Tuesday, June 19, 2012

The Glasses Debate

I am debating whether or not to get glasses.

For most people, this would sound silly. Either glasses will help or they won't, right? Either glasses are affordable or they aren't ... right? For me, and anyone else with very low vision, it's a more complicated decision than that.

I don't have any kind of refractive error such as farsightedness or nearsightedness. This is actually unusual, as most people with my eye condition have refractive errors. Nonetheless, in grade three I was prescribed +12.5 diopter reading glasses to provide magnification only. I still remember how excited I was while I waited for the glasses to be made. I would stop many an adult who would listen and explain how I was going to get reading glasses that would "make it so I can read like this"—as I held a book away from my face at a semi-normal reading distance—"instead of like this," and I'd squash my nose up against the page and squint, to demonstrate how I currently had to read.

Ah, if only that were the case!

The glasses did allow me to read for longer periods of time and made letters look crisp instead of fuzzy; but I wasn't able to read significantly smaller print with them than I was without. And even when reading large print, I still had to hold material so close it touched my nose to see it. A year or two after I got the glasses, an eye doctor asked me to read newsprint while wearing them. Even holding the paper up against my nose I couldn't read three words without it being obvious that I was just guessing. He turned to my parents and said, "These don't help her at all." I felt defensive about him criticizing my glasses. They did help me! They made reading easier—and besides, I definitely needed them to be able to draw well!

I used the glasses daily throughout elementary and high school. Even with them, I still needed large print books and handouts, but they carried me through many a late night of homework or an afternoon spent drawing. In addition to the glasses, I used a slantboard to bring material closer to my face (so that I didn't develop posture issues hunching over as I worked), and also a task light which I used to put so close to the page—and my face—as I worked that it would sometimes "fry" stray strands of my hair. I used to develop an ink smudge on the tip of my nose from it rubbing against the reading material, and red spots on the sides of my nose from the weight of the glasses, but I didn't care.

Then, in college, three things happened. First, the reading load increased exponentially. In high school we had been expected to read a couple dozen pages a week from our textbooks—and, in truth, I skimmed a lot. (I still graduated with honours.) In college, however, we were suddenly expected to read a hundred or more pages a week. And that wasn't even including the "extra" material we had to read when a term paper was assigned! I found myself spending hours each night reading large print, and I was jealous of people who were able to read on the bus on their commute to and from campus, which I wasn't able to do.

Second, my CCTV (closed-circuit television, now more commonly referred to as a video magnifier) that I'd been using for the past ten years suddenly bit the dust in the middle of the semester. Since there were few large print materials available in college, I had begun to rely on this device for almost all my reading. And when it died, I suddenly found myself completely unable to do any homework at home. For the few weeks it took to replace the unit I spent hours on campus using the old, dilapidated CCTV in the college library.

It was at this point that I decided that my complete reliance on technology and my complete inability to read and write effectively without it was ridiculous. Suddenly, the braille I had been taught in early elementary school—but had never actually used for schoolwork—became useful. I relearned the code on my own (which was made much easier by the fact that I'd already learned it once as a kid), and began using both hardcopy braille and a Braille Lite on loan from the government. Suddenly, with the portability of the braille notetaker and the ability to put dozens of books and other documents on the device, most of my reading and writing was done in braille. Later, I exchanged the Braille Lite for a more modern BrailleNote, which was then upgraded to a BrailleNote Apex—which I still use at present in my work as a graduate student. With braille, I was suddenly able to do things I've never done before, such as read in bed, read and write on the bus, reference notes during class discussions, or study at a regular study carrel in the college library rather than having to sit in the corner of the computer lab where all the equipment for students with disabilities sat.

And the third thing that happened was that I lost my reading glasses. I didn't mean to; and in fact at the time I was still utilizing them for some things such as when using the computer and while drawing. But at some point they disappeared, and despite searching at home and school I was unable to locate them. (I always wonder where lost items like that go, and whether some random student found Coke-bottle glasses sitting at a study carrel in the library ...)

Parallel to my sudden rediscovery of braille as a useful skill, technology for those who used large print took leaps and bounds in advancement. In recent years I have acquired a flatscreen desktop video magnifier, a portable video magnifier, the ZoomText software on my computer has greatly enhanced magnification abilities compared to versions ten years ago, and I have an iPad which has magnification and other accessibility features built-in. Years after I began using braille, technology in the realm of large print had caught up to a degree that I am able to comfortably use it even for somewhat lengthy reading tasks—although I still use a combination of braille and large print on a daily basis. At some point during the past ten years I did replace my reading glasses. But, with my new technological tools that enable me to increase the font size to whatever degree was comfortable, that allowed me to sit back at a more ergonomically-friendly distance, and that allowed me to access virtually any material in braille, my glasses became relegated to the role of nice-to-have rather than essential.

And so, since I don't use my current prescription all that often, I probably won't get it refilled. I have also noticed problems with the frames on my current glasses: they interfere with the angle at which I prefer to look at print (which is down-right) when reading. So, if that were fixed, I might use them more. But mostly I am thinking that I might want to go one or two other routes: I either want stronger lenses that will enable me to read smaller print, or I want weaker lenses that will enable me to focus at my "new" technologically-enabled reading distance of 10-12 centimetres. I am not sure the second is even possible, but I've made an appointment with the optometrist I see who specializes in low vision so that I can ask.

There are issues against glasses, though, one being cost ($600+), and the other being the fact that I don't really use them. Still, it would be nice to have glasses I that could use comfortably while on the computer ... or, alternatively, glasses that might enable me to read the display on my Animas Ping insulin pump without having to guess (never a good thing when calculating bolus doses!). In the end, though, I'm currently getting along fine without glasses, and having new ones might disrupt my current working system of technology and print, speech, and braille reading.

This issue of when and where to use vision and when and where to use other techniques (such as braille, speech output, a white cane) is an issue those of us with low vision are constantly struggling with. Vision is said to be the dominant sense among humans, and from my visual-learner-perspective, I'd have to say that's true for me. If I had my way, I'd use my vision for everything and just enlarge things to a point that I could see them and take as long as I needed to read. But if I'd gone that route, I wouldn't have gotten through two undergraduate degrees taking full courseloads, I wouldn't have gotten through student teaching at all, and I probably wouldn't be in graduate school working on a 100-page research thesis. It's taken me years to become truly proficient in braille and to become comfortable reading academic material with speech output. Add to this mix of factors the fact that different individuals and groups have different opinions about what is "right"—some believing those with low vision should use use their vision to its maximum potential even at the cost of eyestrain or lowered achievement while others believing that those with low vision are essentially blind and should minimize use of residual vision—and the situation becomes even more complicated, throwing a "peer pressure" factor into the decision-making process.

I, personally, have come to a point where I am comfortable using a combination of methods. Large print when it works best, speech when it works best, and braille when it works best. I am proficient in all three areas of access, and most people do not necessarily have this advantage. Yet, even for me, whenever a new low vision gizmo comes out on the market I have a little stint of wondering whether that might be the solution to being able to read print for extended periods of time. Often, I will find somewhere to borrow the device from and will try using large print alone for a while; but inevitably, I always find myself coming back to braille and speech output. This issue of wishing to use print is a thousand times worse for people who are new to low vision. I usually come around to speech and braille again fairly quickly, even if they aren't my preferred medium if I were to have unlimited time (which, obviously, I don't; the world doesn't work that way!). But for many people who are losing vision, this quest for the perfect low vision device that can fix their vision dominates their life for months or even years.

And so, I find myself wondering if I really need new glasses. Are they worth getting, being more of a might-be-nice convenience rather than a necessity? At the price, maybe it would just be a waste of money. Maybe I'd use new glasses as seldom as I use my current ones, even with better frames and a better prescription. But, on the other hand, maybe it would make some small aspect of life such as computer use or using my insulin pump or reading all the other little electronic LCD devices that pervade our everyday lives easier. (Just today I struggled to use a point-of-sales device with a touchscreen I could not read at all, and had to try three times before, with assistance, I was able to hit the right areas of the screen in the correct sequence.) It's too bad I can't just try out a sample of the potential new glasses for month or two to see if they're useful; but with such a strong prescription it's often an ordeal just finding a shop that can actually make them. For the time being, the debate rages on in my mind. Hopefully the appointment with the low vision specialist will yield some direction.


  1. Hi Jen,

    I was wondering if you accepted any guest posting on your site. I couldn’t manage to find your email on the site. If you could get a hold of me at jeff@drugwatch.com, I would greatly appreciate it!


  2. I'm in a similar position, but for different reasons. I've worn +25D glasses because of cataract surgery and having very short eyeballs. I had no choice if I wanted to see anything. With them, I could read normal print and see things far away as well. Peripheral vision is a problem; or not, as I don't have any. But now that my glaucoma has progressed and I can't see detail anymore,I wondering if going without glasses makes sense. My eye doc has suggested I try this.

  3. BTW Jen, I have had good luck getting fairly cheap glasses online. You might try http://greateyeglasses.com. I got a pair of bifocals from them recently for under $100!