Using a computer, smart phone, or any digitally driven device can be tough with wet age-related macular degeneration (AMD), a condition that causes abnormal blood vessels to grow into the eye's macula—the most sensitive part of the retina. These weak vessels leak blood or fluid, which can lead to scarring and rapid loss of central vision, if not promptly treated.
Of course vision loss impacts everything you do, but it can be particularly disruptive to the business of running your day: reading emails, direct messaging, answering texts, or even being able to sort out the clutter from essential files on your desktop’s screen.
But having low vision does not mean turning away from technology forever. “Don’t be discouraged,” says Joe Fontenot, M.D., medical director of Community Services for Vision Rehabilitation in Mobile, AL. He says that advancements in accessibility features—most of which you likely have on your computer right now—can make technology use a “to do” task. And he speaks from firsthand experience: Dr. Fontenot had to learn how to use computers after experiencing vision loss 30 years ago. “Everyone with vision loss should try,” he adds.
But, how, when reading type or spotting the mouse pointer can be a challenge even for people who don’t have wet AMD? Try the following tips from Dr. Fontenot and other low-vision experts—you’ll be up and running (and back on-screen) in no time.
1. Switch the Contrast
A white background causes glare, which is especially uncomfortable for people with AMD. Reducing glare decreases eye strain and allows you to use your computer more comfortably for longer, says Jason Vice, OTR/L, SCLV (the official credentials used for an occupational therapist who is certified to treat low-vision needs) at the University of Alabama at Birmingham.
Sure, you can buy anti-glare coating for your computer screen, but it reduces light from the computer—and may make things harder to see, he adds. Instead, try changing to white type against a black background to reduce glare and improve contrast. “It takes getting used to,” admits Vice. “But the trade-out is worth it.” But, how, exactly, do you do this? Follow a few simple steps. (And it goes without saying, for these instructions and all that come after it, if you need help from a fully sighted friend to navigate your computer’s settings, ask for it! Ten minutes of their time just might be enough to get you back on your laptop, desktop, or iPhone for a lifetime.)
On a Mac: Go to System Preferences, click General, and select the appearance option “dark” to enable Dark Mode, which uses a dark color scheme. (It’s available on your iPad and iPhone too!)
On a PC: You can do a similar thing on Windows 10 by choosing a “dark” theme. Go through Ease of Access settings, advises Vice, and choose “high-contrast” mode to make buttons and menu colors stand out better against the black.
2. Skip Desktop Designs
OK. So, now your screen is reversed—great! But do you still have your old patterned desktop in the background? We know how you love that photo of your puppy, but people with wet AMD often struggle to discern objects against busy backgrounds, so a simple black or gray desktop is best, says Vice. Boring? Maybe. Less distracting? Definitely. So do it.
On a Mac: Go to System Preferences and choose Desktop & Screen Saver. Now pick something plain!
On a PC: Click on the Windows button on the lower left corner, choose Background Image Settings, then do the same—a simple, dark color.
3. Create Some Folders
Let's move on to organizing your actual desktop. Visual clutter can slow down people with wet AMD. One of the first things Vice does when working with someone new is to clean things up. Yep, that means dragging unnecessary files straight to the digital recycle bin (usually found in the lower right hand corner of most computers and laptops).
“People can be really bad about having icons on their screen for programs they don’t use, or files that have built up on their desktop over time,” he notes. “It makes the computer harder to use.” So tidy up: Delete those long-ignored apps and organize files into folders. If you share your computer with family members, ask them to do the same, suggests Julie Nastasi, Sc.D., OTR/L, assistant professor of occupational therapy at the University of Scranton in Pennsylvania. Icon or folder size can also be increased so they are more visible on the desktop.
4. Bump Up the Font Size
Because people with wet AMD often struggle with fine detail, one simple fix is to make your type size bigger, either when navigating through systems or when you’re working in computer programs like Microsoft Word. But don’t assume bigger is always better, says Nastasi. “If you increase type size too much, it can make everything so big that things get lost.” Bump up the size just a little at a time to see what works for you, she suggests.
On a Mac: Click on View at the top of your screen, then select View Options. A window box appears. Here you can increase font and icon size of everything that appears on your screen by as much as 500%, Nastasi notes. (If you’re not sharing and printing the doc for others to read, just highlight your text, then head to the font box in Display and up the actual font size there.)
On a PC: Same thing. Just click View in the Display box at the top of your screen, then click on the “Zoom In” feature—it looks like a magnifying glass.
5. Give Your Mouse a Tail (or Learn to Shake It!)
Now, for the infamous mouse pointer—the arrow that moves around your screen—which can so easily get lost, even for well-sighted people. Vice says the solution is simple: Make it bigger. Or even change its color.
On a Mac: Open System Preferences, then choose Accessibility, then Display. Use the “cursor size” slider to adjust the size of the pointer. Or, click the box that says “shake mouse pointer to locate”—then, whenever you lose your mouse, just shake it to enlarge it.
On a PC: You can use the inverted colors option in the Ease of Access Center under “make the mouse easier to use” to change colors, depending on your background, so it stands out wherever it is on your screen, says Vice. You can also activate “pointer trails” to leave after-images of the pointer. And you can make the blinking cursor stand out, too, by increasing its thickness—a neat trick to make search bars easier to find, notes Vice. To do so, select “make the computer easier to see” (in Ease of Access), then scroll to “set the thickness of the blinking cursor.” Use the dropdown to choose a number (1 through 20) to select the thickness you want.
6. Consider New Software
Other options for people with wet AMD include proprietary software programs, such as ZoomText, which doubles as a screen magnifier. One major plus: The program maintains more definition and clarity than built-in computer magnifiers found in programs like Word, says Vice. The downside? It’s pricey—the most recent version retails for $875. If you use your computer often or for work, it may be worthwhile. Otherwise, the free options on your computer may be enough, Vice adds.
7. Bump Up Your Keyboard
Many computer users love to use shortcuts—and these are especially helpful for people with wet AMD who don’t love a tough-to-see mouse pointer. Luckily, most accessibility features can be turned on and off this way. The problem? Those keys can be hard to find. “Most keyboards come with raised ridges on the F and J,” Vice notes. His simple hack? Steal that strategy by placing special bump dots made for computer keyboards, like this six-set of orange dots for $8.
On a Mac: Put one on the Command key—it’s the key to most shortcuts.
On a PC: Put one on the Windows key. Then, doctor up the Control, Alt, and Option function keys, too, as well as volume and brightness controls.
8. Let the Computer Read to You
For people who have wet AMD with 20/200 vision or worse—“low vision” starts at 20/70, according to the World Health Organization—an auditory approach might help, says Nastasi. Built-in programs like VoiceOver (OS X) and Narrator (Windows) can read everything on your screen, including dialogue boxes and error messages, plus text, icons, and data.
On a Mac: Go to System Preferences, then Accessibility, and select VoiceOver. Check the “enable VoiceOver” box. Unlike Narrator in PCs, VoiceOver reads every little thing on the screen, whether you want it to or not. Too much? Select Speech instead, says Vice. Check the box for “speak selected text when the key is pressed”—this enables speech controls to read only the words you want spoken out loud. Simply highlight the words you want to hear, then press a chosen key command, says Vice—likely a better option for those who can still make out folders and icons but struggle with text.
On a PC: Press the Windows key, Control, and Enter to toggle Narrator on and off. (On older versions of Windows, press the Windows key plus Enter.) Use key commands to tell Narrator what you want it to read. (Press Caps Lock and F1 to open a list of Narrator commands.)
9. Then Talk Back
Plenty of computers also come equipped these days with voice-command recognition. Windows has Speech Recognition, and Mac has Siri. You can open files, dictate a note, or check the weather—just ask.
On a Mac: Simply enable Siri—go to System Preferences to do so. You can summon her with keyboard shortcuts. Or, check the box that says: “Listen for ‘Hey, Siri,’” then follow the verbal setup process.
On a PC: You’ll need to set up your computer for Speech Recognition (under Ease of Access) before you get started.
10. Make Your Browser Work Harder
Your operating system isn’t the only thing with accessibility options. You can make helpful changes to your Web browser, too. Customize the way you view websites by changing the text size and color. With Chrome you can install “extensions,” small software programs that let you customize your Web browsing. (Try the Negative - Revert Web Colors high-contrast extension to change Web page color schemes, making text easier to read.) In Safari, you can enlarge font size up to 300%. And, in any browser, you can manage settings to block distracting popups. Have a spouse who doesn’t need your browser settings? You can each use a different browser, suggests Vice.
For Chrome: Select Settings, search “pop,” click Site Settings, click Pop-ups and redirections, and toggle the Pop-ups option to Blocked.
For Safari: Make sure Block Pop-ups is enabled in Preferences.
For Internet Explorer: Select the Tools button (the gear), then Internet Options. On the Privacy tab, under Pop-up Blocker, check the box for Turn on Pop-up Blocker, then click OK.
For Firefox: Click the menu button (three horizontal lines) and select Preferences. Choose Privacy & Security, and look for the Permissions section. Check the box next to “block pop-up windows.”
11. Rethink Your Computer Space
Don’t face a window or have your back to one, Vice urges. Sunlight may shine in your eyes or bounce off the computer screen. Look for a corner or wall that’s not directly across from a window. Keep ambient lighting dim and adjust a gooseneck task lamp to shine light directly onto the keyboard to make it easier to see. “Never position it in a way that it’s shining in your eyes. You want it to be evenly illuminated and shining down,” Vice says. Finally, avoid table lamps with shades, which can diffuse the light source, he adds. Some LED lamps can vary the warmth of the light and as well as brightness with a light touch. You can choose the combination that works best for you.
12. Or, Opt for a Tablet or Smart Phone
Tablets are being used more and more by the low-vision community, says Nastasi. The touchscreen may be more intuitive and makes enlarging text easy. You can hold it close to your face and more easily maneuver the device to use a technique called preferred retinal locus (PRL) training—where you learn to look above, below, or to the left or right of the scotoma in your central vision. (Your scotoma is often referred to as your “blind spot.”) Like computers, tablets come with built-in accessibility features.
On a Mac: Set up your iPad so you can triple-tap the home key for an easy shortcut to turn on (or off) the features you use most, Nastasi says.
On an Android: Once you turn on the Accessibility Menu, simply swipe up with two fingers to bring up the menu options.
Seems that everyone these days, including those with wet AMD, has a smart phone—and these ubiquitous personal devices have many of the same accessibility features as computers, such as voice-command recognition (hey, Siri!), high-contrast themes, and magnifiers. Like a tablet, you can bring a phone super-close to your face, says Nastasi. And try this simple trick: Snap a picture of something you’re struggling to see—say, the label on a medication bottle—then stretch the photo to make it larger. To do so, open your camera icon and make like Annie Leibowitz—click, click, flash, flash—and you’re ready to go.
Another advantage of a smartphone or tablet is the ability to download low vision apps such as Money Reader, Talking calculator, Audio Books, Alarm/Reminder apps, Reader apps that convert text to speech, and Voice controlled GPS apps.
Ask for Help If You Need It
Everybody’s needs are different, notes Dr. Fontenot. If you have vision loss from wet AMD, don’t be afraid to explore your accessibility options and see what works for you. Something go wrong? Don’t panic. Ask your eye doctor for a referral to a low-vision therapist for help, or find one here. In addition, both Windows and Apple have dedicated support teams for accessibility users. Apple users can call 877-204-3930. Windows users can call Microsoft’s Disability Answer Desk, 800-936-5900, from 6 a.m. to 10 p.m. PST during the week, and 7 a.m. to 6 p.m. on weekends.