Macular Degeneration Foundation

Macular Degeneration and the Art of Using a Computer

Having macular degeneration does not mean you should stop using the computer or that you would not be able to learn.  If you have central vision loss from macular degeneration, computer use is not only possible, but highly advisable.

Both Microsoft and Apple are aware of the needs of the visually impaired and of the rapidly growing number of older people using the computer. A Nielsen survey in 2009 reported that the number of people over 65 using the computer from 2004 to 2009, increased by 50%. Apple computers have many accessibility features,, as does Windows. Proprietary companies have products such as ZoomText, Magic, JAWS and Window Eyes software that make computer use possible for even the totally blind.

Why should I use the computer?

The quick and easy answer is that “Everyone else does”. Using the computer allows you to keep in contact by e-mail with family and friends, search the internet, shop, plan trips and generally stay in the loop, keeping up with a rapidly changing world. Computer literacy is now a requirement for almost any job and even for much volunteer work. Computer use may even improve your mood and mental health. A 2005 study reported by the American Psychological Association found less depression in seniors who used the computer.

How can I learn to use the computer despite low vision?

More than 50% of the visits to American libraries are to use the computer. Those out of work, students, people whose computer is out of order or shared, or who seek quiet refuge from a noisy household go to a library to use the computer. Almost all libraries have computers and free computer classes for seniors. Many have instructors who are familiar with the accessibility features, and some may be familiar with the specialized adaptive software for the visually impaired.

I am a hunt-and -peck typist, and can’t see the keys anymore. What can I do?

The best thing to do is to become a touch typist. If you do not see well, the ability to use the keyboard without looking at it is an invaluable skill. There are specific programs designed for the blind and visually impaired which will teach you how to use the keyboard. Talking Typing Teacher program gives immediate voice feedback and is good for any level of keyboard skill and any degree of vision impairment.

Large keyboards with high visibility letters are available through speciality catalogues for those who want to continue hunting and pecking.

Who can tell me where to go for computer classes?

If you have vision loss of any degree, ask your local low vision clinic or state agency such as the Department of Vocational Rehabilitation or Rehabilitative Services. They usually maintain a resource list which should include computer classes. Most of these classes are free. You can also check with your local library. Most do have computer classes for different levels, especially for beginners.

Summary

Anyone living with vision loss should acquire or improve their computer skills. The opportunities to deal with further vision loss are greater if you are aware of the computer programs that will make transitioning easier.

Recognizing Faces

Humorous Faces of Monkeys at Zoo

These tips for recognizing human faces won’t work at the zoo, but they should help people with low vision in challenging social settings:

Written by: Joseph L. Fontinot MD, CLVT
Medical Dir: Community Services for Vision Rehabilitation
Mobile, Alabama

I’m sorry, who are you?

The inability to recognize faces is one of the most common complaints of people with age-related macular degeneration and is a frequent cause of embarrassments and concern in social activities.

If you have AMD, you will have blind spots in the center of your vision (central scotomas) and decreased contrast sensitivity. The blind spots will occupy part of a person’s face and the impaired contrast sensitivity prevents you from seeing shades of texture and color. Since the blind spots are funnel-shaped, being smaller at close distance and greater at further distance, you will have less difficulty recognizing people up close. You will begin to recognize people by their voice, the way they walk and dress, their size, height and other characteristics. The problem with this sort of recognition is that it is not as quick or exact as normal face recognition.

Face recognition is an important part of everyday life. We recognize people, hail them and begin a social dialog. The ability to do this is important in order to respond appropriately or know what to say. Some people may be offended if we do not recognize them.

What can be done? At a distance, any telescopic magnifier will help. It has been shown that bioptic glasses (glasses with a small telescope mounted in the upper part of the glasses) does help identify people. The new head-mounted mounted electronic magnifiers (Iris Vision, Patriot, Nu Eyes, etc.) do help. However, these are difficult to use in ordinary circumstances such as walking and would not be comfortable in some social events.

Simple tips

Speak up. Sometimes simply saying “Hello” or “Good day” will elicit a response that identifies the person or you will recognize their voice.

If the situation is appropriate, get closer. This makes your blind spot smaller, covering less of their face.

Engaging in small talk will give you clues as to identity.

Moving to the side where the person’s face is least in shadow may help and you may recognize them better from a different angle. Also, try positioning yourself so the light is behind you and on the face of the person you are trying to identify.

Knowledge of your scotoma position and your “preferred retinal focus” will help in directing your gaze so that more of the person’s face will be visible.

As always with vision loss, plan ahead. If you are going to meet a small group of people, find out ahead of time who they will be and this will help with recognition.

If all else fails, simply say “I’m sorry, I have macular degeneration and I have trouble identifying people. What is your name?”

If you are with a close friend or family member, you can quietly ask them to identify people as they approach.

A white-tipped cane will make it obvious why you do not recognize people.

There are also lapel pins saying “I have Low Vision” and you can simply call attention to the pin.

Remember that a minor degree of embarrassment is better than staying at home. Get out there! Say “Hello” to everyone.