What is "Legally Blind"? Let's talk about this simply!

You've probably heard the phrase "Legally Blind." But you're probably wondering, "Does that mean you can't see at all? Or does it mean something else?" This is something that needs some clarification. Because it's not a medical term that doctors often use. So, let's talk about it in more detail, shall we?

What exactly does "Legally Blind" mean?

Simply put, "Legally Blind" is a legal and administrative term for severe visual impairment. It is not a medical term used to describe a disease. Rather, it is used by institutions such as government agencies to determine who is eligible for various policies and benefits related to vision loss. That is, if a person's visual acuity, or visual acuity, is equal to or lower than these levels, that person is considered "legally blind."

Think about it this way, some people can't see clearly even with glasses. In such cases, the government can measure how poor their vision is and provide some relief. This "legally blind" thing is like that.

What is the difference between total blindness and "legal blindness"?

When we say "blind," most people think of a state where they can't see anything, everything is pitch black. Doctors call this "No Light Perception" (NLP) . That means they can't see even a little bit of light. However, not everyone who is blind falls into this category. In fact, only 15% of people with eye disease are completely blind. The other 85% have some level of vision. That means they can sometimes read large print, recognize large objects, or distinguish light from darkness.

"Legally blind" means that a person has some level of vision, but it is not sufficient to receive relief from the law.

How is "legally blind" determined? (American example)

The way in which this "legally blind" is determined can vary slightly from country to country. Let's take a look at how it's done in the United States, for example. There, the Social Security Administration (SSA) is the government agency that sets the regulations. They use a definition that was introduced by the American Medical Association in 1934.

According to that definition, for someone to be "legally blind," at least one of the following must be true:

• Even if you wear glasses or contact lenses, your vision in your better eye should be 20/200 or worse. This refers to the vision in the center of your field of view. If one of your eyes is better than the other, the measurement is taken in the better eye.
• Your field of vision should not be wider than 20 degrees. This means that the range you can see should be very narrow. Again, if the field of vision in one eye is wider than the other eye, the measurement is taken from that better eye.

Important: This is a definition from the United States. There may be different definitions or methodologies in Sri Lanka or other countries. But the basic idea is very similar - that is, a significant degree of vision impairment.

What is 20/200 vision? Let's understand it simply

When we get our eyes checked, doctors give us two numbers, for example 20/20, 20/40, 20/200. What does this mean?

Generally, 20/20 vision is considered healthy, normal vision.

Now let's see what 20/200 means:

• The first number (20) is how far away you are looking at something (in feet).
• The second number (200) is how far away a person with normal vision can see the same object clearly.

Simply put, a person with 20/200 vision would need to move about 20 feet closer to see something that someone with normal 20/20 vision could see clearly from 200 feet away. Otherwise, the object would need to be ten times larger to be seen clearly at that distance.

Imagine, if you're walking down the street and a normal person can read a bus number from 200 feet away, you, who have 20/200 vision, have to wait until you're about 20 feet away from the bus to read it. Do you understand?

• If the second number is small (e.g. 20/15), it means your vision is better than average.
• If the second number is large (e.g. 20/200), it means your vision is weaker than average.

How do other countries in the world perceive this situation?

While the threshold for "legally blind" in the United States is 20/200, some countries use other terms or define even more severe levels of vision impairment.

For example, the United Kingdom (UK) uses the metric system. There, a vision of 6/60 (which is roughly equivalent to 20/200) is considered "sight impaired (partially sighted)" . They have a threshold of 6/150 (which is roughly equivalent to 20/500 in feet) and call it "severely sight impaired (blind) .

Also, many countries around the world rely on the World Health Organization's (WHO) International Classification of Diseases (ICD) for their legal definitions. The latest 11th edition of the ICD classifies vision impairments, which has three categories for "blindness."

The ICD classifies visual impairment and blindness according to the following criteria:

• Mild visual impairment: Vision in the best eye, with glasses, is less than 6/12 but equal to or better than 6/18.
• Moderate visual impairment: Vision in the best eye, with glasses, is less than 6/18 but equal to or better than 6/60.
• Severe visual impairment: Vision in the best eye, with glasses, is less than 6/60 but equal to or better than 3/60 (or no light vision). (This is often the equivalent of "legal blindness").
• Blindness: Vision in the best eye, with glasses, is less than 3/60, or the field of view is less than 10 degrees. (There are other subcategories within this too).

How common is "legal blindness"?

"Legally blind" is not a common condition. But experts expect the number of people with the condition to increase rapidly in the coming decades. A 2016 study estimated that just over one million people in the United States meet the 20/200 vision criterion. That same study also estimated that this number would double by 2050.

This may be due to eye diseases that occur with aging (e.g., cataracts, glaucoma, age-related macular degeneration) and increased damage to the eyes due to diseases such as diabetes.

How do I obtain a certificate for this "legal blindness"? (Normal process)

The process for obtaining a certificate for this type of situation can vary from country to country. In the United States, the Social Security Administration (SSA) is the main agency that sets the qualifications for this.

In general, here are some things that you may find important to know when it comes to obtaining a certificate like this:

• Agencies can request your medical records: Although you may need to provide evidence to prove that you are "legally blind," agencies can help you gather that evidence if necessary. They can request records from your ophthalmologist or other healthcare providers. But they need your permission to do so.
• Your doctor is the main source of information: but if you do not have one, or if your doctor is unable to meet the screening requirements for some other reason, the agency can arrange a consultative examination to determine whether you meet the criteria for "legal blindness."
• You may still qualify for the certificate even if your vision loss is not permanent: Even if your vision impairment is temporary or reversible, it may not be a barrier to receiving such benefits. It depends on the laws and policies of the country in question.

In Sri Lanka, you can get information about receiving relief and services for such situations from institutions such as the Department of Social Services . Also, your ophthalmologist will be able to provide guidance on this.

What benefits are available if you are "legally blind"?

Once you are certified as "legally blind," you may be eligible for various benefits and services in different countries. Let's look at some federal benefits available in the United States as an example:

• Monthly Social Security Disability Insurance (SSDI) payments.
• Monthly Supplemental Security Income (SSI) payments (these may vary from state to state).
• Insurance coverage through Medicare (even if you are not over 65).

These are just examples from the United States. There may be different types of assistance available in Sri Lanka or other countries. These may include financial assistance, educational assistance, special accommodations for employment opportunities, travel assistance, and assistive devices (e.g., white canes, special software).

If you would like to know more about this, you can ask your ophthalmologist, healthcare providers, or relevant government agencies (e.g., the Department of Social Services).

Most importantly: The message to take to heart

Finally, here's the thing. "Legally blind" is not a label that defines you. It's just an official status that helps you get benefits and services related to blindness. Government agencies use this term to define what specific criteria you need to meet to qualify for certain benefits and services.

If you or someone you know has vision impairment, don't panic. See an eye specialist for advice. They can tell you exactly what your condition is, what treatments are available, and how to apply for such benefits if needed. Remember, it's never too late to ask for help.

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