3 HR Processes Human Resources Practices Vision Impairments

Vision Impairments

What types of vision impairments exist?

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 (American Foundation for the Blind, 2008b).

Common Errors of Refraction

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

Common Diseases of the Eye

  • Cataracts: Clouding of the eye’s lens that causes loss of vision.
  • Glaucoma: Pressure inside the eye is elevated and can cause damage to the optic nerve, which results in damage to peripheral vision.
  • Macular Degeneration: There is a disturbance of blood vessels in the eye resulting in progressive loss of central vision.
  • 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.
  • Retinopathy (due to Diabetes): Retinopathy typically affects the blood circulation of the retina, which causes blotchy vision.

Other Vision Related Conditions

  • Night Blindness: Night blindness results from pigmentary degeneration of the retina, which leads to difficulty seeing in low light.
  • 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.
  • 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.
  • Floaters: Floaters are small specks or clouds moving in the field of vision.

How prevalent is vision impairment?
The National Institutes of Health recently found that about 6% of the general population is visually impaired, which is about 14 million people. Of these 14 million, more than 11 million have visual impairment that can be corrected by contact lenses or glasses, but about 3 million have visual loss or impairments that cannot be corrected.46 According to the VA, over 157,000 of today’s veterans are legally blind. About 44,000 of these veterans are enrolled in VA healthcare, and a majority of them are elderly or have other chronic health conditions. As of 2006, at least 78 service members from Operation Enduring Freedom or Operation Iraqi Freedom were receiving VA benefits for vision loss, and medical staff at the Walter Reed Army Medical Center treated almost 120 soldiers for vision problems. Early estimates held that by 2010, the number of blinded veterans would grow to more than 50,000 and continue to rise.47

Do people with vision impairments have disabilities under the ADA?
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 (EEOC Regulations . . ., 2011). Therefore, some people with vision impairments will have a disability under the ADA and some will not.

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 (EEOC Regulations . . . , 2011). For more information about how to determine whether a person has a disability under the ADA, visit http://AskJAN.org/corner/vol05iss04.htm.

What accommodations are suggested to support individuals who are diagnosed with vision impairments?
The Job Accommodation Network (JAN) has listed several accommodations for vision impairments. These include activities or actions around various topics such as:

Reading printed materials

Low Vision:

  • Closed circuit television (CCTV) system, which is sometimes referred to as an electronic or video magnifier
  • Hand, stand, or portable magnifier
  • Information in large print
    Note: The American Foundation for the Blind (2008c) recommends that the font size be at least 16 point but preferably 18 point.
  • Photo copier enlarged paper material
  • Color paper, acetate sheet, or overlay to increase color contrast between printed text and document background
  • Optical devices such as monoculars or binocular systems, loupes, or prism spectacles
  • Frequent breaks to rest eyes when fatigue is a factor

No Vision (individuals with low vision may find the following helpful also):

  • Auditory versions of printed document
  • Braille formatted document
  • Reformatted document that displays as accessible Web page
  • The Kurzweil-National Federation of the Blind Reader, which takes a picture of a text document and reads the contents of the printed document in clear synthetic speech
  • Optical character recognition (OCR), which scans printed text and provides a synthetic speech output or text-based computer file
  • Qualified reader, which may be used to “be the eyes” for a person with a vision impairment
    Note: There currently is not a standard for providing or hiring readers, and no certification requirements exist.
  • Tactile graphic document

Accessing computer information

Low Vision:

  • Increased operating system font size with large-size computer monitors
    Note: Computer users can modify their computer display so that text is shown in large print
  • Screen magnification software
  • Locator dots and/or large print keyboard labels for keyboard navigation
  • External computer screen magnifier
  • Flicker-free monitor
  • Anti-glare guard and computer glasses to reduce glare
  • Frequent breaks to rest eyes when fatigue is a factor

No Vision (individuals with low vision may find the following helpful also):

  • Screen reading software
  • Computer Braille display
  • Qualified reader

Writing notes and completing forms

Low Vision:

  •      Closed circuit television (CCTV) system, which is sometimes referred to as an electronic or video magnifier
  •      Pens that include a bold felt tip or lighted pen
  •      Paper with tactile lines, bold print, or low glare
  •      Form/line guide

No Vision (individuals with low vision may find the following helpful also):

  •      Personal data assistants, note takers, and laptops with speech output or Braille display
  •      Cassette or digital recorder
  •      Braille stylus/Braille slate
  •      Braille printer or embosser
  •      Scribe

Accessing a telephone

Low Vision:

  •      Large print/color labels or tactile markings on telephone to identify keys and lines
  •      Hand/stand magnifier or optical magnifier

No Vision (individuals with low vision may find the following helpful also):

  • Telephone light sensor, which is held over a phone line to indicate if a line is lit steady or blinking
    Note: Line status is indicated by audible or vibrating signal
  •      Talking telephone console indicators and message displays

Working with money

Low Vision:

  •      Hand/stand magnifier or optical magnifier
  •      Task lighting or headlamp

No Vision (individuals with low vision may find the following helpful also):

  •      Talking money identifier, cash register, coin counter/sorter, calculator
  •      Training on how to fold money for identification purposes

Reading from instrument or control board

Low Vision:

  •      Hand/stand magnifier or optical magnifier
  •      Large print/color labels or tactile markings on telephone to identify keys and lines
  •      Task lighting
  •      Glare reduction

No Vision (individuals with low vision may find the following helpful also):

  •      Braille/tactile labels or indicators
  •      Qualified reader
  •      Instrument modification by manufacturer, rehabilitation engineer, or employer

Repairing, constructing, assembling pieces/parts

Low Vision:

  •      Hand/stand magnifier or optical magnifier
  •      Task lighting
  •      CCTV

No Vision (individuals with low vision may find the following helpful also):

  •      Braille/tactile labels or indicators
  •      Talking multimeter, micrometer, caliper, stud finder, level, tape measure
  •      Tactile ratchet-action wrench


  •      Service animal and/or mobility aid (e.g., cane, electronic aid)
  •      Mobility and orientation training
  •      Detectable warning surfaces
  •      Colored and/or textured edges on stairs
  •      Improved area lighting
  •      Traveling/evacuation partner
  •      Tactile map of evacuation and common routes
  •      Talking landmark or global positioning system


  •      Shift change to daylight hours
  •      Driver (e.g., hired driver, volunteer, coworker)
  •      Public transportation or carpool
  •      Modified or flexible work schedule to meet public transportation needs
  •      Reassignment
  •      Telework

Working with light sensitivity

  • Lower wattage of overhead lights
  • Task or alternative lighting
  • Full spectrum lighting and/or filters
  • Flicker free lighting
  • Tinted optical wear
  • Workstation relocation
  • Window treatments

Distinguishing colors

  • Labels
  • X-Chrome lens
  • Prescribed glasses for color discrimination
  • Colored acetate sheets
  • Assistant to identify colors such as a volunteer or co-worker

Other accommodation considerations

  • Training materials or company correspondence in alternate format (e.g., large print, Braille, CD-ROM, audiotape)
  • Time off for training on adaptive technology, mobility training, and/or service animal training
  • Additional training beyond what is typically given to others
  • Accessible versions of employee related Web sites or Intranet material

For more information about vision impairments and accommodations, please visit http://askjan.org/media/Sight.html