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NEW YORK—With every passing year, millions of aging Baby Boomers lose some, or all, of their sight due to age-related eye disease. Gen X is not far behind.

The fact is that as we live longer due to advances in healthcare, the number of people suffering from low vision and blindness continues to increase. According to 2021 study published in JAMA Ophthalmology, 20 percent of all people aged 85 and older in the U.S. experience permanent vision loss. As a result, the need for assistive technologies and improved access to them has never been greater.

To help mitigate this growing global low vision crisis, an expanding ecosystem of vision care providers and vision organizations, along with a broad array of suppliers—including several Big Tech companies—are developing new solutions to help those living with visual impairments perform everyday tasks. Through their combined efforts, everything from handheld and desktop magnifiers to smartphone apps, specialized software, AI-powered wearable devices and other new technologies are becoming more accessible for all those with low vision, blindness and hearing impairments.

Yet significant obstacles to accessibility remain. A recent study from The American Foundation for the Blind (AFB) notes that barriers to digital inclusion for people who are blind or have low vision remain significantly high and pervasive. The study examined the prevalence of obstacles encountered across a wide range of online services, social networks, and other web and mobile applications. Overall, 21 percent of participants stated they encountered at least one obstacle to accessibility each day on the web, while 24 percent experience similar daily issues on mobile applications. At least four out of five participants experience some kind of accessibility barrier on either web or mobile platforms in categories pertaining to online shopping and food delivery, education, job seeking, and travel.

“While the explosion of digital content over the past 15 years has brought so many opportunities to improve the lives of millions of people who are blind or have low vision, it is disheartening that these opportunities continue to be shadowed by the high prevalence of inaccessible online content and lack of accessible functionalities,” said Eric Bridges, AFB president & CEO in a recent release. “Without a firm commitment from the public and private sectors for digital accessibility, we are going to continue to see the accessibility gap widen across the internet in this post-pandemic world when everything has shifted online.”

According to the study, these obstacles prohibited users who are blind or have low vision from being able to perform simple tasks such as accessing information or completing online forms. Because of these barriers, just shy of 80 percent of participants indicated frustration with the loss of their independence as a result of the obstacles, and 40 percent chose to take their business elsewhere.

Jennifer Sagalyn, director of strategic partners at Perkins Access, the accessibility consulting division of Perkins School for the Blind.

Creating accessible spaces and promoting inclusion was one of the main themes at the VM Summit this year. Jennifer Sagalyn, director of strategic partners at Perkins Access, the accessibility consulting division of Perkins School for the Blind, told the audience at Vision Monday’s 2023 Leadership Summit, “The first step to becoming an accessibility champion is to understand the barriers,” she said, adding that a digital world is elevating the barriers for students as tactile experiences disappear. She said that businesses need to focus on creating digital products that offer accessibility now that there is greater access to tools and resources. Perkins Access helps consult on this for businesses of all size.

“Most people think digital accessibility is only about websites, videos and software. But more and more physical locations have digital touchpoints for customers, patients and employees,” she said, noting that more businesses are recognizing the importance of removing barriers. According to the Centers for Disease Control, 40 percent of adults over 65 have some form of disability. In the United States, working age people with disabilities control disposable income of nearly $500 billion. “[Companies] are at risk of excluding 61 million potential customers and employees with disabilities, including 4.9 percent that have a visual disability,” she said. “So much progress is being made to improve accessibility for people with visual impairments and for everyone who benefits from digital inclusion.” There is a helpful Knowledge Center on the Perkins Access website.

Prevent Blindness also offers on its website a “Living Well With Low Vision” special-dedicated section that includes low vision resources for healthcare providers, patients, and caregivers. The mission of Living Well With Low Vision is to make it as easy as possible for people to educate themselves about loss of vision and to meet the daily challenges resulting from it.

Assistive Tech is Advancing

Bryan Wolynski, OD, FAAO, chief technology officer at Lighthouse Guild

“With the importance of digital platforms and the increasing active lifestyles of seniors today, technology has become necessary in daily life. There is a growth in the need for assistive technology but also for the accessibility of mainstream technologies,” said Bryan Wolynski, OD, FAAO, chief technology officer at Lighthouse Guild, a New York-based organization that provides medical assistance and social support to people who are blind or visually impaired. “The demand was always there, but people were unaware of it or needed to learn how to access it. Social media and encouragement from friends and family has increased awareness. However, there is more work to be done regarding access and understanding, as well as developers making these technologies easier to learn and use.” [To learn how tech companies such as Apple, Amazon, Google and Microsoft are making their devices and systems more accessible for low vision and blind users, see “Tech Giants Sharpen Focus on Assistive Tech.]

A Lighthouse Guild client uses an electronic magnifier.

“The future of assistive technology is rapidly advancing thanks to artificial intelligence and natural language processing, which will allow for more human-like interaction, ease of use, increased customizations, and for use across the spectrum of vision loss, including multiple disabilities,” Dr. Wolynski observed. “There is also better awareness now about “age-tech” among early developers and start-ups using these new concepts and tools, as well as social responsibility, affordability, and equality, helping the growing aging population continue to be independent and active despite functional vision loss from aging eye disease.”

Envision’s Occupational Therapy Assistant shows an older woman how to read a newspaper through a CCTV that enlarges the print for people with low vision.

Other experts are also encouraged by the progress being made with assistive technologies. “Assistive technology is constantly evolving and improving and can be high tech and low tech. Most computers, tablets and smartphones are already equipped with accessibility features for blindness and low vision,” said Emily Hurst, senior director, Envision Workforce Innovation Center, which is part of Envision, a Wichita, Kan.-based organization that provides occupational and other services for low vision and blind people. “There are also digital magnifiers that allow individuals with low vision to continue performing reading tasks. In addition, there are many apps that can support low vision and blind individuals to further improve their independence with low to no cost. I predict there are great advances on the horizon that will further enhance independence for those with low vision.”

Expediting Referrals for Early Diagnosis and Intervention

Although technology is essential to the success of a low vision rehabilitation plan, those who work in the field stress the importance of referring patients to low vision specialists as soon as possible. Expedited referrals for vision rehabilitation programs and services, as an early intervention, are key. This includes technology awareness and the importance of behavioral health services.

“Persons with low vision can be referred to occupational therapy to further assess and determine the best types of assistive technology/resources recommended to increase independence with day-to-day life,” said Karen Kendrick, OTR/L, CLVT, occupational therapist, Envision Vision Rehabilitation Center. “This skilled treatment and training is billable through Medicare/Medicaid and most private insurers. Although the purchase of adaptive equipment and assistive technology is not reimbursed through insurance, some patients may be able to receive funding through Older Individuals who are Blind (OIB) grants to obtain these devices and resources.”

A Multidisciplinary Approach Yields Results
The Vision Council and its Low Vision Division also work to raise awareness of low vision rehabilitation among eyecare professionals, visually impaired consumers and their caregivers. According to Henry Greene, OD, FAAO, chair, Low Vision Division at the Vision Council, and cofounder and president of Ocutech Inc., all individuals with a permanent reduction in vision should have two eye doctors—their medical eye doctor, usually an ophthalmologist, who will manage the visual disorder with medical or surgical treatments when indicated, and a low vision doctor, either an optometrist or an ophthalmologist, who will help to maximize the individual’s vision by prescribing low vision aids. The Vision Council website also includes a Low Vision Prescriber Network listing where individuals can search for low vision specialists most convenient to them.

“We need to empower patients to ask for low vision referrals,” said Dr. Greene. “Making referrals happen is a challenge and educating patients is important as well as developing a methodology for referring patients for low vision care.”

The Vision Council is part of a coalition of interested organizations led by the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition to lobby the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) to cover the provision of low vision aids within the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) program. Traditionally, low vision aids have been excluded as they have been considered equivalent to eyeglasses, which Medicare does not cover.

The Vision Council also educates consumers and caregivers in the low vision community through, a dedicated online resource for people with vision impairment due to macular degeneration, diabetic retinopathy, glaucoma and other eye conditions. In addition to educational resources, research, and a doctor locator, the website maintains a blog with current stories, low vision updates, and guest posts.

Low vision specialist Maria Richman, OD, Shore Family Eyecare, New Jersey

“Patients have been scheduling low vision eye exams with me for over the last 30 years. A low vision exam by a doctor of optometry is an integral part of helping this population because their visual systems are fragile and may fatigue easily,” said Maria Richman, OD, FAAO, Shore Family Eyecare in New Jersey. “Instead of finding a low vision aid by trial and error, a low vision optometrist takes measurements and examines the healthy and unhealthy part of their eye to determine the correct devices to prescribe for the patient and provide the appropriate training. The benefit is to improve the quality of life for those who struggle with vision loss. There are numerous studies showing that improving visual function reduces fall risk, reduces depression and increases overall personal happiness.

“In addition to prescribing low vision devices, I often share external resources such as the National Library Service for the Blind and Print Disabled, state libraries, State Agency/Commission for the Blind and Visually Impaired Services, and local support groups,” added Richman. “Additionally, as a low vision optometrist, I work with other team members including ophthalmologists, low vision therapists, counselors, social workers, orientation and mobility instructors and those offering educational support, vocational support, guide dog options, braille classes and assistance with activities of daily living.”

Dr. Richman noted that the primary barrier for patients is finding their way to a low vision optometrist in the first place. “Often patients spend months to years bouncing from one place to another until they get to someone that practices low vision. This is also worsened as many low vision patients cannot drive anymore,” she said. “Another barrier is not having a support system, such as family and friends to encourage and assist with in-home training following in-office device training. Another barrier is the cost of high-tech assistive devices, compounded by insurance not covering the necessary device in most situations.

“More optometrists are providing low vision services, which opens the door to patients earlier in their journey. Patients can visit low vision doctors by using rideshares, cabs, buses or other means of public transportation. Some states allow for driving with low vision devices, while others restrict it.”

ECPs who want to expand their scope of practice to include low vision can take advantage of educational programs such as Eschenbach Optik of America’s Low Vision Program, which includes in-office staff training for whoever will be working with low vision patients.

An Eschenbach ECP uses the Low Vision Program with a patient.

“Eschenbach’s innovative Low Vision Program is specifically designed to make adding low vision care as easy as possible for ECPs,” said Ken Bradley, the company’s president and CEO. The three-part turnkey program includes in-office staff training for whoever will be working with patients, consultative support to include reimbursement and marketing support for the practice manager or owner, and a customizable diagnostic assortment of devices in a professional-looking and lockable cabinet.

Added Bradley, “Whether a practice wants to offer comprehensive low vision care or just basic low vision care for their patients with slight to moderate vision loss, our Low Vision Program has the essential elements needed to ensure the service is successful—both in terms of patient and practice outcomes.”

Eschenbach takes a full-service approach to the low vision market. The Connecticut-based company is also a leading supplier of low vision aids. One of the company’s recent offerings is Smartlux Digital, a compact, handheld video magnifier that features a 5-inch screen and provides a wide magnification range from 3x–15x that can help patients with varying needs. It can be set in three different positions: one for reading, one for writing and one where both hands are free to hold an object behind the camera.

Virtual Assistants and Apps Play a Growing Role
A relatively new class of assistive tech comprised of virtual assistants and apps is gaining popularity in among low vision and blind people. For example, Aira offers a novel solution for people who are blind or have low vision: a real-time, visual interpreting service.

Aira offers a real-time, visual interpreting service that offers human-to-human professional assistance service.

This live human-to-human professional assistance service enhances independence by delivering on-demand, skilled and reliable visual interpreting for just about any task, according to Aira. Using the camera and an app on a smartphone, a trained agent will assist the user by visually interpreting their surroundings, from describing to reading, from explaining to navigating.

Among the latest offerings is Envision’s “Ask Envision,” a powerful virtual visual assistant that’s available on the company’s smart glasses. Ask Envision is built upon ChatGPT by OpenAI and harnesses this much-discussed technology to immediately deliver life-enhancing experiences for people who are blind or have low vision.

Also announced recently, Zappar, in partnership with Envision announced the integration of their Accessible QR codes (AQR) into the Envision App, expanding the reach of this new assistive technology to hundreds of thousands of blind and partially sighted people around the world. Zappar’s accessibility-enhanced QR codes can now be scanned using the Envision App, available on both iOS and Android, expanding the reach to people who are blind or who have low vision.

New Smart Glasses Enhance Mobility
Recent improvements in the design and performance capabilities by several leading suppliers of smart glasses have made these wearable devices more functional not only for mainstream consumers, but to those with vision impairments, too.

For example, Envision recently unveiled a U.S. pilot of a new Subscription Edition of its AI-powered Envision glasses. Subscribing to a pair of Envision glasses provides customers based in the U.S. with an affordable monthly option to access all Envision glasses features and updates without the need for a substantial upfront payment or commitment.

“Our endeavor continues to be to make the experience of interpreting the visual world as seamless, intuitive, and natural for our users as possible. Hence, we work tirelessly on these AI models so that we can do all the heavy lifting abstractly in the background,” said Envision CEO Karthik Mahadevan. “Our move to smart glasses was also in service of this mission, offering a more natural way of accessing the world around you without a phone in your hand. The next set of AI improvements we are working on, will hopefully make people forget about the technology, and make the whole interaction as natural and easy as having a talking parrot on your shoulder.”

EssilorLuxottica’s new Ray-Ban Meta smart glasses have hands-free features that let low vision users control the device without having to look at the small screens on their phones.

The newest smart glass from EssilorLuxottica, Ray-Ban | Meta comes with several hands-free features to help people capture photos and videos, and comunicate with loved ones. Simple voice commands can be used to send messages, hear message readouts of incoming messages and make calls all via Messenger, WhatsApp, and phone number and can send photos to contacts hands-free. As a Ray-Ban spokesperson told VM, “Whether you’re listening to music or your favorite podcast, you can use your voice to pause/resume, skip, and adjust the volume. You can also adjust these controls by using the touchpad on the right temple of your glasses. And if you’re curious how much battery life you have left, you can check with a simple voice command.”

The Ray-Ban | Meta smart glasses are available in prescription lenses with Varilux progressive or Eyezen single vision lenses, as well as in sun and Transitions lenses. “Those with low vision can benefit from seeing clearly at all distances, in all lighting, from day and night,” the spokesperson said. “With the Meta AI capability in the U.S., wearers will also be able to find information and control their glasses without looking at their phone. Not having to rely on looking at the small mobile device screen can alleviate many worries for those with low vision who use their phone throughout the day.”

Amazon has collaborated with Safilo, a leading eyewear manufacturer, to blend the power of Alexa with Carrera designs. Amazon recently introduced a range of new Echo devices designed for even more personalized, proactive, and intuitive Alexa experiences at home and on-the-go—the next-generation Echo Show 8, all-new Echo Hub, and new Echo Frames. In addition, the tech giant collaborated with Safilo, one of the world’s leading eyewear manufacturers, to blend the power of Alexa with Carrera designs.

Carrera Smart Glasses let wearers with mobility disabilities or who are blind or have low vision access their favorite Alexa features while on the go.

“Carrera Smart Glasses bring together Carrera’s iconic frame styles with Alexa AI. Carrera Cruiser and Sprinter fuse high end fashion with function—they are lightweight designs made with high quality materials and are built with Alexa to simplify customers’ day to day,” said Jean Wang, director of smart eyewear at Amazon. “Making our devices and services accessible to more customers is a guiding belief in how we build technology.”

She continued, “With Carrera Smart Glasses, customers who have mobility disabilities or are blind or have low vision can access all of their favorite Alexa features while on-the-go, whether that’s making a call, requesting a playlist, setting a reminder or adding an event to their calendar, all without pulling out their phone. Customers who are hard of hearing have also shared with us that the open-ear audio design, which directs sound to the ear without completely covering them, enables them to access audio content and the capabilities of Alexa while also wearing hearing aids.”

Earlier this year, Innovative Eyewear announced a major upgrade to its flagship Lucyd Lyte eyewear platform. The new line brings several advances to the company’s core product and is available now, in any optical prescription. The Lyte 2.0 marks the culmination of years of R&D. The company offers smart eyewear under the Lucyd, Nautica and Eddie Bauer brands. Also available is the Lucyd app which enables a voice interface for ChatGPT on the company’s smart eyewear. With the Lucyd app, all of these frames provide on-the-go access to ChatGPT on a hands-free wearable.

“We are excited to be the first company to provide ChatGPT enabled smart eyewear. With our new Lucyd app, which is free to our eyewear customers, we are continuing to make smart eyewear more accessible and functional than ever before,” said Harrison Gross, CEO of Innovative Eyewear.

Orcam’s Ai-powered MyEye wearable device turns virtually any pair of glasses into smart glasses.

Although not a smart glass per se, OrCam’s MyEye is an intuitive AI wearable assistive companion that can make almost any pair of glasses “smart.” The compact, AI-powered device attaches to the temple and can read text from a book, smartphone screen or any other surface, recognize faces and help perform other daily tasks.

Some smart glasses are designed for hearing enabled wearers. One example is a unique wearable developed by Nuance, an Israeli startup that was recently acquired by EssilorLuxottica.

Using proprietary technology, Nuance has developed a unique product which marries high-quality hearing technology with fashionable frames. The audio component is virtually invisible, removing a psychological barrier that has historically stood in the way of consumer adoption of traditional hearing aids, the company said. The new hearing solution, which is not due to be introduced until the latter part of 2024, are hearing aids within a hands-free pair of glasses. The new product will benefit the 1.25 billion consumers suffering from mild to moderate hearing loss, according to Nuance.

“Meeting critical consumer needs with the boldest actions is part of our DNA. While sight remains our core business—and growing the optical market our strategy—we are uniquely positioned to open up a new avenue for the industry by addressing the need for good hearing with innovative technologies” said Francesco Milleri, chairman and CEO, and Paul du Saillant, deputy CEO at EssilorLuxottica.