Hesperian Health Guides

Poor Vision and Eyeglassess

In this chapter:

Many children and adults do not see well. A person may not see people or read signs clearly from far away or must squint to see up close. They may have headaches or blurred vision after reading before realizing they need eyeglasses. With eyeglasses matched to your eyes, you can see better. See if there are programs where you live that test vision and supply free or low-cost eyeglasses.

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It is common for a person’s vision to change. You may need to change your eyeglasses every few years.

 woman with a child wearing glasses speaking to another woman
Before I didn’t want Sarita to use the glasses too often because I worried they would break, but now I know she must wear them all day so she can see.

Testing sight for distance vision

 child taking an eye test that is hung from a palm tree

Check vision with an ‘E’ chart (Click here for a print quality version of an ‘E’ chart). Test each eye separately by having the person cover the other eye with the palm of their hand or thick paper. The person looks at each row and uses their free hand or a paper ‘E’ to show if the bars on the ‘E’ point up, down, or to one side. The row with the smallest size of letters they see well is the measure of their eyesight. For example, if the person can read most of the row of letters labeled 6/12 but less than half of the row of smaller letters after that, we say they have 6/12 vision.

 how to use hands to show directions of the E in an E eye chart
Use your hand to point the same way as the bars on the ‘E.’
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Print the ‘E’ chart on letter-sized paper to use with the person standing 3 meters away from the chart.

For an adult, if distance vision is poor (they cannot read the 6/18 or smaller letters on the eye chart), send them to an eye doctor. For school children, check to make sure they can read the 6/12 line letters. Sometimes a child does not do well in school only because she cannot see clearly from far away. Eyeglasses will help her learn.

‘E’ charts are made in different sizes to be used at 6 meters, 3 meters, or other distances. There are also mobile phone applications that make an ‘E’ of different sizes to do the same test without a chart. For the test to be accurate, follow the instructions carefully for the chart or phone app you are using. Carefully measure the correct distance where the person needs to stand.

Reading glasses

 older woman using glasses to do handcrafts

People over the age of 40 years may have a harder time seeing well enough to do closeup tasks like reading, sorting seeds, or threading a needle. Reading glasses magnify close-up things to look larger. They come in several different strengths of magnification. Glasses that are labeled +1 make close objects look slightly bigger, +2 make them look even bigger, and +3 the biggest. Test each of the different reading glasses by trying to read a book or thread a needle at a comfortable distance.

If a person has trouble seeing close up and also cannot see well far away, reading glasses may not solve the problem. Help them visit an eye clinic to find out what is affecting their vision.

Contact lenses and surgery to correct vision

Contact lenses are tiny plastic lenses that rest directly on the eye to correct vision, just as eyeglasses do. After a vision test, a specialist can help you find contact lenses that will work for your eyes. Do not use contact lenses made for someone else. Do not sleep wearing contact lenses unless they are made for overnight use. There are many different kinds of contact lenses and each needs specific liquids to disinfect, store and rinse them. Do not use homemade versions of the contact lens liquids.

While contact lenses are convenient, they can cause serious problems if not cared for and used properly. To prevent infections, always wash your hands before touching contact lenses. If you have mild irritation in your eye or an eye infection, do not use contact lenses until your eyes are better. Clean and disinfect lenses before wearing them again. If a contact lens has a torn edge, do not use it. If you have pain, burning, discharge, unusual redness, or blurred vision, this could be a danger sign of a scratch or ulcer on the cornea or another serious problem. Get help from an experienced health worker.

For some people, poor vision can be repaired with laser surgery (surgery using a very strong beam of light instead of cutting instruments). This is different than the kind of surgery to treat cataracts and may be expensive. Before spending money, it is wise to talk to others who have used the same eye surgeon with good results.

People with blindness or poor vision that cannot be improved

Sometimes a child is born blind or a person’s poor vision cannot be improved with eyeglasses, surgery, or medicines.

People learn to live with blindness and poor vision. With support from family and community, people who are blind attend school, earn a living, and have their own families.

 girl walking outside guided by fence made of rope attached to polls
 sign in front of house that says careful blind child

To make life easier and safer for a person with poor vision or blindness:

  • Introduce yourself when speaking to the person, speak to him directly and let him know when you are walking away from him.
  • Let him grasp your elbow when you walk together. You can alert him and lead him around any danger. This is a more respectful than pulling a person along by his hand or body.
  • Create handrails or guide ropes to the latrine or other places the person goes to daily.
  • Do not move furniture or other objects to a different place in the home, school or workplace. Alert the person if you do move something.
  • Drive carefully in the area where a blind person lives. A bell on a cow or other animal warns a person who does not see.

Children with disabilities, including blindness, can be more at risk for abuse, including sexual abuse, than children who can see. They need family and community protection to keep them safe, especially while young.

See the Hesperian book Helping Children Who Are Blind to learn more about how young children with vision problems can learn to take care of themselves, go to school, and lead good lives. Helping children to move about, understand the world around them and learn the skills they need is very important. See A Health Handbook for Women with Disabilities for ideas about how health workers, families, and communities can support everyone with disabilities to have better lives and better health.

This page was updated:10 Jan 2020