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LIVING WITH RETINAL DYSTROPHIES

 

   

EFFECTIVE GUIDANCE

The light we normally see is called "white light". This is made up of several different colours, which are only seen when they go through a transparent object, which shows these colours. The best everyday example of this is the rainbow when white light passes through rain and shows up as the colours of the rainbow - red, orange, yellow, green, blue, indigo and violet. Colour is mainly caused by the blue part of the white light. To protect eyes from sun and glare, it is important to wear sunglasses, which absorb this blue light. It is important to seek professional advice from an optometrist or ophthalmologist. Many of the blindness agencies also have a range of glasses, which are effective.

A person with a degenerative disease of the retina experiences progressive vision loss and that loss of visual function necessarily changes the individual's relationship to the physical environment in which he or she lives.

The vision-impaired person will treasure and want to maximise independence of movement and action. Some aspects of the physical environment are so intimately familiar as to be easily and safely negotiated on an independent basis. This will be particularly the case within the home environment where levels and dimensions are well known and where lighting conditions can be manipulated.

However, once out of the predictably familiar everyday physical environment the vagaries of level, distance, lighting and all the movement of human activity impinge on the vision impaired person's independence and safety of movement. It will be in this context that the affected person may appreciate sighted guidance.

However, for this to be successful it is essential that both the parties are completely comfortable with the way of doing things. To become a proficient sighted guide entails both learning what guiding techniques generally work best and practice. As long as you stick to mutually understood basic rules you will find that with practice it can become second nature, though to begin with it will usually pay to practise in relatively quiet surroundings. The following has been adapted from "How to Guide a Blind Person", published by RNIB in London in 1987 and in very wide use in Australia as well as worldwide.

Getting Started

The starting point is to ask the vision impaired person whether any assistance is wanted. If it is, you will need to start looking ahead for any obstacles or difficulties. Stand slightly in front with your arm at your side. The person being guided holds the arm above the elbow in a C-grip, so that you can retain free use of your lower arm and hand. This will ensure that the person being guided will be half a step behind you and slightly to the side. You need to walk at a pace, which is at all times comfortable for the vision-impaired person.

Narrow Spaces

Often a narrow space will need to be negotiated. Frequently this will take the form of a doorway, a corridor or a confined space between people or between chairs. First tell the person clearly that a narrow space is ahead. Then move your guiding arm towards the centre of your back to indicate a need to step in behind you and keep a full arm's length behind to avoid tripping on your heels.

As soon as you have passed through the narrow space return your arm to its former position by your side and the person being guided will respond by resuming the original position half a step behind and slightly to the side.

Doorways

The person being guided needs to be told three things:
  1. that a doorway is being approached
  2. whether the door opens towards or away from you
  3. which side the door is hinged.

Before reaching the doorway, the person being guided should be positioned on the hinges. This may entail changing sides by moving behind you without losing contact. On reaching the door you need to open it, walk through and allow the person to slide a free hand along the door and close it if appropriate.

Steps and Stairs

It is essential to forewarn the person that steps or stairs are ahead and, importantly, whether they go up or down. Approach the steps squarely and stop when you reach the edge of the first step. Explain where the handrail is and allow the person to change sides if desired. Depending on the circumstances, you may need to help guide the person's hand to the rail. The vision impaired person may also like to quickly measure the step by sliding one foot to the edge before moving off.

You should always be one step in front of the person on a flight of stairs. Try to walk at an even pace so that a rhythm develops and balance is maintained. Stop when you reach the bottom of the stairs, at the same time letting the person know that the last step is being negotiated.

Coping with kerbs requires a similar technique to that for other steps. You need to forewarn the person of the approach of a kerb, identifying whether the step is up or down. Pause at the edge of the kerb, then step forward and pause again before proceeding.

Seating

On approaching chairs you will need to look and think ahead to decide which of the available chairs to guide the person to. You may ask the individual's preference or you may, for example, already be aware of preference not to sit facing into glaring light.

Having reached the selected chair, simply take the person's hand from your arm and place it on the back of the chair. It will be helpful to also say what way he or she is facing in relation to the chair and if it has arms or any other feature to take into account. No further guidance will generally be needed for seating to be completed.

It is important that you avoid backing a vision impaired person into a seat unless circumstances make it an unavoidable last resort and, even then, opportunity need to be afforded the individual to check out the dimensions of the seat before sitting down.

Getting into a Car

Leave the car door closed and, if appropriate, indicate which way the car is facing. Place the vision-impaired person's hand on the door handle so that he or she can open it. When the door is opened the person's free hand can find the edge of the car roof to avoid bumping the head or, alternatively, can locate the back of the car seat if that is preferred. Once seated the individual can close the car door.

If for some reason the car door is already open, place the person's hand instead on the top corner of the open car door before proceeding as before.

Describing Surroundings

In describing surroundings you need to aim to be clear, accurate, definite and concise. Adjust the quantity or information you provide to what the guided person is comfortable with.

The terms left and right and clockface numbers can be helpful as direction guides but for their use to be effective the sighted person has to be able to view them from the vision impaired person's perspective, which can necessitate a mental reversal when facing one another. As with other aspects, practice (can bring easy facility to) describing surroundings (and) help to make for smooth and relaxed sighted guidance.

Important note

Because not all vision impaired people will necessarily use these methods it is most important to ask the individual whether help is wanted and, if so, what type of help would be welcome.

Sunglasses

The light we normally see is called "white light". This is made up of several different colours which are only seen when they go through a transparent object which shows these colours. The best everyday example of this is the rainbow when white light passes through rain and shows up as the colours of the rainbow - red, orange, yellow, green, blue, indigo and violet. Colour is mainly caused by the blue part of the white light. To protect eyes from sun and glare, it is important to wear sunglasses which absorb this blue light. It is important to seek professional advise from an optometrist or ophthalmologist. Many of the blindness agencies also have a range of glasses which are effective.

 

 

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