Factsheets What can help a person with monocular vision

Introduction

In the previous factsheet, About Monocular Vision, we looked at the causes and effect of Monocular vision

This second factsheet aims to give supporters a basic understanding how to give practical help to people who may have monocular vision and learning disabilities. 

The following are some of the ways a person with monocular vision may be helped in day-to-day life:

Consider the person’s environment

• Lighting - light can assist people to overcome problems with depth perception. Lights that provide shadows for objects may give depth clues to the person.
• Contrast – Consider contrasting colour schemes and colour contrast between objects the person might be using.
• Surfaces and texture – people may be want to use changes of textures as landmarks and orientation clues.
• Sound - keeping background noise to a minimum will reduce distraction and may help people to concentrate on their activities.
• Organisation – make sure items are always kept in the same place and position them in the person’s field of vision.
• Wheelchair users - ensure that wheelchair users are in a position where they can see and where they are not excluded from people and activities.

Activities that may overcome perceptual difficulties 

• Use Activities and games  Games that involve catching and throwing are good and are useful for helping people overcome the effects of having monocular vision.  Jigsaws and sorting games may also help.
• Use Enlargement - enlarging objects can sometimes help overcome some perceptual difficulties. For example, using a low vision aid such as a magnifier, prescribed by a low vision clinic. Link –Low vision Services for People with Learning Disabilities.
• Encourage Eye and/or head movements - these can compensate for a visual field loss and can help the person gain similar information to that obtained when both eyes work together. 
• Encourage the use of Both hands - encouraging the person to use two hands for tasks will help with difficulties with depth perception

Moving around

• Safeguards - encourage the person to wear a bag or carry something in their hand on their ‘blind side’.  This can offer them a little prior warning of an obstacle or act as a buffer. 
• Carrying a symbol cane (a foldable small white stick) - it may be worth the person carrying a symbol cane to show others that they have a sight problem.  A symbol cane is simply held in front of the person’s body, it is not a walking stick!  Symbol canes can be purchased from RNIB or local society.
• Guiding – whenever possible guide a person on their ‘blind side’.  Encourage the use of stair rails.
• Corridors - if walking down a narrow walkway encourage the person to have their ‘blind side’ nearest to the wall.
• Hands - encourage the person to make contact with doorways and corridors with the back of their hand.
• Landmarks - teach people to notice permanent ‘landmarks’ to help them identify exactly where they are. 
• Road crossings - ensure people look for and use controlled or tactile paving crossings.

Independent living skills

• Some self-care tasks may be more difficult when a person has sight in one eye only.  Help the person adapt to their visual field loss by assessing the support they might need when undertaking daily living skills.

Communication

• Positioning - when interacting with someone with monocular vision position yourself on their ‘good side’.  Consider where people sit in cinemas and theatres.
• Attention gaining - don’t assume that the person knows that you are talking to them if you are on their blind side.  Say the person’s name to attract their attention, then introduce yourself.
• Attention sustaining - don’t think that the person is not paying attention if they adopt an unusual head position when you’re talking to them.  They are likely to be trying to see you within their field of vision.
• Prompting – in a discreet way encourage the person to scan their head or their eyes to see around them.
• Saying what you need - encourage the person to be assertive for example, "can you talk to me/sign to me from this side".

Emotional support

• Time - people should be allowed time and support to experience a whole range of emotions from anger, loss to sadness.
• Post-traumatic stress disorder - some people can feel very distressed and post-traumatic stress disorder may occur in people who have lost the sight in one eye or have had an eye removed.
• Self-injury - the person may experience an increased desire to injure (eye poke, eye rub, face slap, head bang and so on) the affected eye. This should be interpreted as a means of expressing extreme emotional distress.  It is important that help is obtained to prevent sight loss in the second eye.
• Fear – With only one eye the person’s world might appear to be frightening and less predictable.
• Overcoming failure - if people continue to experience failure when attempting tasks or they have negative experiences, it may reduce their enthusiasm to perform tasks in the future.  This can/will lead to low self-esteem and possibly make the person depressed.  People will need to be motivated to persevere and their successes should be celebrated.
• Supporter’s attitude – supporters should avoid criticism or negativity such as “He’s so clumsy!”  Supporters should show skills, understanding and be motivating and supportive.

 June 2009

For Further Information on this Topic please read:

Factsheet 1 – About Monocular Vision

Factsheet 3 - Considering the Needs of People who may Need to Undergo the Surgical Removal of an Eye 

Related Information:  

Supporting People to use Their Sight Effectively

Recognising Eye Problems in People with Learning Disabilities 1

Recognising Eye Problems in People with Learning Disabilities 2

Adapting accommodation for People with Learning Disabilities