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Low Vision

Accommodation and Compliance: Low Vision

About Low Vision

Vision impairments result from conditions that range from the presence of some usable vision, low vision, to the absence of any vision, total blindness. Low vision is a term that describes a person with a vision impairment that cannot be improved by correction but has some usable vision remaining. Legal blindness is defined as 20/200 or less in the better eye with the best possible correction. Errors of refraction, diseases of the eye, and other vision-related conditions are usually the cause of vision loss. Each of these categories includes more specific disorders, which are described below.

•  Common Errors of Refraction

o  Myopia (Nearsightedness): Close objects look clear while distant objects appear blurred.
o  Hyperopia (Farsightedness): The ability to see objects clearly at a distance while close objects appear blurry.
o  Astigmatism: Due to the irregular curvature of the cornea, vision is blurry for both near and far objects.
o  Presbyopia: The eye lens becomes less elastic (associated with aging) and produces blurred vision when focusing on near objects.


•  Common Diseases of the Eye

o  Cataracts: Clouding of the eye’s lens that causes loss of vision.
o  Glaucoma: Pressure inside the eye is elevated and can cause damage to the optic nerve, which results in damage to peripheral vision.
o  Macular Degeneration: There is a disturbance of blood vessels in the eye resulting in progressive loss of central vision.
o  Retinitis Pigmentosa: There is a degeneration of pigment in the eye that is needed to absorb light and create visual images, leading to “tunnel vision” and night blindness.
o  Retinopathy (due to Diabetes): Retinopathy typically affects the blood circulation of the retina, which causes blotchy vision.

•  Other Vision Related Conditions

o  Night Blindness: Night blindness results from pigmentary degeneration of the retina, which leads to difficulty seeing in low light.
o  Color Vision Deficiency: A color vision deficiency occurs when cone cells of the retina, which provide daylight and color vision, are affected and there is difficulty distinguishing among colors. Typically this only involves certain hues, for example a red–green deficiency; total color blindness (achromatic vision) is rare.
o  Lack of Depth Perception: A lack of depth perception is often caused by the loss of sight in one eye, resulting in difficulty with foreground/background discrimination.
o  Floaters: Floaters are small specks or clouds moving in the field of vision.
 

Low Vision and the Americans with Disabilities Act

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Low Vision

People with low vision may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

Events Regarding Low Vision