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Career Counseling for Clients who Are Blind or Visually Impaired

Lauri Dishman, M.A., LCPC Manager of Counseling Services Guild for the Blind

Purpose: To provide information on best practices when encountering clients who are blind or have vision loss.

Eye Conditions: Their Impact on the Workforce

Age-Related Vision Loss in the Workplace

As baby boomers age, people with agerelated vision loss is expected to double over the next 30 years. 65% with VI are people 55 and over Onset begins in people in their late 40s or early 50s --American Foundation for the Blind

Ranges of Vision Loss

Low Vision
Vision loss that may be severe enough to impede a person's ability to carry on everyday activities, but still allows some functionally useful sight. Examples: macular degeneration, cataracts, glaucoma

Legal Blindness
A level of visual impairment that has been defined by law to determine eligibility for benefits. It refers to central visual acuity of 20/200 or less in the better eye with the best possible correction, or a visual field of 20 degrees or less.

Total Blindness
The complete lack of form and visual light perception

Types of Visual Impairments

A condition in which the lens of the eye, which is normally clear, becomes cloudy or opaque.


Macular Degeneration
Disease that causes dysfunction of the macula, the area in the middle of the retina that makes possible the sharp central vision needed for such everyday activities as reading, driving, and recognizing faces and colors

Macular Degeneration

Disease in which the pressure of the fluid inside the eye is too high, resulting in a loss of peripheral vision. If the condition is not diagnosed and treated, the increased pressure can damage the optic nerve and eventually lead to blindness.


Diabetic Retinopathy
Eye condition that results from the damaging effect of diabetes on the circulatory system of the retina. Changes in the tiny blood vessels of the retina can lead to vision loss.

Diabetic Retinopathy

Professionals Who Can Help

A health care provider who specializes in refractive errors, prescribes eyeglasses or contact lenses and diagnoses and manages conditions of the eye as regulated by state laws. Ay also perform low vision examinations.

A physician who specializes in the medical and surgical care of the eyes and is qualified to prescribe ocular medications and to perform surgery on the eyes.

Certified Vision Rehabilitation Therapist (CVRT)

Personal Management (grooming, hygiene, clothing organization, medical measurement) Home Management (organization and labeling, repair and home maintenance, budgeting and record keeping, etc.) Activities of Daily Living (cooking, cleaning, shopping, safety, money organization and management) This includes techniques to stay organized in the workplace.

Certified Orientation and Mobility Specialist (COM)

Concept Development, which includes body image, spatial, temporal, positional, directional and environmental concepts Motor Development, including motor skills needed for balance, posture, and gait, as well as the use of adaptive devices Sensory Development, which includes visual, auditory, senses and their interrelationships Techniques for traveling in indoor and outdoor environments

COM (Contd)
Residual vision stimulation and training Human Guide Technique Locating Dropped Objects, trailing, Cane techniques Soliciting and Declining Assistance Utilizing Landmarks, search patterns, route planning, Analysis and identification of intersections and traffic patterns, techniques for crossing streets Using public transportation

Breakthrough Technology

Computer Software
JAWS (Freedom Scientific) ZoomText (Ai Squared) I Zoom Portable Screen Magnification (No installation needed)

Text to Digital
Zoom-Ex (ABISee)

Audio Files
Victor Reader Stream (Humanware)

Video Magnification
Acrobat (Enhanced Vision)

Where to Get Help

Government and Private Agencies

State Department of Rehabilitation Services/Bureau of Blind Services Local Veterans Administration Local Blindness Agencies (Guild for the Blind, Chicago Lighthouse) American Foundation for the Blind 800232-5463 (To find services in your area)

Model of Successful Work Experience for Employees Who are Visually Impaired

Golub Study

Golub Study
Surveyed employers of workers with visual impairments who demonstrated great success on the job. Through data analysis of results, was able to devise an integrative model of successful employment. Includes 7 steps that employers can take and 7 steps employees can take to ultimately generate success for both parties.

Model for Employers Step 1

Core Values from the Top Down
Instill the value of diversity as a strength. Have this flow from the top of the organization down to the working core.
The Counselors Role: Look for employers with these values. Mission statements are often good places to look. Also, what types of charities do companies and organizations contribute to?

Model for Employers Step 2

Fill the Toolbox
Provide the physical tools that employees need to do their jobs.
The Counselors Role: Help the client learn how to advocate for themselves. Lead them to resources such as the Job Accommodation Network with information and resources for how people with difference levels of vision loss can accomplish certain tasks. Find out where to get these devices and their approximate costs. Help them work with their DRS counselor to acquire these products.

Model for Employers Step 3

Accessibility and Accommodations
All employees should have equal access to all information
The Counselors Role: If there is a problem, help clients learn how to advocate for themselves in a way that doesnt jeopardize their working alliance. Understand the letter and spirit of the ADA.

Employer Model Step 4

Attitude Counts
Try to remove the blindness stigma from the attitudes of other employees. Do what is necessary to make the workplace a level playing field where everyone is treated equally (both positively and negatively)

Employers Role Step 5

Words Speak as Loudly as Actions

Using words instead of actions to let the worker with visual impairment know whats going on. Understand the proper etiquette when encountering someone who is blind or visually impaired.

Model for Employers Step 6

Expect the same Performance

Model for Employers Step 7

Mutual Accommodation
recognize that differences among individuals are substantial and must be accommodated regardless of whether they add value

Model for Employees Step 1

Your Comfort is Contagious
Person with visual impairment is comfortable in their skin, can ask for what they need. Treats the disability as just a part of who they are. People at this stage have accepted their situation, are open to talk about it and show people the tools and devices they use to do their jobs.
The Counselors Role: Refer for support and counseling services if necessary. Encourage the expansion of social networks and support systems. Expose client to successful and mobile people who are B/VI.

Model for Employees Step 2

Blindness Competencies

Be up-to-date on mobility and assistive technology skills

The Counselors Role: Refer to a CVRT and COM. Refer to the state DHS for free services

Model for Employees Step 3

Be An Ambassador for Blindness

Its the responsibility of the person with vision loss to ameliorate the awkwardness.
The Counselors Role: Encourage clients to be open with fellow workers.

Model for Employees Step 4

Positive Attitude Having a positive attitude is contagious. Takes away the discomfort.
The Counselors Role: Help client work through barriers, increase confidence and self-esteem. Refer out if necessary.

Model for Employees Step 5

Work Etiquette Show manners and good social skills. Understand non-verbal communication without the eyes
The Counselors Role: Job Readiness Training with emphasis on ways to instill these skills for people with Vision Loss. Tactics that are B/VI specific. (e.g. the Guilds C.E.O. Program)

Model for Employees Step 6

Insist on Being Held to the Same Standard This applies in terms of performance and job duties

Model for Employees Step 7

Mutual Accommodation
People with Visual Impairments need to help the employer move toward a model of mutual accommodation, where there is open dialogue about different ways to accomplish tasks and discuss things from different perspectives. Counselors Role: Encourage clients to ask employers to form multi-cultural taskforces

American Foundation for the Blind; Glossary of Eye Conditions; www.afb.org Blasch, Wiener, Welsh; Foundations of Orientation and Mobility, Second Edition; AFB Press 2000; p 750. Academy for Certification of Rehabilitation and Education Professionals, www.acvrep.org/Rehabilitation_Teaching.html Golub (2006); A Model of Successful Work Experience for Employees Who are Visually Impaired: The Results of a Study; Journal of Visual Impairment and Blindness Photos provided by Lighthouse International, ABISee, Humaware, and Advanced Vision.

Contact Information
Lauri Dishman, M.A., LCPC Manager of Counseling Services Guild for the Blind 180 N. Michigan Ave., Suite 1700 Chicago, IL 60601 312-236-8569 lauri@guildfortheblind.org www.guildfortheblind.org