Tools that help when it's hard to see

Your grandfather's best defense against daily vision struggles might have been a magnifying glass or a pair of eyeglasses. The tools at your disposal are vastly different, with sophisticated computers and artificial intelligence making up for vision impairment in ways Gramps could only imagine. "Advances in technology have revolutionized what people with vision impairment can do, especially in the last 20 years," says Alex Bowers, an associate scientist at the Schepens Eye Research Institute at Harvard-affiliated Massachusetts Eye and Ear. She's investigating new ways to help people make the most of their remaining vision.

Today's basics

Most smartphones, tablets, laptops, and desktop computers have built-in tools that can help people with vision impairment. These accessibility features can enlarge the text or cursor size, adjust a screen's contrast, zoom in for a close-up of anything on screen, turn speech into text, and read information (such as documents, texts, emails, or calendars) out loud.

Most devices (including smart speakers) also have built-in digital assistants that understand voice commands and can complete tasks for you. For example, you can tell a digital assistant to make a phone call, look up information online, place a grocery order, give you directions, send an email or text message, type out information in a document, play music, read you a book, or operate other smart home devices (such as lights, thermostats, appliances, or home security systems).

Apps that help

"There are perhaps 100 or more apps that are designed specifically to help people with vision impairments," Bowers says. They can perform a wide variety of tasks, such as the following.

Describing what you are looking at. Some apps can say out loud what your smartphone camera is seeing. For example, the Seeing AI app can identify products, people, or currency; describe the scene in front of you; or read text and handwriting. (If you don't have a smartphone, OrCam MyEye does the same thing using a small camera that clips onto your eyeglasses.) Other apps, such as Be My Eyes or Aira, connect you to a live person who can tell you in real time what you're seeing. "You can use it in all sorts of situations. Maybe you're in a train station and can't figure out which way to go, or you need assistance shopping in a grocery store," Bowers says.

Magnifying images. Smartphones come with built-in magnifier apps. You can also download special magnifier apps, such as SuperVision+ (developed by Massachusetts Eye and Ear Associate Scientist Gang Luo), that magnify and stabilize images. "That's important if your hand is shaking but you need to read medication directions or the fine print on a bill," Bowers says.

Helping you navigate. There are apps to help you reach a destination, not only by saying step-by-step directions out loud (like Google Maps does), but also by describing the terrain around you, helping you find bus stops (the way Massachusetts Eye and Ear's All Aboard app does), alerting you to a bus arriving at a bus stop (the way BlindSquare does), or giving you directions inside a building (the way NavCog does).

Note: Apps for impaired vision may or may not be free, so make sure you investigate before installing them. Some services are available by subscription only. An example is Aira's connection to a live person who tells you what you're seeing: you need to buy a certain amount of monthly minutes to use it (starting at $26 per month).

Wearable tech

Some tools that help you cope with vision impairment are wearable — mounted in a headset, in spectacles, or in a device that fits onto your eyeglasses. Some contain software that makes it possible to see far away or up close, and may be helpful for people with macular degeneration, glaucoma, and other eye conditions. For example:

Spectacle-mounted telescopes. These magnify objects in the distance, and you can use them for driving (a "bioptic" telescope) or looking at a computer screen, a TV, or people's faces. Some have autofocus features.

Video display systems. This type of low-vision device (such as eSight) is a futuristic-looking headset. It has a high-definition video camera that captures what it sees and projects the images onto screens inside the headset. The images can be enhanced to improve contrast, magnify, or expand your field of vision. Some gadgets also enable you to stream TV shows or view computer screens. (There are also handheld versions of these tools.)

Costs for these high-tech devices are in the thousands of dollars, similar to getting a pair of hearing aids. The U.S. Department of Veterans Affairs covers some devices for some veterans, but Medicare does not. You need to check to see if your private insurance covers a particular device.

Peripheral prism glasses

People who've suffered a stroke or traumatic brain injury sometimes lose half of their field of vision (a condition called hemianopia). The Peli Lens, developed by Bowers and Massachusetts Eye and Ear Senior Scientist Eli Peli, can help.

"The Peli Lens uses high-powered prisms to shift light from one side of your eye to the other, giving you back 30° of lost vision," Bowers says. "Now we're setting up a clinical trial to evaluate a different type of prism that's even higher-powered than the Peli lens, and has the potential to provide up to 45° of lost vision."

Other tools

Lots of other tools can make life easier for people with impaired vision. There are household gadgets like "talking" thermometers, scales, and calculators that audibly read out results. Large-print books, filters that reduce screen glare, and even good old-fashioned magnifying glasses are also helpful.

But the more technology advances, the more it will show up in low-vision devices. "Computing power continues to increase every year," Bowers says. "Scientists are constantly trying to find ways to improve assistive devices."

Illustration courtesy of Be My Eyes