Being blindfolded and led through a busy street is a terrifying experience, writes ÉIBHIR MULQUEEN
I GRIP Dee O’Farrell’s arm, above her elbow, as she leads me blindfolded along a busy Galway street to a pedestrian crossing before we cross over and make our way up steps and – the most difficult obstacle – through a revolving door to our destination.
With my vision shut down, I am more aware of other senses: traffic sounds seem heightened and menacing, and through the soles of my shoes I feel the surface of the pavement, the bubble paving at the pedestrian crossing, the halfway “island” and the welcome sanctuary of the far side.
I realise I am clenching my guide’s arm and make a conscious effort to relax my grip. O’Farrell, a National Council for the Blind in Ireland (NCBI) mobility officer, explains that it is a sign of tension in people who, when beginning to learn how to negotiate the physical environment using a trained helper – a sighted guide – find themselves alone in a strange, new world that is built around vision.
“We are a species who are very eye dominated and I think the thought of loss of vision is a huge negative for most of us,” says Ian Grierson, professor of ophthalmology at the University of Liverpool, who, in conjunction with Bausch Lomb and the NCBI, gave a presentation in Galway recently on age-related macular degeneration (AMD), the most common cause of vision loss in Ireland for people over 50.
Sighted guide-training is an increasing part of the NCBI’s work as the number of people with vision impairment grows. It involves the training of a close friend or a relative in how to provide guidance.
“We train people how to do it correctly. Otherwise, people are inclined to let the blind person pull out of their arm or link in with them.
“The whole idea is to make it as subtle as possible so they are barely holding the elbow.”
Cane training is often a step up from this, typically involving a specific route that the partially sighted or blind person frequently takes.
O’Farrell is also a resource worker, which involves helping people adapt to loss of vision.
This involves practical measures like claiming entitlements and learning to use devices such as speaking weighing scales, measuring jugs and microwaves.
“You can get a lot of equipment to help you if you are vision impaired, and we would also refer people to a low vision clinic,” she says.
O’Farrell has two people aged over 100 on her books, one whom lives alone, and both of whom sought support for their loss of vision in their mid-90s.
At the other end of the scale are babies with eye problems who, along with training for their parents, will have direct intervention from about six months.
“You can follow a child through school right through to adulthood to college. Beyond that, most of the people we work with are elderly,” says O’Farrell.
An increase in age-related sight conditions such as age-related macular degeneration, cataracts and glaucoma has led to a big increase in visually impaired people at an age when they find it difficult to adapt.
O’Farrell’s work is also about helping people come out of the feelings of isolation and depressions that often result.
“A lot of them cannot cope because suddenly they cannot drive. They might be living in the country and they can be extremely lonely. That would be a huge factor in what we have to deal with.”
There can be a lack of awareness among the public of the degrees of vision impairment that exist. It is not an either/or case of being blind or having vision.
There are degrees of vision impairment and partly-sighted people find it difficult to get others to understand that they do not recognise them at a distance, for example, or at the periphery of their vision or at dusk if they have retinitis pigmentosa.
Over the next 30 years, the population aged over 65 will increase by up to one million from the 2006 figure of 426,000, according to the CSO, while there will be a four-fold increase in those aged over 80.
Taken with a greater willingness to avail of services, it means the number of people presenting with eye problems will continue to rise.
“There is a steady increase every year,” says Elaine Howley, NCBI’s director of services.
“The issues facing the NCBI are the same issues facing the country: the huge increase in the numbers of people who we are going to have to meet the needs of and take care of. Over the next 25 years the incidence of people with impaired vision is going to increase by 170 per cent.”
Grierson adds that while people are used to doing risk assessments in their working lives “for all sorts of things”, it is important that they do the same for their eye health and common conditions that can affect it, such as AMD.
“If you then look and say, ‘I have got some of these other risk factors as well that are preventable, maybe I should be addressing some of these’.
“AMD develops throughout your life.
“Because you do not have the disease at 40 does not mean that if you are in the risk group for developing it, that you are not going to get it,” he says.
