In honour of Helen Keller Deaf-Blind Awareness week on 24-30 June – and coincidentally June also being both Cataract Awareness month and Fireworks Safety month – this seems like the perfect time to give you some information about sight loss. Losing your sight is very distressing and has a massive impact on any life. Imagine the things you now take for granted that you can only do because you can see. If you can see, you can choose to walk anywhere you feel like walking. If you are blind, then that simple walk is not impossible but will be much more challenging, and even frightening. If you get lost easily and you can see, you can find your way or see people to ask. Imagine the same scenario if you were blind or partially sighted, and you will quickly grasp how anxious and alone you may feel. Of course as well as suffering from walking issues from sight loss, you also can’t drive, or read a standard printed book, recognise faces, or identify money. Sight loss means that the daily life you have been used to so far will change, and most likely change for good. You couldn’t even read this Web page or see the pictures. So what are the main types of sight loss? Can they be prevented? How can you help a loved one who is losing their sight to feel safe, acclimate and begin to live a normal life? Blind Facts Over 14 million Americans are either blind or visually impaired. The four main causes of sight loss, as opposed to being born blind, are age-related macular degeneration (AMD), diabetic retinopathy (related to diabetes), glaucoma (raised pressure in the eyeball) and cataracts (clouding of the lens). Of course not all people who are registered blind are completely blind, as there are degrees of blindness, but for the purposes of this article, let’s talk about sight loss in general terms. Complete blindness and partial sight carry with them most of the exact same problems, lifestyle changes and social difficulties. Age Related Age related macular degeneration (AMD) is sight loss related to age. As you age, the macula, at the centre of your retina, can degrade and you lose sight in the centre of your field of vision. Although you can see to move around with your peripheral vision, close work and reading may become impossible. Your peripheral vision is not clear enough to read or discern fine detail. This condition is usually hereditary, and the causes are not yet well understood, although it is known that smoking over a lifetime can be a contributory factor. There are treatment options for certain types of AMD, so if there is a history of this condition in your family it’s sensible to have your eyes regularly checked as you get older. Diabetes Advanced diabetes can cause diabetic retinopathy resulting in patchy vision, where there is still some sight but the picture is not complete. Similar to AMD, diabetic retinopathy is caused by intermittent structural changes over the whole of the retina, this time caused by slower and thicker flow in the blood vessels. Of course not all diabetics suffer from sight loss, but it’s wise to have regular sight tests to be sure. If problems do develop and you can catch them early enough, you can take steps to minimise the damage by managing or maintaining your blood sugar, diet and exercise. Glaucoma The opposite of macular degeneration is glaucoma, a loss of peripheral vision as opposed to the center. The loss of peripheral vision causes difficulty walking around as you always have to turn you head to see hazards coming towards you from the side. Glaucoma is caused by damage to the optic nerve through increased liquid pressure in the eyeball. The normal eyeball requires a certain amount of pressure in its internal fluid to maintain its size and shape, but if the drainage channels in the eye get blocked then the pressure rises, causing damage to the optic nerve. If caught early enough there are simple treatments to prevent further damage, but sometimes the rise in pressure is too slow to detect, or cause any pain which would warn the patient that something is wrong. Once again, regular eye tests can make all the difference and save your vision. Cataracts Cataracts cause the lenses of the eyes to gradually go opaque. The symptoms are of blurry or discoloured vision, and poor vision under bright lights, such as the sun or car headlights. The condition is caused by age, diabetes, injury or the long term effect of certain drugs. Like other forms of sight loss, there are treatments, in this case a lens transplant where the cloudy lens is replaced with a plastic lens. Surgery is the only real treatment as there are currently no effective drug or diet treatments. What to do about Losing Sight If a friend or loved one is losing their sight, what can you do to help? The most obvious thing is support. If the sight loss is sudden then this is more important than almost any other step. Losing your sight can be distressing, and the normally mundane problems of everyday life become profoundly difficult. If the sight loss is sudden there is an inevitable grieving process, an overwhelming sense of loss, and the patient will possibly need some professional counselling to get over this period. Adapt And Survive If the sight loss is slower and more progressive, then changes can be made gradually to the environment to make it easier to interact with. If the sufferer is partially sighted then adaptations can be made to make things easier to see. The simple solution is “bigger, brighter and bolder” – large print signs on appliances, stronger lights, etc. Also devices with voice alerts can be installed to replace important household items, like speaking clocks and watches, and computers with screen reading software to speak what is on the screen, as well as illuminated magnifiers and large print books. Adapting the home to blind living is mostly about visibility and touch, but also about support. Handrails must be fixed everywhere where there are stairs to climb to allow the blind person to maintain their balance and move around safely. Safety First It’s essential when someone has lost or are losing their sight that they feel safe at home. Make sure that that any safety hazards, loose stair carpets, trip hazards and cabling are regularly maintained and checked. If everything in a home is safe that increases the feeling of safety and security for the patient. Also for security and comfort the heating and water systems in the house must be easy to use and the controls adapted to be more visible or easy to use by touch. Caring Human Contact Above all the person losing their sight needs to have help with human interaction. A blind person may not be aware they are being spoken to, as they lack the normal visual cues that we all take for granted. They may not even know that someone has walked up and sat with them. Sudden unexpected touches can be unnerving too, so be aware and sensitive to how the world feels to a blind person. Announce your presence clearly; identify yourself verbally by name, as sometimes “it’s me” is not sufficient information. Above all, try to make the world a friendlier place for a blind person. If they feel safe, secure, included in what’s going on without feeling slightly patronized, then they will begin to not only put their life back together but also begin to enjoy it again.