Author: midwestlowvision

Glasses for Stroke or Brain Injury (Updated 2026)

Posted on by midwestlowvision

Losing half your vision after a stroke or brain injury is more than just a diagnosis on paper. It can make everyday activities more difficult, like navigating a crowded store, noticing a person approaching from the side, or even just walking through a doorway. For people struggling with side vision loss, finding ways to adapt is incredibly important, and one option that can help is Side Vision Awareness Glasses. In this article, we discuss what these specialized lenses are and answer some frequently asked questions. 

What Are Side Vision Awareness Glasses?

Side Vision Awareness Glasses®, or SVAGs, were developed by Dr. Errol Rummel of Jackson, NJ, after years of treating people with stroke-related, or brain injury-related hemianopsia. Hemianopsia is the clinical term for the loss of half the width of your field of vision; it is one of the most common side effects of a stroke or traumatic brain injury. 

Side Vision Awareness Glasses are specialized low vision glasses that use built-in prism technology to expand the field of vision for patients with peripheral vision loss. 

There are multiple benefits of SVAGs, including:

  1. A wide viewing area, allowing better field awareness. And because SVAGs have a vertical edge, a patient just needs to move their eyes a couple of millimeters to get into the SVAG area of the lens. 
  2. A discreet appearance because the front of the lens is smooth, making the area with prism barely noticeable.
  3. A higher index of refraction. SVAGs are thinner, lighter, and more comfortable than other types of hemianopsia glasses.

The goal is not to make the blind area disappear; it is to improve awareness, navigation, safety, and confidence using the vision that remains.

How the London Bridge would look to someone with a hemianopsia
How the London Bridge would look to someone with a hemianopsia
Side Vision Awareness Glasses in Bloomington, IN | Midwest Low Vision
Notice the prism on the right lens of this pair of SVAG.

Who is a Candidate for SVAGs?

A potential candidate commonly has:

  • Stable right- or left-sided visual-field loss.
  • Enough intact vision to recognize information redirected by the prism.
  • Difficulty detecting people, doorways, carts, furniture, curbs, or other objects on the affected side.
  • Sufficient attention and cognitive ability to learn how the shifted image should be interpreted.
  • A realistic functional goal and willingness to practice.

Patients with significant visual neglect, uncontrolled diplopia, severe cognitive impairment, or difficulty understanding the prism image may have more trouble using the system. Hemianopia and visual neglect are not the same condition, although they can occur together. A careful neurological and functional assessment is essential.

How are SVAGs prescribed?

SVAGs are not an off-the-shelf pair of glasses. The evaluation should include:

  • Confirmation and characterization of the visual-field defect.
  • Assessment of visual acuity, ocular alignment, contrast, cognition, and visual attention.
  • Discussion of specific functional problems.
  • Demonstration of different prism configurations.
  • Observation of the patient using the system during realistic tasks.
  • Custom measurements and lens fabrication.
  • Training and follow-up after dispensing.

General eye care practitioners do not have to prescribe the system themselves. Their most important role may be recognizing the functional problem and referring the patient to a low-vision or neuro-optometric practitioner experienced with hemianopia rehabilitation.

What Do Side Vision Awareness Glasses Look Like?

From a distance, SVAGs can look similar to conventional prescription glasses. Up close, another person may notice a vertical line where the standard lens area meets the prism portion.

These lenses generally appear less conspicuous than temporary Fresnel prisms. However, cosmetics should be a secondary consideration. The more important questions are whether the patient can interpret the shifted image, use it without excessive confusion, and gain meaningful functional awareness.

New Design: Exclusive to Midwest Low Vision

Typically, these glasses have a prism on the back of the lens so that someone can use it when they need to by shifting their eyes to the left or the right. However, Dr. Rummel generously gifted Dr. Jarrod Long a set of his brand new full-field side vision awareness glasses. They work similarly to the standard SVAG but the entire lens is specially designed to shift the missing part of your vision into view. This expands a person’s awareness of objects in their path and enhances peripheral vision. Currently, Midwest Low Vision is one of the only practices in the Midwest with the full field SVAG.

New Full-Field SVAG design

This picture shows a pair of the new full-field glasses. Notice how there is no extra attachment on either lens- instead, the entire lens is designed to adjust the field of view. You can see how the lens shifts the image of the eye chart to the left. This specific type of lens is ideal for someone missing their right visual field. The new design allows someone to see more of their side vision without compromising the view right in front of them.

Frequently Asked Questions

How do SVAGs differ from Peli peripheral prism glasses? 

The two systems redirect information from the blind side, but they use different optical arrangements. SVAGs use a vertically oriented prism area beside the central viewing area, requiring the wearer to deliberately look briefly into the side prism area. They usually have a faint vertical dividing line between the conventional lens and prism area, and are intended to provide a relatively large, clear area through which the shifted scene can be inspected.

In contrast, Peli peripheral prisms use prism segments above and below the central line of sight to provide peripheral awareness while central vision remains unobstructed. They may begin with visible Fresnel press-on segments and later be made as permanent prism segments, and they are intended primarily to alert the wearer to objects in the blind-side peripheral field.

SVAG developers report better optical clarity and contrast than Fresnel press-on prisms. That comparison is optically plausible because Fresnel material introduces blur and contrast loss, but it should not be presented as proof that SVAGs are superior to permanent Peli lenses. The Peli design has substantially more peer-reviewed clinical research supporting its use as a mobility aid. Community studies found that some patients continued using Peli prisms because they were helpful for obstacle avoidance, although not everyone adapted or continued wearing them.

Therefore, the best system is not determined by appearance or prism power alone. It depends on the patient’s field loss, visual processing, cognition, mobility needs, ability to learn the system, and response during an in-office trial.

They require training and practice. Initially, the shifted image may feel unfamiliar, displaced, or confusing. The wearer must learn:

  1. To recognize an image appearing in the prism area.
  2. To use it as an alert rather than assuming the object is in the apparent location.
  3. To turn the eyes and head toward the object.
  4. To confirm its actual position through the clear portion of the lens.
  5. To incorporate the technique into walking, shopping, social situations, and other daily activities.

A properly prescribed device should be paired with structured instruction—not simply dispensed with the expectation that the patient will “figure it out.”

Can SVAGs be worn all day?

Some people may wear them for extended periods, while others use them primarily for mobility or visually complex environments.

The right wearing schedule depends on the design and the patient’s goals. Prism field-expansion systems may be less helpful for sustained reading, computer work, or other detailed central tasks. Some patients benefit from a separate pair of glasses for walking and daily mobility.

Can SVAGs help someone qualify to drive?

Possibly in isolated cases, but these glasses should never be described as a route to “passing the vision test.”

Driver-licensing requirements vary by jurisdiction, and many people with homonymous hemianopia do not meet the required horizontal visual field. A prism may increase awareness without restoring the underlying field or automatically satisfying a licensing standard.

Oblique Peli prisms can provide approximately 30 degrees of expansion in parts of the visual field and have been studied in driving-related detection tasks. Research found that peripheral prisms, particularly when combined with perceptual-motor training, improved blind-side hazard detection in a driving simulator. That does not prove that every wearer is safe to drive or legally qualified. Peripheral prisms and driving-simulator detection

Any discussion of returning to driving should include:

  • Current state licensing requirements.
  • Formal binocular visual-field testing.
  • Assessment of visual attention, processing speed, cognition, and motor function.
  • Training in prism use when applicable.
  • Evaluation by a certified driver rehabilitation specialist.
  • Behind-the-wheel assessment and approval by the licensing authority when required.

In Indiana, the BMV may require documentation from an optometrist or ophthalmologist and may apply restrictions such as corrective lenses, additional mirrors, or daylight-only driving. The BMV—not the prescribing doctor or the glasses—makes the licensing determination.

Conclusion

Dr. Long is specially trained to prescribe and dispense the right pair of glasses for you or your loved ones. If this sounds like something that would improve your quality of life, please call for more information!

The inside of a children's classroom representing an article about the support for students with low vision and blindness in Indiana

How Indiana Schools Support Students with Low Vision or Blindness

Posted on by midwestlowvision

If your child has low vision or blindness, school can present some challenges. Whether it is difficulty with reading the board, seeing print in handouts, or utilizing technology, a student with visual impairment shouldn’t have to work twice as hard to access the same education as their peers. Fortunately, Indiana families have options: legal protections, specialized educational services, assistive technologies, and other resources are available to help students succeed in the classroom and beyond. Read on to learn more about the support available to your student with low vision or blindness.

What Challenges Do Students with Low Vision or Blindness Face?

For students with visual impairment, learning is not as straightforward as “receive information and study.” It may be a struggle to read textbooks, see the board, navigate the school, use online materials, or simply keep up with the class without significant visual fatigue. Without support, students must spend extra effort trying to access information rather than focusing on learning.

What Legal Protections are Available for Indiana Students?

Eligible Indiana students with low vision or blindness are protected by federal law under the Individuals with Disabilities Education Act (IDEA) and Indiana special education rules. Support is typically documented through an Individualized Education Program (or Plan) (IEP) or a 504 Plan. An IEP is a written plan developed by the student’s educational team that outlines the specialized instruction, services, and accommodations a student needs. A 504 Plan provides accommodations that allow students with disabilities to access education alongside their peers.

What Classroom Accommodations and Devices Can Help Students?

Accommodations are based on a student’s individual needs—not simply their diagnosis or visual-acuity measurement. For students with low vision or blindness, common supports might be:

  • Large-print, Braille, audio, or accessible digital materials
  • Magnification tools
  • Special glasses designed to improve visual function
  • Screen readers
  • Video magnifiers
  • Preferential seating
  • Improved classroom lighting
  • Additional time for assignments or tests
  • Visual breaks to reduce fatigue
  • Instruction from a teacher of students with visual impairments
  • Orientation and mobility training

The most effective accommodations are individualized. A tool that works well for one student may not be the best option for another.

Do Teachers and School Staff Receive Training?

Certainly, not every classroom teacher is trained in visual impairment, so specific staff training may need to be requested and included in an IEP. If your child is struggling, you should request a school evaluation in writing. I don’t recommend waiting for the school to recognize every problem, and you definitely don’t want to assume your child simply needs to try harder.

What Specialized Schools and Programs Exist?

You might already be familiar with the Indiana School for the Blind and Visually Impaired (ISBVI), but many would be surprised to know its role extends far beyond operating a specialized school.

ISBVI also supports students and educators in local school districts, provides short-term programs, and helps schools obtain accessible educational materials. Through outreach services, ISBVI works with students who attend their local schools by providing resources, training, and support to help meet their educational needs.

Additionally, BOSMA offers transition and employment services for eligible Indiana students ages 16 through 22. These programs can help students develop skills related to employment, independence, and future planning.

Indiana Vocational Rehabilitation can also often help cover the costs of special glasses, assistive devices, and other testing and services for older students.

Resources for Parents and Guardians

While managing a visual impairment comes with challenges, there are fortunately many resources to help. Here is a list of programs and organizations that offer assistance in navigating your child’s education:

Conclusion

I see children and adults from around the world who benefit from specialized low vision care right here at my offices in Indiana. So, call us at Midwest Low Vision at 877-577-2040, or reach out via our contact form, for advice on getting the help your child needs to see and function better. Thank you.

A doctor takes the blood pressure of a patient representing how hypertension may cause retinopathy

How Does Hypertension Cause Retinopathy?

Posted on by midwestlowvision

Hypertension, commonly known as high blood pressure, is also referred to as the “silent killer” because it can cause damage in a person’s body for years without producing any noticeable symptoms. It is well known that unmanaged high blood pressure can lead to cardiovascular disease, but what is lesser known is that hypertension can also affect the eyes—one of the most common of these conditions being hypertensive retinopathy. Below, we discuss what hypertensive retinopathy is, along with risk factors, stages, diagnosis, and treatment.

What is Hypertensive Retinopathy?

Hypertensive retinopathy occurs when high blood pressure strains the tiny blood vessels that supply blood to the retina. If we think of the eye like a camera, the retina is the digital sensor (or the film for those that remember film!) that captures the electrical signals, sending that information to the brain to tell us what we are seeing.

Like every other part of the body, the retina needs a steady supply of oxygen and nutrients delivered through a network of blood vessels. When blood pressure remains elevated over time, this vascular pressure causes those blood vessels to harden, narrow, or leak fluid, all of which reduces healthy blood flow and potentially leads to permanent vision loss.

Risk Factors for Hypertensive Retinopathy

The biggest risk factor is, of course, having hypertension, especially when it has been poorly managed for a long time. In addition, there are other factors that can compound the risk, including:

  • Hypertension
  • Older age
  • Diabetes
  • High cholesterol
  • Smoking
  • Kidney disease
  • Obesity
  • Family history of cardiovascular disease

The longer that blood pressure remains elevated, the greater the chance of permanent damage to the retinal blood vessels. However, it’s important to note that not everyone who has high blood pressure will go on to develop hypertensive retinopathy.

What are the Stages of Hypertensive Retinopathy?

In the early stages, patients often have no symptoms. As the condition progresses, however, an eye doctor will begin to notice retinal changes. While there are different classification systems for grading hypertensive retinopathy, many doctors use the Keith-Wagener-Barker system, which categorizes the disease into four levels:

Grade 1 (Mild) Hypertensive Retinopathy

This is the earliest stage, in which retinal arteries are slightly narrowed. Most people don’t notice any vision changes; the findings are discovered during a routine eye exam. Along the same lines, some people may not even be aware they have high blood pressure until the eye doctor directly observes blood vessel changes in the eye. (Just another reason why your routine eye exam is so important!)

Grade 2 (Moderate) Hypertensive Retinopathy

As the damage progresses, the blood vessels become increasingly constricted and may even begin to compress nearby veins. Small areas of bleeding, tiny retinal hemorrhages, or deposits of fatty material called hard exudates may appear. Vision quite often remains normal at this stage, though some individuals may notice mild blurriness.

Grade 3 (Severe) Hypertensive Retinopathy

At this stage, the retina shows more extensive bleeding, swelling, cotton wool spots (small areas of nerve fiber damage caused by reduced blood flow), and fluid leakage. For people at this stage, vision may be blurry, or images may appear distorted.

Grade 4 (Malignant) Hypertension

At this stage, blood pressure has reached dangerously high levels, causing widespread retinal damage and swelling of the optic nerve (papilledema). This stage requires urgent care to help prevent permanent vision loss as well as other systemic complications of hypertension.

How Is Hypertensive Retinopathy Diagnosed?

Because hypertensive retinopathy often doesn’t have symptoms until an advanced stage, your annual eye exam is incredibly important to detect any changes early on. At your appointment, you can expect the doctor will:

  • Review your medical history, including any diagnosis of high blood pressure
  • Evaluate your vision
  • Dilate your pupils to carefully examine the retina and optic nerve
  • Look for narrowing blood vessels, bleeding, swelling, or other signs of retinal damage

In some cases, Optical Coherence Tomography (OCT) or fundus photography may be used to better document swelling, bleeding, or other retinal changes.

How Is Hypertensive Retinopathy Prevented and Treated?

Prevention and treatment start with controlling blood pressure. This means:

  • Working with a primary care doctor
  • Taking medications as prescribed
  • Reducing salt intake
  • Exercising
  • Managing weight
  • Treating diabetes or cholesterol problems
  • Stopping smoking

Eye findings can improve when blood pressure is controlled, but severe damage may be permanent.

Low Vision Care

Vision damage from hypertensive retinopathy may include blurred or reduced central vision, blind spots, distorted vision, reduced contrast, or optic nerve damage. While in many cases, this vision loss is not reversible, low vision care may be able to help maximize the vision a person has left.

Protect Your Vision with Regular Eye Exams

The bottom line is that hypertensive retinopathy is a warning sign. If high blood pressure is showing up in the eyes, the whole vascular system deserves attention. Conversely, if you have hypertension, it is extra important to keep up with regular eye exams to maintain healthy vision. If you have suffered vision loss due to hypertensive retinopathy, or another condition, we might be able to help.

 

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Grandparents with a grandson gathered together for a photo representing an article about is macular degeneration inherited

Is Macular Degeneration Inherited?

Posted on by midwestlowvision

If you have immediate relatives with age-related macular degeneration (AMD), the question of whether the disease is hereditary is a very personal one, often raising concerns about your own future vision health. In this article, we review what AMD is and discuss how family history and lifestyle factors play into a person’s overall risk for developing macular degeneration.

What is Macular Degeneration?

Age-related macular degeneration, more commonly known as just AMD, is an eye disease that affects the macula, which is the central part of the retina responsible for central vision. A simple way to think about the eye is like a camera. Light travels through the cornea, pupil, natural lens, and vitreous before reaching the retina at the back of the eye. The macula sits at the center of the retina, and its job is to help us see fine details clearly, whether that’s reading small print, recognizing faces, or telling colors apart. When the macula becomes damaged, these tasks become increasingly difficult.

For people with AMD, the experience is more than just “blurry vision.” While symptoms can vary widely, people with AMD cope with:

  • Distorted or warped vision, such as straight lines appearing crooked, making text difficult to read
  • Dark or blind spots in central vision
  • Needing brighter lights, particularly when doing close-up work
  • Changes in color vision, with colors appearing less vibrant or more difficult to distinguish

How Common is Macular Degeneration?

Age-related macular degeneration is a highly common condition. Affecting over 20 million Americans, it is the leading cause of vision loss for adults over the age of 50, though AMD’s prevalence is much higher in adults over 60.

Is Macular Degeneration Inherited?

For those who have relatives with AMD, this is the big question. The answer, unfortunately, is not a straightforward one. AMD is not usually inherited in a simple, direct way. Rather, it is a complex condition influenced by both genetics and lifestyle.

Studies indicate that having a first-degree relative—a parent or sibling, for example—with AMD means your risk is about 3 to 4 times higher compared to someone without that family history. Researchers have identified over 30 genes associated with the risk of developing AMD. This tells us there is a genetic component to AMD; however, association does not mean causation, and just because a person carries these genes does not guarantee they will develop AMD.

Genetics is not the only factor in whether someone will go on to develop the disease—lifestyle also plays a role. That means family history certainly matters, but it does not determine your future by itself. A useful way our low vision colleague in North Carolina, Dr. Edward L. Paul, Jr., OD, PhD, FIALVS, explains this is: “Genetics loads the gun, but lifestyle often pulls the trigger.”

What Lifestyle Factors Influence the Development of AMD?

There are a number of lifestyle factors that can influence the risk of developing age-related macular degeneration. These include:

  • Smoking: Smoking is one of the strongest modifiable risk factors for AMD. Studies show smokers have a substantially higher risk of AMD than non-smokers, and smoking is repeatedly identified as an important environmental risk factor.
  • Advanced age: While not a controllable risk factor unfortunately (if only!), advanced age is one of the leading factors in the development of AMD. The risk increases after the age of 60 and goes up with added years.
  • Cardiovascular disease and high blood pressure: The eyes need healthy blood vessels to provide oxygen and nutrients. Conditions that decrease circulation, such as cardiovascular disease or high blood pressure, can reduce blood flow and increase the risk of macular degeneration.
  • Poor nutrition: Nutrients such as lutein, zeaxanthin, omega-3 fatty acids, and vitamins C and E are critical to eye health, and a diet lacking in these is a known risk factor for AMD.
  • Excess weight: Obesity and a sedentary lifestyle have been associated with a higher risk of developing macular degeneration.
  • Long-term UV light exposure: Research has indicated that long-term exposure to UV light may contribute to retinal damage.

Can You Prevent Macular Degeneration?

Because AMD is a complex disease controlled by genetics and lifestyle factors, it is not possible to 100% prevent the disease. You can, however, significantly reduce your risk of it, or slow the progression of the disease if you’ve already been diagnosed, in several ways:

Conclusion

While age-related macular degeneration does run in some families, it is only one piece of the puzzle. Developing AMD is not a certainty, and it does not always lead to significant vision loss or low vision. If AMD runs in your family, the most important thing you can do is live a healthy lifestyle and keep up with regular eye exams, as early detection allows for timely intervention, should changes be observed. If you are dealing with vision loss from macular degeneration, get in touch with us today. We’re here to help.

The inside view of a vehicle with a person's hands on the steering wheel with an image of a "Welcome to Indiana" sign overlaid representing an article about what to know about the vision exam for a driver's license in Indiana

What to Know About the Vision Exam for a Driver’s License in Indiana

Posted on by midwestlowvision

Whether you’re applying for a new driver’s license, or renewing an existing one, the vision screening is a critical step. For those with vision challenges though, this process can feel a bit confusing. What are Indiana’s standards? How is the test administered? What happens if you don’t pass the vision exam the first time around? Fortunately for Indiana residents, the state takes a more case-by-case approach to the vision requirements for a drivers license, and even if you have less-than-perfect vision, there may be a pathway to help you get on the road safely.

Why Are Vision Exams Necessary?

Driving is a visual task. Since we’re not at the point of completely autonomous vehicles (we’ve got a ways to go!), it remains necessary to be able to see well enough to operate a vehicle. The vision exam, administered in Indiana by the branch of the Bureau of Motor Vehicles (BMV), confirms that a person can view stoplights and signage, maintain awareness of other drivers, and detect obstacles in time to respond defensively.

Who Needs to Take the Vision Exam in Indiana?

In Indiana, the vision exam is required for anyone applying for a learner’s permit or a license—whether you are getting a new license or just renewing. It’s possible to skip the vision screening at the BMV if you provide the Vision Screening Documentation, which is a form that must be filled out by a licensed optometrist or ophthalmologist certifying that your vision is sufficient for safe driving.

What Are Indiana’s Standards?

Driving rules vary from state to state, which can cause a lot of confusion–especially for people with less-than-perfect vision. In Indiana, passing the eye exam is not “all or nothing.” Instead, each eye is considered independently, with varying combinations of vision levels permitted.

What is first looked at is whether a person requires glasses or contacts. If you do, there will be a Type B restriction on your driver’s license.

Common restrictions placed on a driver’s license include:

  • Type B: A type B restriction means that the driver must wear glasses or contact lenses when driving
  • Type F: A type F restriction indicates a need for outside rearview mirrors when driving
  • Type G: A type G driver is only permitted to drive during daylight hours

For those who drive without glasses, the standards are:

  • No restrictions: Both eyes are 20/20 to 20/40
  • Type F restriction: One eye is 20/20 to 20/40, while the other eye can be 20/50 to blind

For drivers who read with glasses, the requirements are:

  • Type B plus F restrictions: One eye must be 20/20 to 20/40, and the other eye can be 20/50 to blind
  • Type B restriction: It is permitted for both eyes to be 20/50
  • Type B plus F plus G restrictions: One eye must be 20/50, and the other eye can be 20/70 to blind
  • Type B plus F plus G restrictions: One eye 20/70, and the other eye can be 20/70 to blind (must show proof of normal peripheral vision)

Indiana’s approach allows for flexibility—matching restrictions to a driver’s unique level of vision rather than applying a one-size-fits-all rule.

How Is the Test Administered?

At the BMV, the vision screening is conducted using a tabletop device called the Optec 1000 DMV Vision Screener (made by Stereo Optical). This machine uses polarized filters which cause each eye to see a different set of letters, with some letters seen by both eyes. This test is designed to test the eyes both independently and together.

What Happens If I Fail the Eye Exam For a Driver’s License?

If you do not pass the vision screening at the BMV, this isn’t the final say that you cannot drive. It means that you will be given the Vision Certificate form and referred to an eye care professional for a comprehensive vision exam to determine whether your vision can be corrected with glasses or contacts. Once the information has been submitted and reviewed, the BMV may request more details, require a driving evaluation, add restrictions, or schedule future follow-ups. In some cases, it may happen that the BMV revokes driving privileges.

Can I Still Drive in Indiana If I Have Low Vision?

In some cases, yes, you can still drive in Indiana with low vision. While not everyone qualifies, Indiana offers a pathway to bioptic driving for individuals who meet specific candidacy, training, and certification requirements. Generally, this includes having at least one eye between 20/80 and 20/200 (with or without glasses or contacts), being able to achieve at least 20/40 vision through a bioptic telescope, and having normal peripheral and color vision. Along with these clinical requirements, candidates must also be motivated, cognitively intact, and medically stable. The process requires a commitment, and not every person is able to become a bioptic driver.

How Does the Bioptic Certification Process Work?

Becoming a bioptic driver in Indiana is a multi-step process involving both medical evaluation and hands-on training. The process generally looks like:

  1. Low vision evaluation: The first step is to have an evaluation with an optometrist specialized in low vision care. After a comprehensive evaluation, you will be fitted for bioptic telescopic glasses. After training with those lenses, your low vision doctor will assess whether you meet the requirements to be a licensed bioptic driver.
  2. If approved by your low vision doctor, you’ll work with a Certified Driving Rehabilitation Specialist (CDRS) to complete 30 hours of supervised training and progress toward your learner’s permit and driving test using your bioptics. This step is often facilitated through Indiana Vocational Rehabilitation Services.
  3. Driving test: Once you’re able to safely navigate on the road, the next step is to take the BMV driving test. If you pass this test, you will be issued a bioptic license, with regular recertifications required.

Conclusion

At the end of the day, the vision screening for a drivers license isn’t meant to unnecessarily restrict people from driving—it’s meant to ensure the safety of all drivers on the road. Whether you wear corrective lenses, drive with restrictions, or require bioptic glasses, there is likely a pathway for you. If you are a person with low vision and would like to learn more about bioptic driver certification, we’re here to help.

Image of a field with sides of vision blacked out indicating peripheral vision problems

Preventing Falls When You Have Peripheral Vision Problems

Posted on by midwestlowvision

Peripheral vision is something most people don’t think about—until you no longer have it. Peripheral vision allows us to detect motion and obstacles outside of the line of sight without turning our heads. When this ability becomes limited, whether due to disease or injury, navigating the world becomes more challenging, and the risk of trips and falls increases. In this article, we look at the role peripheral vision plays in our sight and discuss strategies and aids to cope with peripheral vision problems and move more safely.

What Is Peripheral Vision?

Peripheral vision, also known as side vision, allows you to see objects and movement that are not in your direct line of sight. Also referred to as “tunnel vision,” this visual impairment is often compared to looking through a cardboard tube—you can see in front of you, but not out to the sides.

Peripheral vision plays a key role in helping you move through the world every day, allowing you to notice—and avoid—hazards like steps, uneven surfaces, furniture, pets, and other people.

What Causes Peripheral Vision Loss?

Peripheral vision problems can occur for a variety of reasons. Some common causes include glaucoma, stroke or brain injury, retinitis pigmentosa and other retinal disease, optic nerve disease, and certain neurologic conditions. Depending on the cause, side vision loss can happen suddenly, or it may be a gradual loss.

How Can Lack of Peripheral Vision Affect Mobility?

When side vision is limited, getting around can be challenging. You might find yourself bumping into door frames, misjudging the stairs, or running into people in crowds, all of which increase the likelihood of losing your balance. While avoiding unfamiliar situations may seem like a way to stay safe, this can end up leading to unintended effects of decreased confidence and social isolation over time.

How Can You Make Your Home Safer with Peripheral Vision Loss?

Most people don’t realize just how much they rely on peripheral vision until it starts to change. Fortunately, a little preparation can go a long way. There are many simple adjustments to your environment and daily habits that can make a big difference in your confidence and safety level.

The home is a good place to start, and here are some easy changes you can make:

  • Lighting: Improve lighting in hallways, stairways, bathrooms, and entryways. Small thresholds entering a home or between rooms can be a significant fall risk.
  • High-Contrast Taping: Consider adding brightly colored tape to mark steps, door frames, and furniture.
  • Remove Hazards: Eliminate tripping hazards such as loose rugs, electrical cords, and other clutter on the floor.
  • Pathway Security: Keep walkways clear and furniture in established locations.
  • Pet Location: Put a bell on your pet’s collar, so you always know when they are underfoot.

How Can You Be Safer Outside the Home?

Outdoor environments, particularly unfamiliar locales, are less predictable and increase the chance of a fall. Taking a more mindful approach to how you move can help you stay safer and regain confidence. Consider:

  • Using handrails when they are available
  • Pausing before stepping down off curbs or going down stairs to orient yourself
  • Allowing extra time to move through crowds
  • Walking with a companion, when possible
  • Staying aware of changes in walking surfaces, such as from sidewalk to grass or gravel
  • Wearing footwear with good traction

Are There Behavioral Modifications that Can Increase Safety?

In addition to changes in your environment, there are behavioral modifications you can make to improve safety. Consider:

  • Scanning Techniques: To make up for lost peripheral vision, teach yourself to turn your head frequently, side to side and up to down.
  • Mobility Aids: A cane can help to detect obstacles in your path, particularly in unfamiliar locations.
  • Regular Eye Exams: Stay current on your eye exams to monitor for changes.

What Low Vision Aids Can Help?

For some, lifestyle modifications may not be enough. In these cases, low vision care can play an important role in improving safety and day-to-day functioning.

Examples of devices and glasses that can help our patients include:

Depending on the cause and pattern of vision loss, some patients also benefit from orientation and mobility training, contrast enhancement, selective lighting adjustments, filters, or other low vision tools.

A low vision evaluation with Midwest Low Vision can help identify the specific challenges peripheral vision loss is creating and determine which strategies and devices may be most effective in reducing fall risk and improving confidence with mobility.

Conclusion

If you deal with peripheral vision loss, or have concerns about mobility due to vision challenges, we may be able to help. The first step is to talk with your optometrist or consult a low vision doctor near you. If you are in the Bloomington, Clarksville, or Evansville, Indiana areas, Midwest Low Vision can help you regain confidence and independence with custom solutions for your vision needs. Give us a call at 877-577-2040 or contact us on our website.

Image of glasses sitting on top of a book representing an article about why glasses can't fix my vision

Why Can’t Glasses Fix My Vision?

Posted on by midwestlowvision

One of the most frustrating moments for people is being told that your glasses prescription is up-to-date, yet… you still can’t see well. You may feel confused, discouraged, and also perhaps a bit skeptical. Aren’t glasses supposed to fix my vision? Was something missed? For many patients in this situation, the answer is unfortunately no. While glasses are powerful, they have limits. When vision loss is caused by disease or damage to the eye, “stronger glasses” will not fix the problem. In this article, we shed light on what glasses can and cannot do, explain what low vision means, share how to set reasonable expectations for your vision, and explore what devices and strategies CAN help when traditional glasses cannot.

So, What Vision Problems Can Glasses “Fix”?

Glasses work best when the main problem is focus—meaning, the eye is shaped in a way that causes images to land slightly in front of, or behind, the retina. In these cases, the eye’s “camera” is healthy, but the image is just not focused sharply.

Glasses can correct conditions such as:

  • Nearsightedness (myopia)
  • Farsightedness (hyperopia)
  • Astigmatism (irregularly shaped cornea or lens)
  • Presbyopia (age-related changes to close-up vision)

When vision problems are related to these focusing (refractive) errors, glasses can be very effective. Properly prescribed lenses will sharpen vision as much as possible, reduce eye strain, and may help with some mild magnification needs.

When Are Glasses Not Effective?

There is a common misconception that if you have blurry vision, glasses should “fix” the problem. This is not always the case, however. Vision problems can arise from refractive errors, but issues can also occur due to disease or damage inside the eye or visual pathways. Some of these conditions may include:

  • Age-related macular degeneration: This condition damages the macula, the central part of the retina, and results in loss of central vision.
  • Diabetic retinopathy: Diabetes can cause damage to retinal blood vessels, which can lead to bleeding, scarring, or distorted vision.
  • Glaucoma: Glaucoma causes damage to the optic nerve, often resulting in loss of peripheral (side) vision.
  • Retinitis pigmentosa: This is a genetic condition that gradually reduces side and nighttime vision.
  • Stroke/brain injury: Neurological damage from a stroke or other traumatic brain injury can disrupt how the brain processes visual information.

In these cases, the image can be “in focus” but still missing, distorted, dim, washed out, or broken up. Traditional glasses will not be able to replace missing central vision, restore damaged retinal cells or optic nerve fibers, fix blind spots, or eliminate distortion.

What is Low Vision?

When a person has a disease or damage that glasses cannot fix, that person can be described as having “low vision.” Low vision does not mean total blindness; rather, it takes the form of:

  • Central vision loss: This shows up as a blur, a gray spot, or a missing area of sight right in the center of your vision.
  • Peripheral vision loss: Bumping into things, trouble navigating crowded spaces, the feeling of “tunnel vision” all describe the experience of peripheral vision loss.
  • Distortion: In this case, a person may see straight lines as wavy, faces that look “melted,” or letters that warp their shape.
  • Low contrast: With low contrast, colors look faded, especially in dim light. A person may have trouble reading black-on-white text.
  • Light sensitivity or glare: Headlights, sunlight, or bright indoor lighting can be disabling.

Low vision describes the situation a person is in when vision challenges interfere with the ability to function successfully in daily life. If you’re thinking, “My eye doctor says my prescription is fine, but real life is hard,” that’s the gap that low vision care can address.

How to Manage Expectations with Low Vision

A big part of low vision care is setting realistic goals—and also eliminating unnecessary guilt. Many patients believe that if they just find the right glasses, they’ll be “normal” again. Or, they may feel they are not trying hard enough. Or, some feel that if they purchase a really expensive device they saw online, they’ll be “fixed.” Unfortunately, this thinking is a setup for disappointment. With low vision, a better mindset is: You may not get back to perfect vision, but you CAN regain function and independence with the right tools and strategies. Functional goals may look like:

  • Being able to read for 15-30 minutes at a time
  • Seeing your phone clearly again
  • Recognizing faces across the room (or at least in conversation distance)
  • Watching TV with less strain
  • Using a computer for email or browsing
  • Seeing prices, labels, and medication bottles
  • Improving safety on steps, curbs, and uneven ground

Success in low vision is measured by what you can do; it is NOT a number on an eye chart.

If Glasses Can’t Help, What Devices Can?

Low vision exams are not “one size fits all,” and the solution is not just “bigger print.” When you come in for a low vision appointment, we examine what part of vision is reduced (central, peripheral, etc.), discuss what tasks matter most to you, and determine which tools match your goals, budget, and lifestyle. These steps help us determine which devices would be most effective for you. Common low vision aids include:

  • High-powered reading glasses (sometimes combined with specific lighting)
  • Handheld and stand magnifiers
  • Electronic magnifiers (portable or desktop)
  • Computer/phone accessibility features (These are powerful, but often underused!)
  • Telescopes for seeing at a distance
  • Filters and glare control lenses
  • Training strategies, such as “eccentric viewing” (using a healthier part of the retina) and scanning techniques

Expensive Devices Don’t Automatically Mean Better

Some devices marketed out there to help low vision can be expensive—and the wrong device can be expensive even if the price is cheap. The goal, when identifying the right tools to remediate low vision, is to focus resources on the options that are truly useful for you. The aim is to match the right tool to:

  • Your visual condition and remaining vision
  • Your specific tasks
  • Your comfort and ability to use the device
  • Your real-world environment

A good low vision plan is practical. If a tool won’t realistically be used, it shouldn’t be purchased.

Final Thoughts

In summary, if you’re wondering, “Why can’t glasses fix my vision?”, the key is to examine what is causing the vision issue in the first place. If it is a focusing error, glasses can work for you. If the problem stems from disease or damage to eye structures, the path forward isn’t “stronger glasses”; it’s better tools, strategies, and expectations. It’s low vision care.

If daily tasks are getting harder for you even with your updated glasses, a low vision evaluation with us can help get to the bottom of what is happening and what can be improved. Give us a call at 877-577-2040, or contact us online.

Image of Dr. Long speaking in a video about "Not Blind Enough": Blindness is a Spectrum

“Not Blind Enough”: Low Vision and Blindness are a Spectrum

Posted on by midwestlowvision

A common frustration seen online, and one that I have heard many times in my own practice, is a patient saying “I’m not blind enough.” This may be the person expressing their own feelings, or it could be the patient repeating what someone said to them. On its face, this may seem like an unusual statement to make, but it actually reflects a very real and disheartening experience for people with low vision: a lack of understanding of what “blindness” actually means, and the resulting lack of support that people in this “gray zone” often experience. If this sounds all-too-familiar, this message is for you.

What Does “Not Blind Enough” Mean?

When people say they’re “not blind enough,” what they usually mean is this: they have too much vision to qualify for services, but not enough vision to function the way others seem to, or the way they used to function before they had visual impairment. They’re stuck in a gray zone between “disabled” and “normal”—because the vision loss isn’t always visible, others question it, whether silently or outright. Over time, that external doubt creeps in, and patients start questioning themselves. They tell me they feel like they’re overreacting, like they’re asking for help they don’t deserve, or like they should just try harder. And that emotional toll of not being seen, believed, or validated is very real, and one of the most overlooked parts of having low vision.

Blindness is a Spectrum: What Does Low Vision Mean?

From a medical standpoint, low vision is not about being legally blind, and it’s not about a single measurement on an eye chart. Low vision is about how your vision works or doesn’t work in real life despite glasses, contacts, surgery, or medical treatment. Clinically, low vision can mean decreased clarity of vision, reduced contrast, blind spots, glare sensitivity, poor night vision, or loss of peripheral vision in everyday life. What that looks like in day-to-day life is missing faces in a crowd, struggling in stores, airports or dim lighting, bumping into people or objects, not being able to read a menu, or feeling exhausted just trying to keep up.

What Can These Feelings Lead To?

When people live in this gray zone, something fairly predictable seems to happen—they start to withdraw. They stop going out, they stop asking for help, and they stop pursuing services that could actually help them function better, which often leads to social isolation and not getting the support they need.

Help for Those in the Gray Zone

To get through the day-to-day, some patients report carrying a cane or wearing a “visually disabled” button, not because they need these tools, but because they feel it gives other people permission to understand they have a disability.

Long-term, low vision care may help. And I want you to hear this message clearly: If your vision is interfering with your daily life, your reading, your mobility, your confidence or your independence, you are not imagining it, and you are not overreacting. You do not have to be legally blind to benefit from low vision care. You are blind enough to consider options that can help.

So talk to a low vision specialist. Learn more on our website, visit the International Academy of Low Vision Specialists website, or simply Google “low vision.” Help exists all over the world, and you deserve access to it.

Image of two coffee cups in which one is blurry representing the morning blurry vision that happens with Fuchs' Corneal Dystrophy

What is Fuchs’ Corneal Dystrophy?

Posted on by midwestlowvision

Blurry morning vision that clears up by midday is one of the classic early symptoms of Fuchs’ Corneal Dystrophy. If you’ve been told you have Fuchs’, or even just corneal guttae, you may have a lot of questions. What is Fuchs’ Corneal Dystrophy? How serious is the disease, and what treatment is available? In this guide, we’ll break down everything you need to know, from symptoms to diagnosis to treatment and low vision support so you can stay well informed on your eye health.

What is Fuchs’ Corneal Disease?

Fuchs’ Corneal Disease—also known as Fuchs’ Corneal Dystrophy, Fuchs’ Endothelial Dystrophy, or simply, Fuchs’—is a disease affecting the corneas of both eyes. The cornea is the clear, dome-shaped outer layer of the eye which covers the iris, pupil, and anterior chamber. A progressive disease, Fuchs’ Dystrophy specifically affects the endothelial cell layer, the cells responsible for pumping fluid out of the cornea to keep it clear. When these cells begin to fail, fluid builds up, the cornea swells, and vision becomes cloudy. Fuchs’ almost always affects both eyes, even if one eye is worse than the other.

Fuchs’ Disease: A Genetic Cause

Fuchs’ is genetic, meaning this is not something you caused. It is not related to screen use, eye strain, or anything you did wrong. Endothelial cells decline slowly, often over decades. Symptoms usually appear later in life around the 50s or 60s, though being diagnosed in your 20s, 30s, or 40s is increasingly common. We’re simply able to detect it earlier now, which allows for better long-term planning.

What are the Symptoms of Fuchs’ Disease?

The most common symptoms are:

  • Blurred or hazy vision, especially in the morning
  • Glare and halos around lights
  • Vision that fluctuates throughout the day
  • Pain or discomfort in more advanced stages of the disease

How is Fuchs’ Diagnosed?

The diagnosis is made clinically and does not require tissue samples or a biopsy. During the evaluation, doctors look at several factors, including:

  • Guttae: These are tiny bumps on the back of the cornea that are an early sign of endothelial deterioration.
  • Corneal thickness: The thickness of the cornea increases as fluid builds up in the cornea.
  • Endothelial cell counts: Fuchs’ Disease causes endothelial cells to die; a cell count will indicate the stage of disease a person may be at.

How Serious Is Fuchs’ Disease?

Fuchs’ is a progressive condition, but its severity can vary from person to person. Some people live their entire lives with only mild Fuchs’ and never need surgery. Others progress to significant corneal swelling that interferes with reading, driving, and daily activities. In other words, this condition exists on a spectrum, and where you fall on that spectrum matters for proper treatment.

What is the Treatment for Fuchs’ Corneal Dystrophy?

Treatment for Fuchs’ is not one-size-fits-all. The condition progresses slowly–generally over decades–and the appropriate treatment depends on the stage of the condition and how much your daily life is affected.

Early Stage Fuchs’

Early treatment focuses on managing corneal swelling, not curing the disease. Hypertonic saline (salt or sodium chloride) drops or ointments may be used to reduce swelling and temporarily improve clarity. While saline drops help to relieve symptoms, they do not stop disease progression. Another morning evaporation strategy involves using a hair dryer on low to gently dry the cornea.

Advanced Fuchs’

When vision becomes consistently cloudy, surgery becomes the definitive treatment. In the past, surgery meant a full-thickness corneal transplant, which involved long recovery times and greater risk. Today, modern endothelial transplants—such as DMEK or DSAEK—have dramatically improved outcomes for patients with Fuchs’. These procedures replace only the damaged endothelial layer, leaving most of the cornea intact. Recovery following modern endothelial transplant is generally much faster and better tolerated than the older corneal surgeries. Many patients notice improvement within weeks, with continued visual refinement over several months.

It’s important to note that if you’ve been told you have guttae, that does not automatically mean you will need surgery. Guttae are early warning signs and a relatively common corneal finding. They do not guarantee progression, and some people may never progress to advanced disease.

As an additional note, many patients also have questions regarding Fuchs’ and cataracts. These conditions often occur together, as both are age-related. Cataract surgery places stress on endothelial cells, which can worsen corneal swelling in patients with Fuchs’. When appropriate, many patients with these coexisting conditions could benefit from combined procedures.

How Does Low Vision Care Fit In with Fuchs’ Corneal Dystrophy?

How does low vision care fit into all of this? This is something that doesn’t get talked about enough. Most people do very well after Fuchs’ surgery, but not everyone ends up with perfect vision. Some patients are left with glare, contrast loss, or other visual limitations that still affect daily life.

This is where low vision care comes in. At Midwest Low Vision, we help patients function better even when the eyes can’t be medically or surgically improved any further. If vision problems are still limiting you, it’s important to know there are options beyond “you just have to live with it.”

Conclusion

Fuchs’ Corneal Dystrophy is a progressive condition that affects vision differently for people. Understanding your condition, staying informed about treatment options, and seeking the right support are all key to protecting your vision for years to come. If you’d like to learn more, check out our video on this topic. And if you have questions about Fuchs’ Corneal Disease, or about low vision care, please reach out to us today.

An older woman using a magnifier to see better representing the low vision aids for macular degeneration

What Low Vision Aids Help for Macular Degeneration?

Posted on by midwestlowvision

Age-related macular degeneration (AMD) is the leading cause of vision loss for people over 60. Because the condition affects central vision, tasks requiring sharp, detailed sight, such as reading, recognizing faces, or viewing street signs, can be challenging. Such vision difficulties are disheartening and can even be dangerous. Fortunately, there are low vision aids for macular degeneration available that can help you overcome such challenges and make the most of your remaining vision.

What is Macular Degeneration?

Age-related macular degeneration, or AMD for short, is a medical condition affecting the macula, the part of the retina responsible for sharp, central vision. If you think of the eye like a camera, the light passes through the cornea, pupil, the natural lens, and the vitreous humour until it reaches the retina at the back. The macula sits right in the middle of that retina, handling fine details, faces, colors, etc., and this is the area that becomes damaged by macular degeneration. Some of the symptoms of this disease include:

  • Blurred vision
  • Difficulty reading small print
  • Changes in color vision
  • Distorted vision, in which straight lines like door frames may appear wavy or bent
  • Loss of central vision, as the condition progresses

What Challenges Do People with AMD Face?

The loss of sharp central vision can create many challenges in day-to-day life. People with AMD express difficulty with:

  • Reading or Writing: Printed items like books, magazines, prescription labels, or food ingredient lists can become hard to distinguish, as the letters may appear fuzzy or distorted. Similarly, because writing requires focusing on fine details, it can be challenging to fill out forms, make out checks, or jot to-do lists.
  • Viewing Screens: While a phone may be a handy size to carry in the pocket, the compact nature of the device requires the print on the screen to be equally small. Even watching television is challenging, as the loss of central vision, in combination with glare and poor contrast, can make details hard to discern.
  • Recognizing Faces: Perhaps one of the most frustrating challenges of AMD is difficulty seeing faces clearly. This can lead to awkward social encounters, misunderstanding, and disengagement from social interaction.

What to Know Before Buying Low Vision Aids for Macular Degeneration

AMD is a challenge, but thankfully, there are many aids and devices out there that can help. But before you go out and purchase any old device, here are some tips and tricks that are important to know:

  1. There is no “best” low vision aid. The correct tool depends entirely on the task and the patient’s remaining vision. On a similar note, there is no singular device that suits all tasks.
  2. Magnification strength is irrelevant without clarity, field of view, and proper optics. In other words, magnification strength alone doesn’t promote better vision. The device also needs to be quality enough to provide clear, sharp images that are comfortable to view with minimal distortion. It also helps to have a tool with a large enough field of view so that you aren’t having to move the device around often.
  3. Optical magnifiers can only get so strong before they become impractical. Around 12×–14× magnification is usually the upper limit, but beyond that point, the field of view is too small to be useful. For stronger magnification, you’ll want to use CCTV, digital wearables, or microscopic systems instead.
  4. Be cautious when buying online. One of the biggest mistakes people make is buying random devices on Amazon. Unfortunately, low-quality devices fail more often than they succeed.
  5. Consider your lighting first. Lighting can greatly improve early symptoms before magnification is even added. A good desk lamp will outperform low-quality hardware.
  6. Think about glare control. Amber filters, brown polarized lenses, anti-reflective coatings, or overlays can dramatically improve comfort.
  7. Contrast enhancement matters. Patients often underestimate just how much increased contrast on your digital devices can make text or objects easier to see.
  8. Take advantage of inexpensive upgrades. There are a number of free apps, such as Seeing AI, SuperVision+, and Magnifier, that can help you zoom in on text both on your screen and out in the world. In addition, your phone likely comes with a number of accessibility features like screen readers, magnification, high-contrast modes, and voice commands that can help you use your device more successfully.

What Low Vision Aids Help for Macular Degeneration?

If vision loss becomes more severe, it might be time to consider more specialized tools. Because no tool functions for all tasks, it is important to consider what activity you want to improve, and then select the device that is suited to that need. Here is some information to help:

Reading Aids for Macular Degeneration

High-quality LED handheld magnifiers remain the go-to choice for portable reading, with 3x-7x illuminated magnifiers providing the best balance between magnification strength and a large enough field of view. For sustained, hands-free reading, prescription low vision glasses–such as prismatic, microscopic, or telescopic lenses–offer a solution. For patients with severe central vision loss, CCTV or video magnifiers like the Explore 12 by Humanware outperform optical magnifiers for prolonged reading. Task lighting is also essential, with LED options such as Verilux or Ottlite in the 4000-5000K range.

Using a Phone with Macular Degeneration

Prescription low vision glasses—such as prismatic, microscopic, or telescopic lenses—are important tools, but many patients find that built-in accessibility features on their devices are often enough for everyday tasks. Increasing font size, enabling bold text, using a zoom window, or turning on VoiceOver or TalkBack can make a big difference, especially for those near the legal-blindness threshold. A tablet often works better than a phone because the larger screen provides more usable space while keeping the same familiar ecosystem. For patients with more advanced vision loss, electronic video magnifiers with HDMI-to-phone mirroring can greatly enlarge the user interface and make digital devices much more accessible.

Watching TV with Macular Degeneration

Watching TV with macular degeneration can become difficult as central vision declines, but several tools can significantly improve clarity. Full-diameter telescopic glasses and bioptic telescopes help magnify the screen, making details easier to see from a comfortable distance. VisionBuddy remains the strongest digital option for television specifically, offering a direct HDMI feed that delivers a magnified image into the headset. Before making the investment into a specialized device, however, consider whether a larger TV may sufficiently meet your needs.

Recognizing Faces with Macular Degeneration

Recognizing faces with macular degeneration requires both the right tools and proper training. The strongest optical systems for this task are telescopes—whether full-diameter telescopic glasses or bioptic telescopes—which can magnify facial features at a distance. Digital systems like IrisVision, VisionBuddy, eSight, and NuEyes Pro 3 take this even further by providing powerful magnification, contrast enhancement, and dynamic zoom, giving patients multiple ways to bring a person’s face into clearer view. These technologies, alongside support from a low vision specialist, can significantly improve a person’s ability to recognize the people around them.

Conclusion

Living with AMD presents very real challenges, from reading to recognizing faces. While this can be a frustrating experience, low vision aids for macular degeneration do exist that can help you make the most of your remaining vision. If you have concerns about macular degeneration, or you would like to learn more about specialized low vision tools and devices, we’re here to help.