Low Vision and Visual Impairment: Rehabilitation, Aids and Support

Low vision means that, even with the best possible glasses, contact lenses, medicine or surgery, a person's sight remains reduced enough to make everyday tasks difficult. Reading the post, recognising faces, cooking, moving safely around town or using a phone can become challenging. According to the World Health Organization, at least 2.2 billion people worldwide have a near or distance vision impairment, and in many cases that impairment could have been prevented or has not yet been addressed.

A diagnosis of low vision can feel overwhelming, but it is not the end of independence. Vision rehabilitation, optical and digital aids, practical adaptations at home and emotional support can help people continue to work, read, cook, travel and enjoy hobbies. This guide explains the definitions, the main types of help available and where to find support.

What does low vision mean? Definitions

Vision impairment is usually described in terms of visual acuity (how much detail you can see) and visual field (how wide an area you can see). The WHO classification, based on the better eye with the best correction available, is summarised below.

Countries use their own legal definitions for certification or registration. In the United States, legal blindness is commonly defined as visual acuity of 20/200 or worse in the better eye with correction, or a visual field of 20 degrees or less. In the UK, people can be certified as sight impaired (partially sighted) or severely sight impaired (blind) by a consultant ophthalmologist, which can open access to support and benefits.

Types of vision loss

• Central vision loss: difficulty reading and seeing faces, as in macular degeneration; peripheral vision often remains useful for getting around.
• Peripheral vision loss: tunnel vision, as in advanced glaucoma or retinitis pigmentosa; reading may still be possible, but mobility suffers.
• Blurred or hazy vision: as in corneal disease or some forms of diabetic eye disease.
• Patchy vision: as in diabetic retinopathy or after strokes affecting vision.
• Night blindness and glare sensitivity: common in many retinal conditions.

Vision rehabilitation

Vision rehabilitation is a set of services that help people make the most of their remaining sight and learn new ways of doing everyday tasks. It may be offered by hospital low vision clinics, optometrists with low vision training, occupational therapists, rehabilitation workers and charities.

What a low vision assessment includes

1. A detailed discussion of your goals: reading the post, cooking, hobbies, work, mobility.
2. Measurement of visual acuity, contrast sensitivity, visual fields and reading speed.
3. Trial of magnifiers, filters, lighting and other aids.
4. Advice on techniques, such as eccentric viewing for central vision loss, which trains you to use a healthier part of the retina.
5. Referrals for mobility training, occupational therapy, emotional support or employment advice.

Orientation and mobility training

Specialists teach safe travel techniques, which may include using a long cane, a symbol cane (indicating sight loss to others), or a guide dog. They help with routes to the shops, using public transport and crossing roads safely.

Daily living skills

Rehabilitation workers and occupational therapists teach techniques for cooking, managing money, labelling medicines, personal care and using household appliances safely.

Magnifiers and optical aids

Magnifiers enlarge the image on the retina so that remaining healthy areas can see more detail. Choosing the right one depends on the task, your vision and your hands.

Higher magnification is not always better: it reduces the field of view, so a low vision professional helps you find the right balance. Filters and tinted glasses can reduce glare and improve contrast for people with conditions such as retinitis pigmentosa or cataract.

Screen readers and digital technology

Technology has transformed life with low vision. Computers, tablets and phones can enlarge text, increase contrast or read content aloud.

• Screen magnification software enlarges part or all of the computer screen, with options for colour inversion and enhanced pointers.
• Screen readers convert on-screen text into speech or braille. Examples include JAWS and NVDA (free) on Windows, VoiceOver on Apple devices and TalkBack on Android.
• Optical character recognition (OCR) apps and devices photograph printed text and read it aloud.
• AI-powered description apps can describe scenes, identify objects, read handwriting and recognise currency.
• Audiobooks, podcasts and talking newspapers provide access to reading material.
• Smart speakers allow voice control for reminders, calls, music and home devices.

Smartphone accessibility features

Modern smartphones contain powerful built-in accessibility tools at no extra cost. Most are found under Settings, then Accessibility.

• Text size and bold text: enlarge system text and make it heavier.
• Zoom and magnification: enlarge any part of the screen with gestures.
• Display adjustments: increase contrast, invert colours, use dark mode, apply colour filters and reduce transparency.
• Screen readers: VoiceOver (iPhone) and TalkBack (Android) read everything on screen and allow navigation by gestures.
• Magnifier app: uses the camera as a digital magnifying glass, with light and filters.
• Voice assistants and dictation: send messages, make calls and set reminders without looking at the screen.
• Detection features: some phones can detect doors, people or text and announce them.
• Spoken content: have selected text or the whole screen read aloud.

Adapting your home

Small changes at home can improve independence and safety, particularly reducing the risk of falls.

Lighting

• Increase overall lighting, and use adjustable task lamps directed at what you are doing.
• Reduce glare with blinds, matte surfaces and shaded lamps.
• Light stairs, hallways and entrances well; consider motion-sensor night lights.
• Allow time for your eyes to adjust when moving between bright and dark areas.

Contrast and colour

• Use contrasting colours: a dark cutting board for light foods, a white plate on a dark tablecloth.
• Mark step edges with contrasting tape.
• Choose light switches and door handles that contrast with walls and doors.

Organisation and labelling

• Keep items in consistent places.
• Use tactile markers (bump-ons), large-print or talking labels for appliances and medicines.
• Use large-button telephones, talking clocks and watches, and big-number remote controls.

Safety

• Remove trip hazards such as loose rugs and cables.
• Install grab rails in the bathroom and on stairs.
• Use liquid level indicators to avoid hot drink spills.
• Ensure smoke alarms are audible and tested.

Read our article on vision in older adults and fall prevention for more advice.

Emotional health and support

Losing vision can bring grief, anxiety, frustration and loss of confidence. Depression is more common in people with vision loss, and isolation can follow when reading, driving or socialising becomes harder. These feelings are understandable and treatable.

• Talk to someone: your GP, an eye clinic liaison officer (in some countries), counsellors and peer support groups.
• Charities and organisations: national sight loss charities offer helplines, information, technology support, emotional support and social groups.
• Charles Bonnet syndrome: some people with sight loss see vivid visual hallucinations; this is a common, recognised response to vision loss and not a mental illness.
• Work and education: many people continue working with adaptations; employment support schemes and legal protections exist in many countries.
• Driving: you must meet legal vision standards; your eye doctor can advise. Transport alternatives and concessions may be available.
• Financial support: certification or registration may provide access to benefits, concessions and services.

Preventing further vision loss

Low vision does not mean that eye care is over. Continuing regular examinations and treatment protects the sight you have.

• Attend follow-up appointments and continue treatments such as glaucoma drops or injections for wet AMD.
• Monitor your central vision with an Amsler grid if you have macular disease, and report any changes.
• Manage diabetes, blood pressure and cholesterol.
• Do not smoke.
• Protect your remaining vision from injury and UV.

For an overview of conditions, see our eye diseases guide.

When to see a doctor

If your vision is affecting daily life and you have not been offered a low vision assessment, ask your optometrist or eye doctor for a referral. Also seek advice if your vision changes, even if you already have a diagnosis.