The Wisconsin Department of Health Services, Office for the Blind and Visually Impaired (OBVI), is the government agency designated to provide assessment, training and information to adults with vision loss, their families and interested professionals. These services exist to enhance independent living skills and quality of life for persons with vision loss. Services are provided free of charge in all of Wisconsin's seventy-two counties by Office field staff and contracted agencies.¹ In 2005, the program served 2,000 individuals statewide. To be eligible for services, a person must be legally blind or have significant visual impairment. Specifically, they must meet one of the following criteria:
- Central visual acuity is 20/70 or less in the better eye, with best correction; or
- Field of vision is constricted to the point that it interferes with daily living activities; or
- A permanent or progressive visual impairment impedes independent living.
The Office provides services to adults who meet these guidelines through the direct teaching of adaptive living skills, both in group settings and in participants' homes.
Problems Presented by Low Vision
Blindness or the onset of vision loss changes an individual's life dramatically. Many of the changes are emotional, as the individual faces the loss and all its implications for identity, relationships, and functioning. When family members and friends step in to help and take responsibility for a blind or visually impaired person, previously balanced relationships may take on a new aspect of dependency. Vision problems that impede driving a car or bike, or make walking more hazardous can make people feel isolated and housebound. Feelings of disorientation from the loss of visual cues lead to further immobility outside the home.
Even within the house, fear of tripping, colliding with furniture, falling, dropping things, etc. can lead those with vision loss to restrict their movements and activities, becoming more sedentary - and thereby putting both mental and physical health at risk. All of these changes contribute to sadness and anger as part of a normal grieving process. When they go unresolved, they can lead to depression and sometimes serious mental health problems.
The changes wrought by blindness and vision loss are pragmatic and logistical, concerning a wide range of considerations about accomplishing routine daily tasks and retaining or regaining independence. With retraining, instruction, and sometimes specialized adaptive devices, those with vision loss can learn to move about safely, live independently, read and write, have a social life, enjoy recreational activities, and travel. They can continue to communicate using large print books and newspapers, magnifiers, special lighting, and specialized time-telling and telephone devices. Specific orientation and mobility techniques and tools can enable them to get around safely inside and outside the home. Equipped with new skills, tools, and techniques, many blind or visually impaired individuals are able to maintain a normal lifestyle. Learning to do these things in new ways also helps individuals cope with the emotional effects of their loss.
Achieving the Goals
The role of the Office for the Blind and Visually Impaired is to provide people who experience vision loss or blindness with the skills, knowledge, home modifications and adaptive equipment to achieve these outcomes:
- Learn different ways of doing activities made more challenging by vision loss
- Retain or regain the ability to move around inside and outside their homes
- Retain or regain the ability to prepare meals by themselves and manage housekeeping tasks
- Manage paperwork tasks (mail, writing checks, etc.)
- Enjoy reading, whether on tape, in large print, with magnifiers, or in Braille
- Participate in activities with family, friends, and community
- Retain or regain control over decisions important in their lives
- Feel safe where they live in terms of moving around and accomplishing daily activities
- Cope emotionally with the challenges of vision loss
- Feel confident that they will be able to maintain current living arrangements if they wish to
¹ Field staff are regionally assigned to conduct group training and make home visits.