In the medieval ages of Europe, eyeglasses used to improve vision were a novel idea, treated with suspicion and worn only by those with the most open minds (and worst vision!).  Today, of course, spectacles are a common sight. There remains, however, an optical problem that few know about today known as low vision.

Vision-Aid, a non-profit organization based in Lexington, MA, was created to help those who have low vision, especially those in developing areas, where facilities are fewer, and attitudes can rival those of the Middle Ages toward glasses. Its center in Visakhapatnam, India is its first step toward helping people in developing areas, with grant programs that help those who are not able to afford treatment. There are two major areas in the center, one of Vision Enhancement, and the other of Vision Rehabilitation. With around 120 million people who have this problem, and with very few aware of this disease, this charity is one that lightens the problems in an area largely left untouched.

The World Health Organization’s definition of low vision states that a person with low vision is one who has impairment of visual functioning even after treatment and/or standard refractive correction, and has a visual acuity of less than 6/18 to light perception, or a visual field of less than 10° from the point of fixation, but who uses, or is potentially able to use, vision for the planning and/or execution of a task.

Simply put, low vision is the term used to refer to those who have problems seeing even after using ordinary refractive spectacles, and whose vision cannot be cured by either medicine or surgery.

This summer vacation, I decided to investigate this issue, and spent a few weeks at the L.V. Prasad Eye Institute (LVPEI) in Hyderabad, India, a world famous eye hospital with a wing devoted to low vision care headed by Dr. Sarfaraz Khan. The staff was very helpful in showing me around the hospital and explaining to me the many aspects of low vision enhancement and rehabilitation.

While observing the Low Vision department at LVPEI, I had the good fortune to meet Jataal Prasad Santaram, a young man of twenty-one years who had just completed his B.A. in English. It is impossible to discern at once that he had low vision, because after successful rehabilitation, most patients have little trouble getting around and accomplishing day to day tasks.

Santaram had Ocular Cutaneous Albinism, a congenital disorder, but only began to notice that his quality of vision was lower than the other children around him in the fourth standard. His problem until then, as is often the case when there is ignorance about these conditions, was that he did not know that other people saw differently, or more clearly than he did.

In the United States, where eye testing is standardized and compulsory in schools, such problems are caught quickly. In developing countries like India however, few are aware that they may be having a disease, especially when the condition is present at birth, and the person has no chance to observe the degeneration while in age-related syndromes, the person has a greater chance of noticing the lessened ability to see from comparison of their own vision.

However, there are facilities available for people like Santaram in India as well, but there is still a need for greater help. The difference that vision enhancement makes is great in a person’s life. Santaram was able to use aids such as lenses that not only focus objects like regular eyeglasses do, but also magnify or shrink objects at the same time.

With aids like these, Santaram is now able to join a course for a graduate degree in English, and realize his goal of becoming an English teacher. Without the help he had received in L.V. Prasad, and the use of these aids, it is very possible that he would not have been where he is today. The sad fact is that because knowledge about low vision is practically nonexistent in most areas of developing countries, in places like India children who exhibit low vision are often placed in centers for the blind. This is detrimental to the children’s development because the little vision they do have is under-utilized, and they are not introduced as easily into mainstream society.

Low vision can also have deep psychological impacts on a person. Beula Christy, a therapist at LVPEI states that often children with low vision feel inferior to their classmates, and that it can significantly lower self-esteem. Glasses have long been known to reduce popularity among peers, and devices that are rather more bulky than glasses, with the appearance of binoculars can often make children shy. Sometimes the first and most important step is convincing the patients that they have a problem, and that the use of these devices is not only beneficial, but absolutely necessary. This problem is especially large among young girls, whose desire to be attractive is particularly important, when beauty can be a factor in arranged marriages. Luckily, there are some devices that have a cosmetic value as well, because very few are willing to give up their appearance, even at the cost of their vision. However, these devices and services have to be made available to everybody.

The Vision Rehabilitation wing that I was able to observe in LVPEI offered therapeutic and psychological services. People with low vision were taught how to optimize efficiency in their daily lives in tasks that can be affected by their sight such as climbing stairs, going out at night, recognizing faces, daily chores, and if desired, use of the computer, with a program specially designed for people with low vision known as MAGIC. These services are also available in Vision-Aid’s Visakhapatnam center headed by M.S.Raju, the only one of its kind in the city.

Observing the patients at LVPEI, and watching the way simple steps can make a large difference in a person’s life showed me how important it is to take care of those of this much neglected condition. Sight is one of the most relied-upon senses for those who possess it, and it is important to help those who have only a little remaining. The experience was defintely an eye-opener for me.

For more information about Vision-Aid, and what you can do to help those with low vision in developing areas of India, the Vision Aid website http://www.visionaid.org  offers facts and ways to help those in need. Look out also for the Vision-Aid stall at the IAGB India Day celebration at the H atchshell for a chance to learn more.

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