Can you imagine not being able to read or write, drive a car or recognize faces? This is what life is like for an estimated 2.9 million Americans who are living with low vision, which can be caused by age-related eye diseases such as macular degeneration, glaucoma and diabetic retinopathy.
"You become immediately dependent on other people," says Joseph Fontenot, MD, a certified low-vision therapist. What's worse, the resulting loss of independence can often lead to isolation and depression. It's no coincidence that more than a third of people with low vision also have clinical depression.
Occurrence of low vision is steadily rising as people live longer. Fortunately, new and more accessible technology is empowering more people with low vision to continue enjoying their favorite activities.
Help is arriving in the form of apps for their iPads, e-readers, smartphones and other tablet devices. The digital devices offer text magnification, lighting enhancement, and voice and audio control capabilities to make reading and communicating easier. Building on these tools are software applications that can help meet the unique needs of the visually impaired.
A Return to Reading
Chief among the impacts of low vision is loss of the ability to read, according to recent research by the American Academy of Ophthalmology.
When 79-year-old avid reader and retired executive director Klara Sauer's vision started to become blurry three years ago, she was terrified. "I was diagnosed with wet macular degeneration in my left eye, and then four months ago, I also got it in my right eye. I felt traumatized, and became deeply depressed."
Then her vitreoretinal specialist, Howard Kaplan, M.D., introduced her to a reading application for the iPad called Spotlight Text, which can be configured to help people with particular patterns of low vision read with greater comfort. Kaplan, who created the app, says Spotlight Text was designed to "make the words adapt to the reader, rather than the other way around."
Spotlight Text can, for example, render a whole book into a single line of text that can be adjusted and streams across the screen at the reader's pace, enabling an individual with peripheral vision loss to utilize their remaining vision. The simple, six-button user interface makes it easy to use for octogenarians and techies alike.
"It's very soothing on the eyes," says Klara, who uses Spotlight Text enthusiastically after months of struggling to read print books with a magnifying glass.
Currently reading A Brief History of Time by Stephen Hawking, Klara loves the app's reversed polarity (white letters on black background), and the ability to adjust the font size to her preference. Though she still carries a magnifier everywhere and struggles to read labels in the grocery store, she can now read a book in five or six hours, and is happily participating in her book club again. "It's a gift," she says.
Spotlight Text can be purchased from the Apple iTunes App Store for $30 (for a limited time, a third of the sales driven by this website will go to the Foundation of the American Academy of Ophthalmology). Spotlight Text users need to register with BookShare ($50 setup fee, $25 annual membership), to access an online library with more than 300,000 titles.
Low Vision Apps for Tablets and Smartphones - A Roundup
There are a number of built-in Apple iOS systems like VoiceOver, a gesture-based screen reader that lets you hear a description of everything happening on your screen, and Siri, a voice recognition system that lets you send messages, place phone calls and more.
In addition, other apps that can facilitate daily life for people with low vision include the following.
Speech-to-Text and Text-to-Speech
- Dragon Dictation (Free, iTunes App Store)/ Dragon Remote Microphone (Free, Google Play Store)—Enables users to dictate a text message, email, Facebook status updates or Tweet on any iOS or Android device.
- ZoomReader ($19.99, iTunes App Store)— Uses the iPhone or iPad's built-in camera to take a picture of any text and then read it back to users.
- Voice Brief ($2.99, iTunes App Store)— Collects information that users want to read (calendar, weather, stocks, RSS news, social media, emails) and reads it aloud on iOS devices.
- Spotlight Text ($30.00, iTunes App Store) — An eBook reader for the iPad designed for people with low vision. Text adapts to specific visual needs, and can easily be displayed on any television with an HDMI input.
- LookTel ($9.99, iTunes App Store) Money Reader — A currency identifier that uses the camera of your iOS device to read aloud the denomination of paper money. The developer is also working on other applications that will expand the technology to reading labels and more.
- TapTapSee (Free, iTunes App Store, Google Play Store) — Enables users to photograph objects and have them identified aloud.
- Blindsquare ($29.99, iTunes App Store)— Describes the environment, announces points of interest and street intersections as you travel.
- Google Maps (Free, iTunes App Store, Google Play Store)— Voice-guided GPS navigation and directions for driving, biking and walking.
- SightBook (Free, iTunes App Store) — Allows patients to regularly monitor their visual acuity at home, and send their vision scores to their doctor.
Dr. Fontenot advises patients with low vision to ask their ophthalmologist for help and referral to a low vision clinic. Almost all clinics will be able to help with customizing digital devices and apps. Many low vision centers offer computer workshops or have occupational therapists who can provide training and support on how to use these tools effectively and tailor them to particular visual needs.