Blind and Visually Impaired Community
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Skeptic of a client’s visual reporting (self.Blind)
submitted by sayakov
I’m an occupational therapist and have a client I’m working with to get some mobility equipment (wheelchair, height adjustable bed). They have reported that they have optic nerve damage in one eye with only light perception in that eye and the other eye is reported to have 10% vision. How much would this client be able to see?
I’ve observed the client trial a powered chair and move them self around a room with ease (lots of other equipment present). They do not use a cane. When accessing the community they use a rollator frame and I’ve observed them to be able to use it with no issue (in places unfamiliar to them as well). The client was able to describe a bed rail approx 10 metres away.
There have been a few other areas not matching up between observed function and reporting so am curious as to what their vision would be for the reported visual level. I’m concerned about the safety of the client and others in the community if they were to be using a powered chair independently. My next step is to get into contact with the clients optometrist/ophthalmologist to get some more info. Any info or advice would be very appreciated !
I’ve observed the client trial a powered chair and move them self around a room with ease (lots of other equipment present). They do not use a cane. When accessing the community they use a rollator frame and I’ve observed them to be able to use it with no issue (in places unfamiliar to them as well). The client was able to describe a bed rail approx 10 metres away.
There have been a few other areas not matching up between observed function and reporting so am curious as to what their vision would be for the reported visual level. I’m concerned about the safety of the client and others in the community if they were to be using a powered chair independently. My next step is to get into contact with the clients optometrist/ophthalmologist to get some more info. Any info or advice would be very appreciated !
CloudyBeep 6 points 3y ago
Do you have many blind clients? In many countries, blind people are advised to seek support from OTs or vocational rehabilitation therapists who have undertaken training in visual impairment.
I also think that navigating the external environment with a motorized wheelchair is something that an orientation and mobility specialist is best able to assist with.
I don't think an ophthalmologist will be able to assist you as their expertise tends to be solely clinical—they don't tend to know how blind people live their lives.
Are you affiliated with a blindness service agency? If not, I think that you should refer the client to one (we can provide you with some recommendations if you tell us your location) to ensure that the client is safe..
I apologize if it seems like I'm invalidating your education and experience as that is not my intention.
I also think that navigating the external environment with a motorized wheelchair is something that an orientation and mobility specialist is best able to assist with.
I don't think an ophthalmologist will be able to assist you as their expertise tends to be solely clinical—they don't tend to know how blind people live their lives.
Are you affiliated with a blindness service agency? If not, I think that you should refer the client to one (we can provide you with some recommendations if you tell us your location) to ensure that the client is safe..
I apologize if it seems like I'm invalidating your education and experience as that is not my intention.
ABlindManPlays 5 points 3y ago
I am legally blind and have to use mobility devices. I do have a powered wheelchair due to spine issues, and I use it around my parking lot and apartment complex. I am always nervous when I use it, but I don't show it because I try to keep others at ease with it, and I don't like to show any more weakness than I have to. I am familiar enough with my apartment and complex to get around well, speed bumps notwithstanding. In unfamiliar circumstances, I keep my wheelchair's speed setting as low as possible and rely on a guide, or I make sure to navigate through wise spaces only if I have no guide. Familiarity helps out a lot too. I grew up near where I live, and I can still get around places like the movie theater with apparent ease. I think part of this is all my time spent video gaming. It's made me decent at keeping track of an object's relative position when I am driving my chair.
I'd say the best way to handle it is to address their eye doctor. They may be able to clarify the vision issues. Not all blindness is the same, and I've dealt with too many amateur Clouseaus to make a comfortable call one way or the other.
I'd say the best way to handle it is to address their eye doctor. They may be able to clarify the vision issues. Not all blindness is the same, and I've dealt with too many amateur Clouseaus to make a comfortable call one way or the other.
sayakov [OP] 4 points 3y ago
Thank you for your responses! I’m just a general community OT and I feel out of my depth with this client’s specificity of needs. I will contact some vision-specialist organisations and recommend referral for the client :)
KillerLag 1 points 3y ago
I've worked with a few clients where vision on the chart and vision in reality don't quite match. The problem is when someone expresses the vision as a percent. Vision doesn't operate like that. Generally speaking, at 20/200, someone is legally blind. But I've seen some people who can use their residual vision well enough to travel without a cane, while others don't.
Without my glasses, I fall off the 20/20 vision chart and my vision is CF (counting fingers). However, I can still travel without any issues because I can use my vision well enough to identify contrasts and such.
One common issue is depth perception, with one eye being noticeably so much worse than the other. If a step is low contrast (similar colours, poor lighting, not expected), they may not realize it is there and go over it. Also, they may have trouble with glass doors/walls that don't have anything on them to make them stand out as well.
Without my glasses, I fall off the 20/20 vision chart and my vision is CF (counting fingers). However, I can still travel without any issues because I can use my vision well enough to identify contrasts and such.
One common issue is depth perception, with one eye being noticeably so much worse than the other. If a step is low contrast (similar colours, poor lighting, not expected), they may not realize it is there and go over it. Also, they may have trouble with glass doors/walls that don't have anything on them to make them stand out as well.
changeneverhappens 4 points 3y ago
Sounds like they have extensive training in how to use their functional vision. Have they given you any reason for concern? I work in a school district so your mileage may vary, but my students go thru a PT evaluation that uses medical and functional vision data to determine eligibility for power chairs.
Duriello 2 points 3y ago
If we're talking about 10% of acuity without any other issues then I'm not surprised, as I lived my entire life like that until 9 years ago when my glaucoma became unstable resulting in blindness 3 years later. You can think of 10% of acuity as being able to see as much detail as a normal person would see at 10 times the distance. Assuming that all the other aspects of vision like contrast perception, color perception, movement perception, brightness, night vision, and vision field are normal, I estimate that a person with 10% of acuity should be able to complete 90% of the tasks the same way someone with 100% acuity would, because most tasks simply don't require a lot of acuity.
CAHWY17 1 points 3y ago
I have ON damage, heck severed by a brain tumor. I have that very low field of vision in one eye and totally blind in the other. I can see, but compared to a persons with full vision not so good. My brain has learned a new normal for me. The science of vision as in what the brain can actually process vs. what the eye collects is a fascinating study and worth an hours time to read. Now I feel I can see everything I needed to operate my life. Fact: really poor depth perception between zero and 20 feet, after 20 feet we a re all mono vision so i say I break near even with others. I am working harder to see YES. I know my limits and I took great training from Washington state department for the blind right away. Stairs, carpeting and many other items cause me to hesitiate and determine what I am looking at but over all i can navigate with some very visable delays in my actions.
Blind is a disability but not the end of being capable.
Blind is a disability but not the end of being capable.
bscross32 1 points 3y ago
Please don't try to get their chair taken away unless you see them hitting things with it or something like that. I'm so annoyed, because I know this guy and he has basically the use of one hand. He's blind, but they won't give him a power chair. He can't go too far with the manual one just because of having to use the thing one-handed. My argument is that he could get a mouth device for controlling the chair, keep it at a lower speed, and use a cane, or some other thing for navigation purposes.
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This person gets the short end of the stick on so many fronts and no one will help him. It pisses me off to no end to see that. Now, if someone has a power chair, and they've not done anything with it to cause concern, I see no reason to try to have it taken from them when it would be a huge blow to their independence.
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This person gets the short end of the stick on so many fronts and no one will help him. It pisses me off to no end to see that. Now, if someone has a power chair, and they've not done anything with it to cause concern, I see no reason to try to have it taken from them when it would be a huge blow to their independence.
Bachelor-pad-72 1 points 3y ago
I am almost totally blind and use a power wheelchair with a cane
I am in my late 20s and travel between school work and home. So it can be definitely done
The person would need an orientation and mobility specialist though just to make sure they’re being safe
I am in my late 20s and travel between school work and home. So it can be definitely done
The person would need an orientation and mobility specialist though just to make sure they’re being safe
[deleted] 1 points 3y ago
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