What a Legally Blind Person Can See — And What Healthcare Providers Need to Understand

/ Adaptibility for Life LLC/

What a Legally Blind Person Can See — And What Healthcare Providers Need to Understand

In a New York Times Opinion video, “What a Legally Blind Person Can See,” offers a powerful reframing and understanding of blindness—blindness not as total darkness, but as a spectrum of visual experience. Through the story of Yvonne Shortt, a legally blind artist living with retinitis pigmentosa (RP), the video challenges common assumptions and provides meaningful insight for healthcare professionals.

For providers committed to culturally competent care, this perspective is insightful. Vision loss is not just a clinical condition—it is a lived, evolving experience that affects communication, autonomy, identity, and trust.

What Does “Legally Blind” Actually Mean?

Legal blindness does not equal total blindness. In fact, approximately 85% of people who are legally blind retain some usable vision. This vision can vary dramatically depending on type of vision loss:

  • Lighting conditions

  • Distance from objects

  • Time of day

  • Fatigue

  • Position within their field of vision

For individuals like Yvonne with RP, vision is:

  • Partial (a narrow cone of clarity)

  • Inconsistent (clear in one moment, unclear the next)

  • Fragmented (seeing parts of objects rather than whole forms)

She describes seeing someone as pieces—perhaps a foot, a torso, or a hand—depending on positioning. Over time, peripheral vision loss creates a “tunnel vision” effect, often with blind spots that develop gradually and go unnoticed until they significantly impact daily life.

Adaptation Is Skill, Not Deficit

What’s critical for providers to understand is that adaptation happens alongside decline. Patients are not simply “losing function”—they are actively learning new ways to navigate their world. Yvonne’s story highlights how individuals with vision loss develop sophisticated strategies, including:

  • Scanning: Pausing and mentally mapping a space

  • Sensory compensation: Relying more on touch, sound, and spatial awareness

  • Assistive tools: Using phones, lighting aids, or white canes

  • Environmental awareness: Interpreting subtle cues like airflow, sound shifts, or textures

These adaptations are not signs of limitation—they are signs of resilience, intelligence, and agency.

Practical Tips for Healthcare Providers

To provide effective, ethical, and culturally competent care, providers must move beyond assumptions and adopt intentional practices.

1. Avoid Visual Assumptions: Do not assume a patient can or cannot see based on appearance. Instead ask:
- “What helps you see best in this environment?”
- “Do you prefer verbal guidance or physical cues?”

2. Optimize the Environment: Small changes can significantly improve accessibility:

- Ensure consistent, non-glare lighting
- Reduce visual clutter in exam rooms
- Keep equipment in predictable locations
- Verbally describe any changes in the environment

3. Communicate Clearly and Directly: Always introduce yourself verbally

- Speak directly to the patient (not a companion)
- Use specific language (“The chair is two steps to your right”)
- Avoid vague cues like “over there”

4. Respect Autonomy with Mobility Tools: The white cane, for example, is not just a tool—it can carry emotional and social weight.

- Patients may delay using it due to:
- Fear of stigma
- Concerns about independence
- Professional or relational anxiety

5. Recognize Emotional and Identity Impacts: Vision loss is not just physical—it can affect:

- Career identity
- Relationships
- Confidence
- Mental health

Your role is not to push—but to support informed, empowered choices.

Continuing the Mission of Access and Understanding

Adaptability for Life’s cultural competence - ethics continuing education courses provide engaging and practical skills in supporting their clients with vision/hearing loss.

Approvals - Accreditations:

OHA - Oregon Health Authority - Cultural Competence CE
CEP #18180 CA Board of Registered Nursing, Continuing Education Provider
NASW-OR Nat. Assoc. of Social Workers - Oregon Cultural Competence CE
CRCC - Commission on Rehabilitation Counselors Certification - Ethics CE

Who these courses are helpful for:

Nurses, Psychologist, LCSW, LFMT, PT, OT, SLP, ND, NP, PA, MD, DDS, LPC, Chiropractor, License Professional Counselor, Marriage and Family Therapist, Dentist, Dental Technologist, Dietitian, Emergency Medical Service Provider, Home Care Worker, Lactation Consultant, Long Term Care Administrator, Massage Therapist, Medical Imager, Midwife, Naturopathic Doctor, Occupational Therapist, Optometrist, Pharmacist, Polysomnographic Technologist/Respiratory Therapist, Social Workers, Caregivers and Families.

  • For those seeking to enhance their skills in communicating with those who have vision or hearing loss, consider enrolling.

2-Hour Cultural Competence CE: Effective Communication with Clients Who Are Hard of Hearing
4-Hour Cultural Competence and Ethics CE: Understanding the Diversity of Legal Blindness, Impacts & Solutions
6-Hour Cultural Competence and Ethics CE: Providing Culturally Competent Healthcare for Those Aging with Dual Sensory Impairments

Each course blends over 25 years of experience in rehabilitation counseling and disability services with lived insight and real-world examples. You’ll walk away with tools that help prevent social isolation, improve connection and communication, and foster hope—even in the face of progressive sensory loss.

What You’ll Gain

  • Strategies to prevent social isolation and despair

  • Tools to support clients experiencing progressive loss

  • Skills to improve communication and connection

  • Easy, low- or no-cost accessibility techniques

  • Real-world examples you can apply immediately

About the Instructor

Deb Marinos, MS, CRC, LPC, is a Certified Rehabilitation Counselor, Oregon Licensed Professional Counselor, and CMBM Mind-Body Skills Group Facilitator. She brings decades of teaching experience with health care professionals and other working with individuals navigating sensory loss and disability. Her courses are designed to be interactive, helpful, and will give you more comfort in your work.

Take the Next Step

If you’re ready to strengthen your skills, deepen your empathy, and make your practice more inclusive—join Deb and Olaf on this journey.

👉 Explore the Cultural Competence & Ethics accredited continuing education courses and sign up today at Adaptability for Life

Adaptability for Life LLC
21887 SW Sherwood Blvd. STE C
Sherwood, OR 97140
deb@adaptabilityforlife.com