The Definition of Blindness

The Definition of Blindness

These thoughts caused much speculation about the nature of blindness. In response to a
request for a definition of the term, Dr. Jernigan identified the essential
characteristics. Here is the definition of blindness:

Before we can talk
intelligently about the problems of blindness or the potentialities of blind people, we
must have a workable definition of blindness. Most of us are likely familiar with the
generally accepted legal definition: visual acuity of not greater that 20/200 in the
better eye with correction or a field not subtending an angle greater than 20 degrees. But
this is not really a satisfactory definition. It is, rather, a way of recognizing in
medical and measurable terms something which must be defined not medically or physically
but functionally.
Putting to one side for a moment the medical terminology, what is
blindness? Once I asked a group of high school students this question, and one of them
replied-apparently believing that he was making a rather obvious statement-that a person
is blind if he "can’t see." When the laughter subsided, I asked the student
if he really meant what he said. He replied that he did. I then asked him whether he would
consider a person blind who could see light but who could not see objects-a person who
would bump into things unless he used a cane, a dog, or some other travel aid and who
would, if he depended solely on the use of his eyesight, walk directly into a telephone
pole or fire plug. After some little hesitation the student said that he would consider
such a person to be blind. I agreed with him and then went on to point out the
obvious-that he literally did not mean that the definition of blindness was to be unable
to see.
I next told this student of a man I had known who had
"normal" (20/20) visual acuity in both eyes but who had such an extreme case of
sensitivity to light that he literally could not keep his eyes open at all. The slightest
amount of light caused such excruciating pain that the only way he could open his eyes was
by prying them open with his fingers. Nevertheless, this person, despite the excruciating
pain he felt while doing it, could read the eye chart without difficulty. The readings
showed that he had "normal sight." This individual applied to the local Welfare
Department for Public Assistance to the Blind and was duly examined by their
ophthalmologist. The question I put to the student was this: "If you had been the
ophthalmologist, would you have granted the aid or not?"
His answer was, "Yes."
"Remember," I told him, "under the law you are forbidden
to give aid to any person who is not actually blind. Would you still have granted the
assistance?" The student said that he would. Again, I agreed with him, but I pointed
out that, far from his first facetious statement, what he was saying was this: It is
possible for one to have "perfect sight" and still in the physical, literal
sense of the word be blind.
I then put a final question to the student. I asked him whether if a
sighted person were put into a vault which was absolutely dark so that he could see
nothing whatever, it would be accurate to refer to that sighted person as a blind man.
After some hesitation and equivocation the student said, "No." For a third time
I agreed with him. Then I asked him to examine what we had established.
1. To be blind does not mean that one cannot see. (Here again I must
interrupt to say that I am not speaking in spiritual or figurative terms but in the most
literal sense of the word.)
2. It is possible for an individual to have "perfect sight"
and yet be physically and literally blind.
3. It is possible for an individual not to be able to see at all and
still be a sighted person.
What, then, in light of these seeming contradictions is the definition
of blindness? In my way of thinking it is this: One is blind to the extent that he must
devise alternative techniques to do efficiently those things which he would do if he had
normal vision. An individual may properly be said to be "blind" or a "blind
person" when he has to devise so many alternative techniques-that is, if he is to
function efficiently-that his pattern of daily living is substantially altered. It will be
observed that I say alternative not substitute techniques, for the word substitute
connotes inferiority, and the alternative techniques employed by the blind person need not
be inferior to visual techniques. In fact, some of them are superior. The usually accepted
legal definition of blindness already given (that is, visual acuity of less than 20/200
with correction or a field of less that 20 degrees) is simply one medical way of measuring
and recognizing that anyone with better vision than the amount mentioned in the definition
will (although he may have to devise some alternative techniques) likely not have to
devise so many such techniques as to alter substantially his patterns of daily living. On
the other hand, anyone with less vision than that mentioned in the legal definition will
usually (I emphasize the word usually, for such is not always the case) need to
devise so many such alternative techniques as to alter quite substantially his patterns of
daily living.
It may be of some interest to apply this standard to the three cases
already discussed:
First, what of the person who has light perception but sees little or
nothing else? In at least one situation he can function as a sighted person. If, before
going to bed, he wished to know whether the lights are out in his home, he can simply walk
through the house and "see". If he did not have light perception, he would have
to use some alternative technique-touch the bulb, tell by the position of the switch, have
some sighted person give him the information, or devise some other method. However, this
person is still quite properly referred to as a blind person. This one visual technique
which he uses is such as small part of his overall pattern of daily living as to be
negligible in the total picture. The patterns of his daily living are substantially
altered. In the main he employs alternative techniques to do those things which he would
do with sight if he had normal vision-that is, he does if he functions efficiently.
Next, let us consider the person who has normal visual acuity but
cannot hold his eyes open because of his sensitivity to light. He must devise alternative
techniques to do anything which he would do with sight if he had normal vision. He is
quite properly considered to be a "blind person."
Finally, what of the sighted person who is put into a vault which has
no light? Even though he can see nothing at all, he is still quite properly considered to
be a "sighted person." He uses the same techniques that any other sighted person
would use in a similar situation. There are no visual techniques which can be used in such
circumstances. In fact, if a blind person found himself in such a situation, he might very
well have a variety of techniques to use.
I repeat that, in my opinion, blindness can best be defined not
physically or medically but functionally or sociologically. The alternative techniques
which must be learned are the same for those born blind as for those who become blind as
adults. They are quite similar (or should be) for those who are totally blind or nearly so
and those who are "partially sighted" and yet are blind in the terms of the
usually accepted legal definition. In other words, I believe that the complex distinctions
which are often made between those who have partial sight and those who are totally blind,
between those who have been blind from childhood and those who have become blind as adults
are largely meaningless. In fact, they are often harmful since they place the wrong
emphasis on blindness and its problems. Perhaps the greatest danger in the field of work
for the blind today is the tendency to be hypnotized by jargon.

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