FUDiabetes

Visual Impairment and Diabetes

I do check the disability box, but more so because I’m legally blind and can’t do jobs without accommodations. I’ve never checked it because of diabetes, but perhaps for a highly physical job I would. It’s hard to say because I think it’s highly context dependent.

There are varying degrees of disabilities, and disabilities can be visible or invisible. But it also depends highly on the environment. Some disabilities are present in all environments, and some are only present in a few. Also, once you add in complications (which a majority of people with long-term diabetes have) things become even more variable.

I like what @LarissaW said about using diabetes In a positive light to answer a question. This is almost universally how I deal with bringing up my visual impairment in an interview. But that’s partly because I can’t hide it; whoever interviews me knows that I’m visually impaired, and I prefer to address it positively than let them think about all the misconceptions they probably have. I’ve never brought up diabetes in an interview. But neither do I go out of my way to hide my insulin pump or MedicAlert bracelet. (I haven’t had a job interview since starting on a CGM, but I would go out of my way to ensure it doens’t alarm.)

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Hello @Jen just out of curiosity and if its ok for you to answer me.

Does your blindness is because of diabetes? and you are legally blind, but ‘how blind’ would you say you actually are… sorry I dont know how to phrase it better… (maybe because Im too low right now… im 43 mg/dl just ate some sugar gummies)

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My visual impairment is because I was born very premature (retinopathy of prematurity). I was diagnosed with diabetes when I was 9. So no relationship, just a coincidence that I have both.

It’s hard for me to explain exactly what my vision is like because I’ve never had normal vision. I can’t read any of the letters on a standard eye chart (sometimes can’t even tell there are any letters there). Most optometrists and ophthalmologists record my vision as “counts fingers” (CF) at a certain distance, which is super imprecise but basically means vision is below 20/400. If special low vision charts are used, my vision tends to fall between 20/400 and 20/600, depending on factors like the day, whether my vision is fluctuating, the lighting in the room, and the distance the chart is placed at. I also have some visual field reduction, but it’s not severe.

In daily life, I use a combination of my vision and non-visual aids. My vision is low enough that I can’t read the vast majority of regular print material. If it’s on a high-contrast display with white text on black (such as my phone or my insulin pump) and I put it as close to my eyes as I can, then I can often decipher enough to make it out. But doing that for any more than a couple of words isn’t possible. So I use a video magnifier, screen magnification on my computer and mobile devices, and the largest text size possible in any e-reading apps I use. I also use screen reading software on both my computer and mobile devices and refreshable braille displays. I switch between print, audio, and braille depending on what I am doing. If I’m reading a leisure book and don’t have any timeline attached to it, I might use print. If I’m reading something for work that I have to complete in a certain timeframe, I might use speech. If I have to read something aloud, I’ll use braille. I use my vision for spotting landmarks and obstacles when travelling, but use a white cane because I often miss curbs, steps, and flights of stairs, as well as smaller obstacles such as poles and branches.

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Kind of sounds like my wife. She not only has glaucoma but anaridia, which is the lack of the iris of the eye. She said it’s like going into a dark room, where your IRIS is wide open, and having it stay that way in all light situations. She has about 20/400. She’s taking braille lessons now and uses large print software (Fusion from Freedom Scientific) on the computer, large fonts on her cell phone and handheld magnifiers for everything else. She says she has enough vision to not use a cane when it is familiar surroundings, but usually is around someone like myself to help guide as needed. She also recently had a cataract removed, so that helped quite a bit, but still left her with low vision. She’s a trouper.

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Almost forgot: She just recently applied to work as a crew member for Arbys and got the job! She’s excited to be entering the work force after being a stay-at-home mom for nearly 10 years. Her braille teacher said if she finds she needs a job coach for specific tasks, they can expedite a coach, but not until she has issues (in other words, they won’t do it proactively). I wish her well.

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It does sound like our vision is in the same range, though of course visual acuity doesn’t say much about how someone uses their vision in the real world. I have some acquaintances with aniridia, and they are extremely light sensitive. I have problems with lighting and glare, but am not too light sensitive. If I’m facing a window in a room, everything in the foreground looks blacked out, and if glare is coming in from the side of my vision, it can often block out everything around me. My main problem is night vision, though. At night I have virtually no vision unless I am directly under a streetlight.

That’s great that she’s learning braille! So many people with low vision don’t realize how useful it is. Even just being able to hit the right button in an elevator without having to get nose-to-nose with the panel and struggle to read, or being able to pick the right can out of the cupboard without having to take ten cans down to read them, makes it useful. In my case, I was fortunate to learn braille when I was in elementary school, although I didn’t really take full advantage of using it until I was in college. It takes practice to get and stay fluent (like any skill, it will fade somewhat if not used regularly), but I find it so useful for so many daily tasks, and wouldn’t have accomplished some of the things I’ve accomplished professionally without it.

This is the software I use at work (JAWS and ZoomText). I use Windows Magnifier and NVDA at home, and Zoom and VoiceOver on my iPhone and iPad.

I’m also okay in familiar indoor environments. I didn’t use my cane within my elementary or high school buildings, but have always used it outdoors when travelling alone. But like braille, I didn’t take full advantage of learning good cane skills until I was in college and travelling to places I’d never been to alone. And once a year or so I’ll sort of forget that I can’t see well and not use my cane in a place that I think I know well and trip up or, on occasion, down curbs or flights of stairs. So the older I get, the more consistent I get at using proper cane techniques even when I feel like I can see where I’m going, because I’m just lucky I haven’t smashed my face or broken a bone in some of those falls (and a couple have happened in front of colleagues…embarrassing).

I also have cataracts, but my doctors have not mentioned removal yet. I think cataract surgery is high risk for my eye condition due to retinal scarring and detachments I have. I also had a procedure a couple of years ago to lower my eye pressure, as it was creeping up too high (though I don’t have a glaucoma diagnosis, I’m just as risk). I also had several procedures years ago when I was having retinal issues. Ironically, I’ve had no effects from diabetes on my eyes.

Congratulations to her on the job!! I always feel grateful to be in the minority of working-aged legally blind people who is employed.

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Of course, this isn’t to say that most people who are legally blind shouldn’t have jobs. But there are so many obstacles people face with acquiring adaptive skills, work accommodations, discriminatory attitudes (even unintentional), travel difficulties (such as lack of public transit), and so on, that I feel fortunate that I’ve never had much difficulty with these issues.

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Thanks Jen for the quick replies. She has an older Motorola android phone and just uses the tripple tap to enlarge her phone. Doesn’t really do much with braille except for reading the lessons in braille books rehab provides. The cataract surgery was very scary for us because it was a 50/50 chance that it wouldn’t be successful and they said she could loose all vision in that eye. Her other eye only sees light perception, so she could have become a total. Fortunately, it came out well and she got a little bit more vision back, but not much. She’s not afraid to use the cane, but I think she feels that it is just more trouble than it’s worth. In unfamiliar areas, she just asks for help.

With her new job she will use a bus service called Call-A-Ride for the handicapped. It will take her door to door. She may also explore the bus route if there is a good one.

She loves her Zoometext/Magic. Me and my son hate it though. Don’t like to hear the screen reader. it is so slow compared to actually reading the screen yourself! She also loves to read aloud which we also hate. She claims it helps her digest and remember material better.

So glad to talk with someone with similar circumstances!

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I much prefer to read things in print or braille, because I remember them better that way. But speech is what I use when I need to get through material quickly. I’ve used screen readers long enough that I can crank the speech rate up fairly high. Not as high as many of my friends who are totally blind, but high enough that a lot of sighted people can’t understand it. With the last university program I took, I used to cram—er…study—for the exam by cranking the speech rate to 500 wpm and re-reading textbook chapters on the bus ride up to campus. So there are some advantages to speech. I also find it’s often faster when navigating the computer and websites, especially familiar ones. But there’s still so much of the internet that is not screen reader accessible that at times navigation is much slower, too.

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I would never have guessed that was even possible.

My personal learning is not well suited to audio so the concept of somebody learning material at 500 wpm via audio is amazing !!!

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I’m, sadly, not an auditory learner, either. The key is that in this case, I was reviewing the material. I’d already read the chapters once or twice before this point. I wish that I was a better auditory learner, because I could get through a lot of material if I was.

I think speed comes mostly from practice, and probably anyone can learn to listen that fast if they used audio material every day for many years. My (sighted) dad prefers audio material because he can listen to it in the car and such, and he listens to enough material that way that he has things cranked up almost as much as I do. I much prefer the more mechanical sounding voices, because a lot of the high-quality voices these days turn to gibberish when they reach high speeds.

If I want to actually fully comprehend and remember something on its first reading, I need to read it in print or in braille, which are both very slow in comparison. I think a lot of why I struggle with audio is because I don’t get spelling, layout, or punctuation, which can make even an email difficult for me to understand if it’s dealing with a more technical subject.

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I knew a girl in college who was born completely blind and also needed to have a university job as part of her student loan package. There were any number of perfectly reasonable jobs she could have done just the same as a person with normal vision, with only minimal accommodation – she was very adept with braille, cane skills and many other things. The job they gave her was so far below her level it was comical…because she had this disability they basically treated her as if she was a person with a severe intellectual disability. So the discrimination is real.

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It definitely is real. But what’s worse is that I don’t think most people are even aware they are doing it. I think a lot of people simply can’t imagine how they themselves (with no training or experience) would do something with little or no vision, and then they project that onto the person who is visually impaired (but who does have training and experience). I often get told I’m “amazing” for doing the most simple tasks like walking down the street, pressing the correct elevator button, or paying for something at a store… If people think that’s amazing, then no wonder they can’t imagine how I could do complicated work- and life-related things.

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Sorry we hijacked the thread talking about blindness everyone!

Back on subject: No I don’t put down my diabetes as a disability at all because I don’t need any specific accommodations. When I do, I just notify my supervisors. One time I felt self conscious changing my pump at my desk so I asked for a private area to change it in and they allowed me to use a conference room. My manager (the one above my supevisor) has seen me go low a few times and has allowed me time off the phone with pay in a call center for medical breaks to deliver glucose tabs, finger sticks, and call my doctor as needed. One time it was like nearly an hour, and he told me to take all the time I needed. Other leaders at work know, and when I start beeping, they always check on me. I’ve never had anyone say anything mean or be discriminatory at all. I love working for AAA!

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@bpollina I’m so excited for your wife. Any new job starting is a thrill, and it sounds like it’ll be extra exciting for your wife! Is her vision change a newer thing, or is it something she’s grown up with?

I worry about this. And I wanted to ask you @jen about how I should handle certain situations, but I didn’t want to burden you with needing to explain something to me I should possibly already know.

For instance, I noticed a gentleman with a cane in the middle of an intersection the other day, and by the time I’d pulled over and gotten across the street, another woman had also jumped out of her car to assist him. But he’d gotten a tad off track and ended up in the bike lane on this busy street. I caught up with him and helped him onto the sidewalk and chatted with him, but I didn’t know if I should leave him be or make sure he made it where he was going (he was a little confused it seemed). EH had helped the same gentlemen the week prior in a similar situation. So, does one stop and help if not asked? Is it considered annoying? Does it bug a person or is it helpful?

And thank you so both very much for sharing about your vision and experiences. I’m always thankful to be given the opportunity to learn more about what each person’s day-to-day is like. None of us are the same, and there are many cool things to be learned from everyone. :slightly_smiling_face:

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It’s no wonder you’re confused, because the answer varies a lot by individual and situation. Some people with disabilities hate when they’re even asked if they need help. Others really appreciate it. And sometimes people who don’t need help in most situations do need help in a particular situation.

It may help to know that the vast majority of people using white canes have received training from an orientation and mobility specialist. An O&M specialist trains someone not only how to use the cane but related skills such as how to navigate a neighbourhood or cross a street safely.

Having said that, my rule of thumb is that it never hurts to ask if someone needs help. Just respect whatever their answer is. You can’t be expected to read minds, after all. And sometimes someone is using a technique that they were taught to try to get re-oriented or re-establish their line of travel, and it may look to someone like they are lost or having difficulty when they aren’t. But approaching them and asking if they need help never, ever hurts. And if someone says they are fine, don’t feel bad for having asked. (I sometimes get people who say, “Oh, I’m sorry,” if they ask me if I need help and I said I’m fine; I try to respond with, “No, I’m fine, but thanks for asking!” to let them know that I don’t mind them asking.)

The only thing that I get annoyed with is when someone assumes I need help without asking. Some people try to provide a running commentary of what’s coming up when I’m walking down the street, and I feel like telling them that I”m familiar with the area and also that’s what the cane is for even if I wasn’t familiar with it. And even worse is when people just grab me without any warning if they think I’m going to fall off a curb or fall while getting on the bus or whatever. But I never get annoyed if they just ask if I need help, as long as they don’t insist on trying to help even if my answer is no.

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Your reply was amazing. And certain parts of it totally made me laugh. Although, truthfully, it’s not very funny if somebody is chasing you down the street shouting about what there is in front of you. Or grabbing you. Mostly, I laughed because it reminded me of my best friend with seven children. She has been pregnant and routinely groped by random strangers so often she has lost track. It is strange to me anyone would grab another human without conversing with them first! :upside_down_face:

In all honesty, I am equally as likely to offer help to a non-disabled person as I am to a disabled person, because I am kind of helpful. And when I was using crutches last year, and I had people bodycheck me and slam doors in my face, it really raised my awareness of how much I appreciated assistance. Those folks that did offer me help, I appreciated it so much!

Thank you so much for explaining how people learn to use canes! I had no idea. I knew there was training, and I heard an interview with a gentleman who teaches echolocation to people with visual impairment, and it was fascinating.

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My wife has been legally blind since birth, so nothing new there. The cataract surgery went well, but gave her only minimal more vision.

I agree. Whenever a blind person gets a cane, there is always O&M training by a specialist. My wife hates it when I quote directions as left/right. She said she was taught by her O&M instructor NSEW directions.

I also agree that it is best to ask the blind person if they need help. Since they can’t typically see you approaching, to help without asking could actually disorient them more.

My wife doesn’t really like to use her cane, though, because she can see and she hates it when people seem to steer clear of her like she has a contagious disease or something and feels ostracized.

Job wise, there is an organization in Missouri called RHB (Rehabilitation Services for the Blind) that offers all kinds of stuff related to employment for the blind. They can do things ranging from job coaches to purchasing adaptive equipment for the blind to be able to work such as computers with large print screens, braille devices, speech, etc. They also do home-bound stuff if you just need stuff for the home like braille lessons, books, books on tape, cooking help and tools for daily living.

Being married to a disabled wife has taught me so much. If you guys have any more questions, I’m all ears.

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So am I. And I don’t think it’s all that off-topic, because vision loss affects a comparatively large portion of people with diabetes, yet is hardly ever spoken of aside from people dreading it… So I think it would be great if there were some positive discussions that could pop up when people searched for these sorts of terms.

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I used to feel horribly self-conscious about the fact that I used braille and a cane when I was a teenager. As if I wasn’t “blind enough” and someone would accuse me of faking. Which is ridiculous when I think back to it now, but was a real fear back then.

About ten years ago, the CNIB (Canadian National Institute for the Blind) made a commercial poking fun at the fact that most people assume a cane user can’t see them. I found that around the years that commercial aired, I got a lot more people asking me if I had some vision, so I think it was a good awareness campaign (though at the time the commercial was a controversial in the blindness community, with some liking it and some hating it):

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