Vision Services
Vision Services are primarily concerned with providing rehabilitation services to people who are legally blind, blind and visually impaired. We teach people how to continue a rewarding gainful life by giving them the skills they need to accomplish everyday living tasks. We help people learn how to use their appliances, cook, sew, manage medication, clean, do the laundry, access social services and move around their house or neighborhood.
Services to adults
Low Vision Exams
Instruction in daily living skills
Personal Management Assistance specific to individual needs
Adaptive Equipment-to enable better use of individual’s remaining vision
Instruction for safe and independent travel
Help adjusting to vision loss
Educational/Job/Vocational Training
Need-based Referral Services
One-on-One services provided to individuals at their residence or place of employment
Courtesy Visit Program
Access Adirondacks
Access Adirondacks is a program that was launched in 2014 designed to encourage people who are blind or visually impaired to take advantage of their communities. In the North Country, that means getting out on the lakes, hiking the beautiful Adirondack trails and participating in the cultural community. NCCI organizes activities, events and trips into the Adirondack Park. CLick the following link if you are interested in learning more about Access Adirondacks. Link: https://accessadk.com/ .
Etiquette for Talking with the Visually Impaired Community
When You Meet a Person Who Is Blind …
Don’t – Shout when you speak to us, we can’t see but our hearing is fine.
Do – Touch us on the arm or use our names when addressing us. This lets us know you are speaking to us and not someone else in the room.
Don’t – Grab us to lead us. Allow us to take your arm when we are walking together.
Do – Give specific directions like “the book is five feet to your right” as opposed to saying “the book is over there.”
Don’t – Pet or distract our Guide Dogs. They are not pets, they are working companions on whom we depend.
Do – Direct your questions directly to us. We do not need to have someone else tell you what we want to eat, etc.
Don’t – Be afraid to use words like “blind” or “see”. Our eyes may not work but it is still nice to see you.
Do – Treat us as individuals. Blind people come in all shapes, sizes and colors.
My doctor told me I am legally blind, but I still see some things.
Legal blindness is a term developed and used in the Social Security Act of 1935. A person can be legally blind by either or both of two definitions:
A. Best corrected visual acuity of 20/200 or less in the BEST eye
B. Visual field reduced to 20 degrees or less in the BEST eye.
Legal blindness does not mean you have no vision. It usually means that your vision is reduced, but not totally extinguished. Most people who are legally blind still have some usable vision. Vision can be blurry, hazy, spotty, have missing pieces, or like a tunnel with no side vision. No two legally blind people see in exactly the same way.
Will I be able to read again?
This depends on how much vision you have remaining and how well you adapt to low vision tools. A low vision exam, preformed by a low vision specialist, will determine what low vision tools will help you. Low vision tools are highly specialized magnification devices, and are mostly through prescription only.
Many people are able to read mail, bank statements, check registers, recipes, directions from food boxes, medication labels, and important news articles or documents.
I have never heard of a low vision examination. What is that and why should I consider it after my doctor has told me there is nothing more I can do?
A low vision exam is a different type of an eye exam. It is designed to enhance and use the vision you have remaining to better perform tasks used in your daily living such as reading or using a computer. In many instances the low vision doctor can suggest different glasses, magnifiers, electronicmagnification, or computer software that can help you to do the tasks you want to do. NCCI Vision Services can assist with funding for this exam and the professional staff can assist you after the exam to learn to use the glasses or devices the doctor has recommended.
Magnifiers won’t work for me. I have bought many of them and none of them work.
Many times people buy the wrong magnifiers for themselves or don’t realize how it should be used. A Vision Services professional, often working with the low vision doctor, can help you to determine what the best magnifier is for you and how to use it effectively.
Okay, so what is low vision?
Low vision is when your eye sight is severely impaired. Low vision can be caused by birth defects or disease. Eye diseases such as macular degeneration, glaucoma, cataracts, and diabetic retinopathy are the primary causes of low vision. Many people are helped with Low Vision Exams.
So what is the difference between low vision and legal blindness?
If you are legally blind, you may have low vision. If you have low vision you may NOT be legally blind. Essentially, low vision happens when a person is bothered by the limitations of eyesight that surgery or glasses are unable to correct.
I can’t see my watch. How do I know what time it is? Options:
A large faced watch
A talking watch
A large wall clock
A talking clock
What do you mean by a talking clock or watch?
A talking watch or clock will announces the time only when you push a button.
What would your response be to “if I am diagnosed as legally blind, can I still live independently and how?”
There is no reason why a person cannot continue to be as independent as they want if they are diagnosed as legally blind. Even if a person is totally blind, there are skills that can be learned and equipment that can assist a person to accomplish tasks of daily living so that they can remain independent. He or she needs to adjust to the vision change and have the motivation to learn different methods to carry out everyday tasks and activities successfully.
My doctor told me there is nothing else he can do about my vision. Why should I call The North Country Center for Independence (NCCI)?
Your doctor means that medically, at this time, there is nothing more that can be done to help your specific eye condition. But there are many ideas and strategies that Vision Services staff can offer to help you continue to do the things you need and want to do.
Anyone can call North Country Center for Independence Vision Services at 518-563-9058 for information about services for people with vision impairment. The services are provided to qualified persons living in St. Lawrence, Franklin, Clinton, and Essex counties. (If you live in another county or state an appropriate referral can be made to the proper organization.) To qualify you must be legally blind or blind. We also help folks with visual impairments, but not yet legally blind, when able.
If you qualify, a friendly staff member will visit you at your home or work environment. This way you are provided the services where you need them.
What do they cost?
Services are free for qualified persons: documentation by your eye or medical doctor is required and must meet the qualifying terms of legal blindness.
My doctor says I need to give up driving, but that is impossible for me because of where I live.
This is one of the most difficult issues to deal with when your vision changes. An Orientation and Mobility professional can work with you to find other ways to go to the places you want or need to get to. There are options you can consider. Initially these may not seem to be what you want to do, but you need to know there are options before you harm yourself or others by continuing to drive.
I want to continue to work in my garden because I need the food I grow, but I think it will be too difficult for me to do this.
There are many strategies to consider to continue to successfully grow the things that you want/need to grow. By learning to use the vision you have and learning adaptive ways to garden you can continue to do this and enjoy it.
I don’t walk in my neighborhood anymore because I am afraid of falling. Is there anything I can do?
An Orientation and Mobility professional can help you to learn to walk safely and comfortably in your neighborhood. By working with this staff member you can learn techniques to help you get around safely inside and outside of your home. This may include learning how to better use the vision you have, how to control glare that makes walking difficult, if necessary how to use a cane to assist you to know where cracks and holes are so that you can safely walk around them, and how to cross the street safely
Orientation & Mobility Frequently Asked Questions
Should people who can still see be using a white cane?
Any person who is legally blind is entitled to use a white cane. A legally blind individual may see some things clearly under certain conditions. A long cane is a valuable tool to have when those specific conditions are not met (it gets dark or too sunny for example). The cane is often used to identify the person as having a visual impairment so that other people are more patient and understanding. The cane gives legal protection when crossing streets (drivers must stop for a white cane) and provides information about curbs and steps to people who lack depth perception.
I never go anywhere without an escort. Why would I need a white cane?
A white cane with a red segment at the bottom is an international symbol of visual impairment. Carrying a white cane while walking with someone else is perfectly acceptable and provides advantages such as letting the general public know you can’t see so well. This can literally open doors for you! You can also help your escort as you cross the street by stopping traffic with your white cane. The cane also allows you to carry on a normal conversation with your companion rather than focusing on every step up or down, how far away and how deep it is. Also, there are many times when your escort may not accompany you every step of the way; you might prefer to go to a restroom independently or separate briefly while shopping.
Why are the canes so long?
There are many types of white canes. Some are regular support canes. Crutches, walkers and even wheelchairs may be white and red. The long cane is designed to give the legally blind person who does not need support two and a half steps warning of what lies ahead. When not in use, many long canes can fold to fit in a bag, briefcase or shopping cart.
Where can I buy a white cane?
Long canes are available in many sizes and have many different features. Using one correctly takes training and practice. If you are interested in using a long cane or know someone who might be, contact NCCI Vision Services. We have Certified Orientation & Mobility Specialists who can come to your home to prescribe & provide a cane and training at no cost to the legally blind individual.
What if my cane wears out or breaks?
When your Orientation & Mobility Instructor gives you a cane, she will probably leave you information about replacing or repairing your specific cane. If you have new Orientation & Mobility goals you might be eligible for a new cane and training from NCCI. If you have no needs other than a new cane, there is an 800 telephone number on your cane which you can call to purchase a new cane or tip.
Completion of Services
What happens when I finish working with NCCI? Will someone still come by to visit me?
When you and your service provider agree that you have accomplished your goals and no longer require our services, NCCI staff will step out of the picture. It might help to think of it as “graduation”. Our service providers will move on to help other visually impaired people. If you experience a change in your vision or lifestyle (for example you move or your care giver is no longer available) just give us a call at 518-563-9058. You can also have new services every two years if needed.
What if I don’t need the adaptive aids you gave to me anymore?
NCCI always recycles and will be happy to pick up anything you are not using so we can distribute them to others in the community in need. Just call us at 518-563-9058.
Resources and Links
Consumer Organizations:
National Accreditation Council for Agencies Serving People with Blindness or Visual Impairment (NAC)
Accredited Schools Online, Serving Students with Vision Impairments
Vendors:
BlindlineTM … a fully accessible website created by VISIONS in collaboration with the American Foundation for the Blind to provide direct access to a New York statewide database of organizations and services for people who are blind or visually impaired, their family members, counselors, and other professionals.
Leading Causes of Blindness
Normal Vision
Macular Degeneration affects the central portion of vision but not the side vision. It is difficult to see faces and print may be distorted or have missing segments of words.
Macular Degeneration
Macular Degeneration affects the central portion of vision but not the side vision. It is difficult to see faces and print may be distorted or have missing segments of words.
Glaucoma is caused by elevated eye pressure which causes optic nerve atrophy. It is usually detected by pressure checks and routine eye examinations. In advanced cases, images may appear faded and side vision may be lost. Print appears to lack contrast.
Glaucoma
Glaucoma is caused by elevated eye pressure which causes optic nerve atrophy. It is usually detected by pressure checks and routine eye examinations. In advanced cases, images may appear faded and side vision may be lost. Print appears to lack contrast.
Cataracts
Cataracts develop when protein builds up in the lens of your eye and makes it cloudy. This keeps light from passing through clearly. It can cause you to lose some of your eyesight. There are different types of cataracts. They include:
Age-related. These form as you get older.
Congenital. This is what doctors call it when babies are born with cataracts. They may be caused by infection, injury, or poor development in the womb. Or, they can form in childhood.
Secondary. These happen as a result of other medical conditions, like diabetes. They can also result from being around toxic substances, ultraviolet light, or radiation, or from taking medicines such as corticosteroids or diuretics.
Traumatic. These form after an injury to the eye
Diabetic Retinopathy is caused by retinal changes in advanced or long term diabetes. It may affect the macula or the entire retina and vitreous. Reading is variable, and print may be distorted or blurred. Many diabetics also develop cataracts resulting in hazy and distorted vision.
Retinitis Pigmentosa is a heredity disease causing degeneration of the pigmented layer of the retina. It leads to severe loss of peripheral vision causing problems with travel. Reading area is reduced although some letters in the center may be clear.
History
NCCI Vision Services was formerly an independent not-for-profit agency called the North Country Association for the Visually Impaired, (NCAV).
Dr. Richard Erenstone, of Eye Care for the Adirondacks, attended a meeting of Low Vision Specialists in New York City sponsored by the Lighthouse for the Blind of New York in 1988. When he returned, he contacted local community leaders from the North Country to address the needs of the visually impaired in our area.
Gene Manley, who was District Governor of the North Country Lions Club 20W, was extremely influential in getting the North Country to adopt the agency as a district wide project. Help was not difficult to find as many people recognized the need and value of such an agency.
Initial founders included Dr. Richard Erenstone, Edward Finnerty, Pat (Michaud) Wilson, Cherie Racette, Richard Hunkins, Gerald LaBombard, and Carter Lockwood. Valuable advice was obtained from advisory board members such as Dr. Albert Morier, Dr. Frank Trudeau, Martin Stone, Phil Jessen, and Dr. Kjell Dahlen (founder of Eye Care for the Adirondacks).
NCCI was established as a 501(c) 3 Charitable Organization in 1989. For over 30 years, the agency was characterized by continuous strong support from our community volunteers and dedicated staff throughout the four counties of Clinton, Essex, Franklin and St. Lawrence. It is now in the process of merging with the North Country Center for Independence in order to secure Vision Services for the future and combine with NCCI’s mission serving people with disabilities in the North Country, New York region.