If Your Best Efforts Fail . . .

An Open Letter to Ophthalmologists

As an ophthalmologist, the time and dedication you bring to your occupation of preserving individuals’ sight is a medical necessity and a credit to your profession. There may, however, be a time in your career, when your best efforts fail and one of your patients loses their sight.  At this critical moment, you can render your patient a great service. Your patient's immediate reaction to the news of blindness will be influenced by your attitude toward blindness, and the information you provide.  The National Federation of the Blind wishes to assist you in this area of your professional life.  We hope that the information provided below will help you to develop or enhance a comfortable, positive, and effective approach to blindness in your patients.

Blindness is by no means a sentence to helplessness, isolation, or despair for your patient.  Thousands of independent, self-sufficient, happy blind people have already proven this beyond a shadow of a doubt. They are managing the tasks of everyday living with competence and ease.  They are traveling around the world with poise and confidence in their capabilities.  They are raising children and holding leadership positions in our communities.  Blind business leaders are competing on equal terms with their sighted counterparts. Across the country, there are blind teachers in our schools; there are blind lawyers, blind chemists, blind engineers, blind doctors, and countless other kinds of blind professionals. Given proper training, opportunity, and a positive attitude about blindness, which you can help foster, your blind patient will remain a capable, independent, fully-participating member of our society.

Based on our experience as the National Federation of the Blind (NFB), we believe that your newly blind patient will need to acquire three things in order to regain self-sufficiency and productivity. You, as the professional, can take the critical first step by coming to understand that blindness is not the characteristic that defines blind people or our future. The NFB, the largest organization of the blind, can be a resource to you in coming to this understanding. Our contact information is at the bottom of this letter. We encourage you to reach out to us. With an understanding of the potential and abilities of blind people, you can help your newly blind or soon-to-be blind patients to achieve:

  1. A complete acceptance of his or her blindness
  2. An unshakable confidence in the ability of the blind, and of himself or herself as a blind person, to live a normal life
  3. A thorough mastery of basic skills, including Braille and cane travel, which will enable him or her to operate without vision in a sighted world.

This could be one of your finest professional accomplishments, to initiate the process by which a newly blind patient will be able to live the life he or she wants. In the following section we will discuss the specific areas in which you, as an eye specialist, can play an important role in this cause.

Early Diagnosis:

One of the crucial elements that contribute to a real acceptance of blindness is the certain knowledge that sight cannot be restored.  As soon as you are reasonably certain yourself, it is vital that you inform your patient that he or she is blind, about to become blind or it is a medical possibility to go blind, and that blindness is or will most likely be irremediable.  Many doctors avoid this direct discussion for fear of seeming harsh or cruel.  As a result, many blind people have put their lives on hold for years, failing to admit the severity of their vision loss, or waiting for a cure that will never come.  They need to understand as completely as possible the nature and extent of their visual disability and the relative change in vision from one examination to the next. As a trusted specialist you can tell them the truth about their vision loss. The kindest, most respectful way you can help a patient to cope with his or her eye condition is to be truthful about the impending blindness and to offer positive reassurance that he or she will be able to lead as productive a life as before the vision loss.

Informed Encouragement:

As you inform your patient of his or her blindness, you can extend a very real hope of their capability of living the life they want even without vision. It is critical for you to provide your patient a sincere, positive message of informed encouragement. Try to avoid pity, half-hearted hope, the prospect of an "almost normal" existence, apology, or the implication of inferiority because vision is gone.  Your patient will face those negative attitudes soon enough when he or she leaves your office.  You can help your patient realize that blindness is not a tragedy, but a purely physical nuisance, already overcome by thousands, and one which can be overcome by anyone.  

It would be beneficial if you would guard against imposing restrictions of any kind, other than those made absolutely necessary by the patient's eye condition; you do not want to reinforce the widespread misconception that blindness, in itself, necessarily limits movement or activity.

Above all, you can inspire your patient by citing the achievements of the blind today as proof that the hope you offer is real.  Your patient can learn from you that opportunities for successful achievement without sight are as numerous as the categories of human activity.  You can steer him or her towards the goals of self-respect and self-sufficiency with your confident and positive approach to blindness.

Referral:

Once you have informed your patient of his or her blindness and provided assurances that he or she will be able to resume a normal, active life as a blind person, you can offer one last service. You can provide your patient with information about services available to blind people in your area.  This includes vocational rehabilitation services, the state library for the blind, and the local chapter and state affiliate of the National Federation of the Blind.  The website of the National Federation of the Blind provides a wealth of information that can be beneficial to a newly blind individual; it can be accessed at http://www.nfb.org/. 

You can be a powerful force for good in your patient's life, even if your medical skill cannot preserve or restore sight.  If you can honestly tell a patient that he or she is blind, if you can convey that blindness will not bar him or her from a normal life, and if you can guide your patient quickly to those services that will equip him or her for normal life without sight, then your contribution to society will be that much greater.  For the small portion of patients whose sight cannot be preserved or restored, your best efforts shall not fail.

Sincerely,

National Federation of the Blind Jernigan Institute
200 East Wells Street
Baltimore, MD 21230
(410)-659-9314 ext. 2357
Jerniganinstitute@nfb.org


Resources to share with your patients

  • NFB-LINK, (http://www.nfblink.org/) provides mentoring relationships for individuals who would like resources and guidance on a variety of blindness topics. The easy-to-use online system will match you with a knowledgeable, experienced mentor who can answer your questions and refer you to additional resources. Information on a variety of vocational, educational, and recreational interests is available through this innovative program.