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Home Adaptations

Age-related macular degeneration (AMD), myopic macular degeneration, and Stargardt disease are all chronic, progressive conditions that cause visual impairment. While central vision is affected, peripheral vision is often spared. Visual symptoms are usually not present in early macular degeneration, but as the condition progresses, more vision may be lost.

What is low vision?

Many people with macular degeneration will have some vision. This may also be referred to as “low vision.” In low vision, even with glasses, contacts, medicine, or treatment, everyday activities might be difficult for an individual to do.1 The World Health Organization (WHO) has has further stratified “low vision” into several categories. “Normal” vision is 20/20, but when the vision in the better eye with corrective lenses or measures is2:

  • 20/30 to 20/60, this is near-normal vision
  • 20/70 to 20/160, this is moderate low vision
  • 20/200 to 20/400, this is severe low vision
  • 20/500 to 20/1000, this is profound low vision
  • Less than 20/1000, this is near-total blindness
  • No light perception is total blindness

Making changes

As macular degeneration progresses, it gets harder to see contrasts and depth perception, and you might find that more light is needed to see an object. In order to continue performing your everyday activities safely and maintain your independence, you’ll likely find you need to make some adaptations to your living environment. This doesn’t have to be elaborate or expensive, and the simplest changes can make a big difference.

Lighting and contrast

  • Add floor or table lamps, especially in rooms or areas where you read or do activities
  • Utilize natural light as best as possible: use adjustable blinds or sheer curtains
  • Minimize glare by placing any mirrors in areas where lights don’t reflect off of them3
  • Paint door frames and door knobs a different, darker color to make them easier to see, and get darker color light switch covers for light-colored walls4
  • Mark landings in a contrasting color
  • Use contrasting tablecloths or placemats on the kitchen table to better see your plate and utensils

Safety

  • Have adequate light in rooms, especially near furniture
  • Move furniture away from high-traffic areas
  • Remove or tape down throw rugs
  • Place electrical cords near the perimeter of rooms, or tape them down so you don’t trip
  • Install grab bars where you might need them, especially in the bath or near stairs
  • Light stairwells brightly

Daily activities

  • Use assistive devices like magnifying screens for computers and large-print keypad telephones
  • Wrap brightly colored tape around utensil handles for ease of use4
  • Hang color-coordinated clothes together
  • Use a pill organizer box

OT or low-vision specialist

Talk with your eye doctor about working with an occupational therapist or low-vision specialist to help you go through each of your rooms and help you make the necessary adaptations to best suit your needs. Working with a certified low vision specialist can also teach you ways to use your remaining vision as effectively as possible, as well as show you how to use any assistive devices.5 They can also show you tips and tricks to use when you’re not at home.

Jaime R. Herndon | February 2019
  1. National Institutes of Health: National Eye Institute. Information for Healthy Vision. n.d. https://nei.nih.gov/lowvision. Accessed October 21, 2018.
  2. American Optometric Association. Low Vision. 2018. https://www.aoa.org/patients-and-public/caring-for-your-vision/low-vision. Accessed October 21, 2018.
  3. American Foundation for the Blind. Creating a Comfortable Environment for People With Low Vision. 2018. http://www.afb.org/info/low-vision/living-with-low-vision/creating-a-comfortable-environment-for-people-with-low-vision/235ye-health/low-vision/123. Accessed October 21, 2018.