The Affect of Vision Loss on Independent Travel (Orientation and Mobility)CENTRAL VISION LOSS (Macular Degeneration, Histoplasmosis) People with central vision loss have difficulty with parts of independent travel that involve detail. They have trouble detecting the edge of steps and curbs, as well as the depth. It is often difficult for these people to determine whether a line on the pavement is a step, crack or just a line. Locating and reading street signs and lights is also difficult for people with central vision loss. Crossing streets is hazardous due to not being able to see the traffic movement or knowing when there is a walk sign or green light. Bright lights or sun can cause glare which may make these problems even worse. Orientation and Mobility training can be beneficial for people with this type of vision loss. The individual can learn to use a white cane for detecting steps, curbs, and other obstacles that are difficult to see. The cane can also help in judging depth of steps and curbs. Orientation and Mobility instructors can teach individuals how to cross streets safely by listening to and judging traffic patterns, using the traffic sounds to know when to cross a street instead of relying on the visual cues of a walk light. In some instances, a low vision aid, such as a monocular telescope, can be used to enhance the individual's ability to locate and read street signs and addresses as well as spotting general environmental clues. PERIPHERAL VISION LOSS (Glaucoma, Retinitis Pigmentosa) People with peripheral vision loss have various difficulties with independent travel, depending on the degree of vision loss. A person who is just beginning to lose peripheral vision may find him/herself colliding with obstacles on the sides, door jams, furniture, etc. Someone who has advanced peripheral loss may not be able to detect steps, curbs or other obstacles at all. Where as the person's central detail vision and reading vision may not be affected, their ability to move around safely is severely hampered. People with this type of vision loss also have difficulty crossing streets and detecting traffic. Maintaining orientation when walking is an issue because the person cannot see the surrounding area in order to keep track of their environment. Low lighting can make independent travel even more difficult. Orientation and Mobility training can be beneficial to people with peripheral vision loss. A white cane can be used to detect obstacles on the sides of the body as well as in front of the body when walking. Orientation skills and methods of keeping track of location can also be taught: for example, learning to use other senses such as hearing and touch to locate and use landmarks. Techniques can be taught to help a person learn to scan the surroundings with their remaining vision and as with other eye conditions, a person with peripheral vision loss can learn to listen for traffic to judge street crossings. LOSS OF VISUAL FIELD (Stroke, Detached Retina, Diabetic Retinopathy) People with visual field loss have various difficulties with independent travel depending on which part of the field is affected. A person with a field loss on the right side will have difficulty colliding with obstacles on their right side. The opposite is true with a left sided field loss. A person who loses vision on the bottom of their field of view will have difficulty detecting steps, curbs and other low obstacles. However, a person who loses the top part of their field will have trouble colliding with high obstacles, such as tree branches. Depending on the location of the field loss, a person may have difficulty detecting traffic and crossing streets. Independent travel may be even more hampered by low illumination. Orientation and Mobility training can help people with field losses. Techniques can be taught to help a person learn to scan the surroundings with their remaining vision, and a white cane can be used to help detect obstacles on the sides and in front of a person when walking. Other strategies can be taught to help protect a person from colliding with high obstacles. ACUITY LOSS (Cataracts, Diabetic Retinopathy, Multiple Sclerosis) People with losses of acuity have difficulties with independent travel due to the overall blurring of the surroundings. They may have trouble detecting the edge of steps or curbs as well as the depth of them. It is often difficult for these people to detect small obstacles such as cracks in the pavement as well as some large obstacles like trees or mailboxes. Recognizing and reading street signs is also difficult for people with acuity loss, as is judging traffic movement and crossing streets. Orientation and Mobility training can benefit these people. A white cane can be used to detect obstacles when walking and other strategies can be learned to judge traffic movement at intersections. A monocular telescope can sometimes be used to enhance a person's ability to scan the environment and read signs and addresses. TOTAL LOSS OF VISION (Injury, Various Eye Conditions) People who lose all of their vision have difficulties with all aspects of independent travel. They will be unable to detect large or small obstacles and it is very difficult to remain oriented to the environment when walking. Orientation and Mobility training can be beneficial to these people. Various skills and techniques can be taught to help a person learn to navigate in their home and outdoors. A white cane can be used to detect obstacles and maintain safety when walking. People with no vision can also learn techniques to remain oriented to their surroundings by using their other senses (hearing, touch, smell) to locate and use landmarks or clues. IMPORTANCE OF ORIENTATION AND MOBILITY TRAINING (for all visual conditions) In general, Orientation and Mobility training can help individuals with all types of vision loss. Anyone who is having difficulty with independent travel because of their vision, whether they are not able to judge the depth of a step or not able to see where the sidewalk is, can learn techniques to help them become safe and efficient travelers. The white cane is used to detect obstacles and help individuals walk independently. The white cane is also used to identify that person as having a vision impairment. Informing the public about a person's vision loss is very important to maintain safety when traveling independently. Traffic and other pedestrians are made aware that the person is not able to see everything and therefore may need some special consideration. The Society for the Blind and Visually Impaired has five Orientation and Mobility Specialists who work with clients of all ages and abilities to help enhance their independence and travel skills. | |||
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