Gift Ideas for the Visually Impaired

The holiday season is upon us and there are only 19 days till you’re officially allowed to frantically unwrap all the goodies under the tree.

Upon discovering what this special occasion has given you, some will react with cries of joy while others may lower their faces with signs of anguish.

To avoid spreading disappointment in the festive season of giving, here is OXSIGHT’s list of best gifts for the visually impaired.

 

OXSIGHT glasses

oxsight users at afternoon tea

OXSIGHT PrismTM and CrystalTM are specially designed smart glasses for the visually impaired. With intuitive technology, users have reported being able to see their whole family at gatherings as well as be able to finally appreciate that gorgeous roast turkey at the centre of the table.

OXSIGHT glasses enable users to maintain eye contact with their loved ones with its clear design and avoid eye contact with no-so-loved ones with its attachable shade.

They also come with a variety of accessories allowing the users to customise them to fit their needs.

Also… the launch of a new product in 2020 will bring more Christmas cheer to those with central vision loss.

Pro tip: change modes to highlight objects of interest.

Perfect for: You?

 

Stand by Me RP by Dave Steele

The Blind Poet Dave Steele shares his life with retinitis pigmentosa through the medium of written poetry. Steele tackles issues connected to family, social life, perception from others, and tribulations that he has had to overcome.

The best part?

There are 3 books in the series, so this gift will work for both new and returning readers.

Pro tip: read your favourites aloud to turn your party into a sob fest.

Perfect for: literary buffs, the newly diagnosed, the alienated

 

Watches for the Blind

As a whole, the process of telling the time is almost entirely a visually based task. While it is possible to access services that provide a speaking clock, they are often impractical for general purpose use when speed and efficiency are required.

Watches designed for those with sight loss have come a long way and help improve the ease with which users can tell the time.

There are 2 main types of these watches.

Talking watches are exactly that. They look like regular watches but at the touch of a button, a voice will sound which announces the current time for the user.

Tactile watches, on the other hand, utilise the user’s sense of touch to convey the time. The simple ones look like regular watches, but have have tactile dots which indicate the hours and hands that are touchable. More complex watches use other methods. Eone Bradley watches have 2 ball bearings that move according to the hands of a clock, while the Dot Watch is a smartwatch and displays time (and other info) in braille.

The main downside to these types of watches is their size. Most will be noticeably thicker than regular watches and some may have a larger case diameter.

Pro tip: coordinate with your attire to be cat-walk ready.

Perfect for: techies, the tardy, the fashion-conscious

 

Board Games

Nothing brings the family closer together than a board game session.

Those with sight loss may find it hard to join in with some tabletop classics, but fortunately, accessible versions have been made to make family and friends fun inclusive to all.

Most of these games have had braille added to them, while others now have tactile markers to help players differentiate pieces.

Pro tip: better to have cheaters on your team than not.

Perfect for: those with friends and/or family, kids, the competitive

 

iPhone

Search “phones for the visually impaired” and you will be bombarded with a plethora of options claiming to make phone operation easier for those with sight loss. And while these options are great, not everyone is happy to trade in style, function, and inclusiveness for improved accessibility.

This is especially the case when modern smartphones do a great job at providing options for those with disabilities.

Perhaps the leader in this field is Apple’s iPhone.

Their Voiceover function can read text and image descriptions, Dark Mode will increase contrast, Magnifier will enlarge anything on screen, and these are just some of the features available for use.

Pro tip: “Hey Siri, call me Thanos from now on.”

Perfect for: all ages, Internet addicts, fans of Steve Jobs

 

Audiobook Subscription

man listening to audiobook on street

Book reading has undergone an evolution in recent years. No longer are bibliophiles limited to simply using their eyes to digest written language. They can now experience books in an auditory capacity.

Audiobooks exist mostly in digital form, so simply gifting one to friends or family may be regarded as miserly. Luckily, there are plenty of subscription options on offer.

The only drawback is that subscriptions mean that you will be financially on the hook for a certain amount of time.

Pro tip: obtain login details from the recipient to take advantage of the subscription yourself.

Perfect for: pseudo-intellectuals, book club patrons, lazy students

 

Treatment

surgeon with green bay packers hat

Treatment for someone with a visual impairment is a more situational gift. Not every condition has a corresponding cure.

Fortunately, medical science is progressing at a rapid pace so, even if there isn’t one now, there may be one in the future.

Laser eye surgery may help those with long- or short-sightedness. Patients can also sign up to take part in the latest clinical trials involving the use of gene therapy or stem cells. While these trials may be quite experimental and have no guarantee of success, they also offer the opportunity to be at the forefront of modern medicine and contribute to the eventual production of a cure.

Pro tip: expectation management is a must.

Perfect for: the impatient, gamblers, “I know a guy”

Primer on Nystagmus

Nystagmus (pronounced “ni-stag-muss”) is a condition where the eyes of an individual will undergo uncontrollable rapid movement

The movement can be side to side, up and down, circular, or any combination of the three. It can also occur in both eyes independent of each and can vary in speed. Due to the complexity and recalcitrant behavior, the vision that the patient may experience can be affected. Most will find that they have a reduction in sight.

There are two main types of nystagmus: congenital (or infantile) and acquired. 

Congenital nystagmus occurs in infants within the first few months of their birth. Rather than seeing things as “shaky”, most children will have their vision blurred. Causes may be due to problems in the development of the eyes of regions of the brain that affect the visual system. Some will also find that the condition is inherited from their parents or the byproduct of a different medical condition. There are also those with “idiopathic infantile nystagmus”, which is when the cause is unidentifiable. 

Acquired, on the other hand, is found later in life and can be caused by anything that affects the function of the eye. This can range from eye diseases to seemingly unconnected illnesses to lifestyle choices. Adults with acquired nystagmus will often describe their vision as “shaky”.

The main symptom associated with nystagmus is uncontrollable eye movement. In addition, this can lead to various other problems:

  • Long or shortsightedness 
  • Light sensitivity
  • Dizziness 
  • Headaches
  • Poor depth perception
  • Poor balance

Unfortunately, there is currently no cure for nystagmus. 

However, it is possible to reduce the effects associated. Glasses can be worn to help with reduced vision and larger text sizes can greatly aid children who are learning to read. 

Some people may also find that they have a “null zone”. This is a point at which the involuntary eye movement is reduced and could involve maintaining the head at a tilted position. 

Operations can help reduce the necessity for these awkward positions and studies have been done to test the possibility and efficacy of altering or enlarging a patient’s “null zone” through surgical intervention. There has also been research into the use of non-surgical intervention methods such as contact lenses and prisms. 

Primer on Cataracts

The lens in an eye function similarly to those in cameras. They help to focus the visual surrounding onto the retina to provide an undistorted picture. 

What this means is that in order for the lens to function at its maximum capacity, one vital condition is that the lens remains transparent. 

Cataracts is a condition where the cells and water content in the lens undergo changes. The individual’s lens may then begin to develop cloudy patches. Over time, these patches can increase in size and lead to vision becoming hazy, blurry, and lacking in colour. While the condition usually develops in both eyes, when and how will not necessarily be the same. Some may find that their vision drastically changes in a few months, while others may not experience any changes for years. 

According to an assessment from the World Health Organization (WHO), cataracts are responsible for 51% of world blindness. Although most cases are related to the general side-effects of ageing, it can be caused by injuries, other eye conditions, or a variety of lifestyle choices. It is also possible for children to be born with cataracts (often referred to as “congenital”, “infantile”, or “developmental” depending on how early they manifest). 

Fortunately, once cataracts have been confirmed, they can be removed at any stage. The surgery involves replacing the affected lens with an artificial lens implant. This is normally done under local anaesthetic and can be performed as a day procedure. It is not uncommon for a patient’s ophthalmologist to delay surgery if the cataracts have not progressed very far. This is done due to the slight risk associated with the procedure as well as the personal situation of the patient.  Under the NHS, operations are normally only suggested if the patient’s vision is outside the legal limit to drive. 

For example, if the patient has another existing eye condition, it is possible that cataract surgery may not be able to improve the individual’s sight. 

Additionally, cataracts surgery can only be performed in one eye at a time. This means that there may be a period of months between operations if both eyes need treatment. 

Post-surgery recovery is normal fairly straightforward. The dressing can normally be removed after a day and antibiotic drops are given to help stave off infection. Other short-term precautions including not rubbing the eyes, staying away from heavy activities, and not swimming.

Primer on Charles Bonnet Syndrome

Charles Bonnet (pronounced “bon-nay”) was a naturalist and philosopher born in Geneva in 1720. At around 40 years-old, he released a book called “Essai Analytique sur les Faculties de L’Ame” (Analytical Essays Concerning the Faculties of the Mind) in which he described how his 87 year-old grandfather, Charles Lullin, experienced visual hallucinations that occurred at spontaneous times. 

Fast forward to 1967, the term “Charles Bonnet Syndrome (CBS)” was introduced to the world by another Geneva native, George de Morsier.

CBS can be described as the presence of visual hallucinations among those with sight loss. These hallucinations are completely the product of visual impairments and are not signs of mental health deterioration. 

There are generally two main types of hallucinations experienced:

  • Simple patterns and shapes, like brickwork or mosaic
  • Complex images of people, landscapes, or objects

These will only affect a person’s sight. Smell, hearing, and touch will not be compromised. 

The reasons behind these hallucinations are not yet entirely clear. It is suggested that when sight loss occurs, the brain no longer receives as many signals from the eyes. It then attempts to make up for this lack of communication by creating its own. These end up translating into “phantom” images seen by the individual. 

CBS normally appears in the weeks and months following a big change in sight loss. Fortunately, for the majority of people, these hallucinations get less frequent with time, although reappearance of hallucinations five years after initially starting is a possibility. 

One of the most serious aspects of CBS is its unknown nature. Many people who begin experiencing hallucinations are often unaware of its true nature. This can cause fear for both the individual as well as their family and friends, due to visions being taken to be symptoms of mental health issues. 

Unfortunately, there is no direct way to diagnose the presence of CBS. Doctors will generally talk to the patient about their medical history and may carry out tests to rule out other causes for the visual hallucinations. 

Although no treatment is available, given enough time, CBS can improve over time. It has been found that often simply a better understanding of CBS can help patients cope better as they understand that it is purely a normal result of sight loss rather than anything to do with mental health. In some cases, medication for epilepsy, Parkinson’s Disease, and dementia have been able to help, but due to the possibility of severe side-effects, it is only recommended for those who are seriously affected and under supervision. 

There are, however, a few self-help methods that may relieve any hallucinations experienced:

  • Changing lighting conditions, i.e. making it brighter or dimmer
  • Scanning from left to right repeatedly without moving the head for 15 secs. This can be done 4 or 5 times if hallucination continues.
  • Staring at an image and blinking rapidly, or attempting to touch it. 
  • Performing a task that includes large movement, e.g. going to the kitchen to make coffee
  • Sleeping and resting well. Fatigue and stress may increase the likelihood of hallucinations.

Blind individuals experience new musical “& Juliet” with OXSIGHT glasses

Manchester, 9th September, 2019 — Registered blind individuals were given the opportunity to experience the new musical “& Juliet” in Manchester wearing new smart glasses that allowed them to see the entire performance.

Participants with ‘tunnel vision’ also known as ‘peripheral vision loss’ entered a competition to experience the show using new smart glasses technology which allowed them to see the entire musical “& Juliet” before its West End debut. In addition, a further 10 registered blind winners were given an exclusive touch tour which allowed them to feel the props, costumes and meet the cast – followed by the Opera house’s fantastic audio description accessibility option. 

Enjoying a behind the scenes experience on the touch tour

Enjoying a behind the scenes experience on the touch tour

Kevin Crompton, 48 from Manchester who has lost 95% of his vision and describes his remaining sight as “looking through pin hole”, commented on the performance “It was very emotional putting the glasses on for the first time in the theatre, usually I wouldn’t be able to see the stage, but I was able to follow the entire story and see the full stage and all of the characters. Sight loss doesn’t mean having to give up on life, it means doing life differently – this is exactly what OXSIGHT are doing for people”.   

OXSIGHT teamed up with Opera House Manchester and Henshaw’s to make theatre experiences more accessible for those living with a visual impairment and as part of the World Sight Day 2019 campaign, giving free tickets to new musical.

When we were asked to be involved our answer was a fervent yes. This is an opportunity where we can support developments in accessibility and change how people can experience live entertainment. Working with OXSIGHT means there’s a chance of breaking down barriers and we are committed to making theatre to be accessible to everyone”, said Manchester Opera House Director, Sheena Wrigley.

Winners settling in for a night at the theatre wearing OXSIGHT glasses

Winners settling in for a night at the theatre wearing OXSIGHT glasses

OXSIGHT users have experienced an increased field of view of up to 68 degrees. Many utilise the different modes on offer to enhance their remaining vision and experience sights they thought they had lost forever.

Kirsty Hill from Shrewsbury lost her peripheral vision following a stroke three years ago commented on her experience, “I can’t tell you how much the glasses mean to me, I never thought I would be able to enjoy anything like this properly again. The planning and care that went into looking after all of us and our dogs was so appreciated. The show was an opposite of sensory deprivation, still feel like my hair is standing on end!”  

There are more than two million people in the UK living with sight loss that noticeably affects their quality of life. In addition, it is estimated that 250 people start to lose their vision every day. 

Hayley Allen, OXSIGHT Customer Care Manager, said: “It’s great to be able to collaborate with Henshaw’s, who do such amazing and important work in supporting the visually impaired. And Opera House Manchester have been brilliant. They’re always working hard to ensure that the visually impaired community feel as welcome as possible.”

Guide dogs and their water bowls at Manchester Opera House

Guide dogs and their water bowls at Manchester Opera House

This theatre event marks the first of many partnerships that OXSIGHT and Henshaw’s will be seeking out in order to increase accessibility at cultural venues for the visually impaired community.

retinopathy of prematurity

Primer on Retinopathy of Prematurity

The World Health Organisation (WHO) estimates that over 15 million babies are born prematurely (generally agreed to be at less than 37 weeks) every year. This equates to 1.5 times the population of Belgium.

Premature babies are at an increased risk of complications due to the non-optimal gestation period afforded them. If blood vessels in the retina fail to develop fully, babies can be born with retinopathy of prematurity (ROP). 

The retina is responsible for taking light that enters the eye and converting it into signals for the brain to interpret. They are supplied with blood through an extensive network of blood vessels that start to develop 16 weeks into pregnancy. Normally, it takes the full term (40 weeks) for the blood vessels to fully develop.

If this process is interrupted, it can leave the retina short of the blood vessels it requires to function properly. In order to make up for this deficiency, it may stimulate new blood vessels to grow. However, these are often weak and can lead to scarring and damaging of the retina. Severe ROP can also lead to retinal detachment. 

In the UK, babies born under 32 weeks or at a weight of under 3lbs will be screened for potential ROP. Eye examinations will continue until the risk of needing treatment has passed. 

 

Retinopathy of prematurity can be described in 5 stages:

  • In stage 1, the new blood vessels have not started to grow and the mark between where blood vessels are present and not is flat. Usually recovery without treatment is possible at this stage. 
  • At stage 2, the mark between the two regions has become raised, but still no new blood vessels have begun to grow.  It is still possible to recover without treatment at this stage but regular checkups to monitor the condition are recommended. 
  • Stage 3 is normally characterised by the growth of new vessels. These vessels are weak and can lead to scarring which may cause sight problems. Treatment is normally required at this stage. 
  • The new vessels that grew have begun to shrink and cause scarring in stage 4. This may start to pull the retina away from the back of the eye. 
  • During stage 5 the retina has fully detached and this would lead to permanent sight loss. 

 

Treatment for retinopathy of prematurity most often involves the removal of the fragile new blood vessels that grow. This can be done with laser treatment, eye injections or cryotherapy. 

If retinal detachment has begun, the patient may require surgery to help hold the retina to the back of the eye. Unfortunately, this needs to be done early during stage 4. If the condition has progressed to stage 5, it is unlikely that useful vision can be salvaged. 

nutritional optic neuropathy

Primer on Nutritional Optic Neuropathy

A young boy, aged 17, made the news when he developed a form of blindness after years of malnourished dieting.

After examination, it was found that the teenager’s diet had given him nutritional optic neuropathy, a type of acquired optic neuropathy.

Optic neuropathy is when the optic nerve is damaged which can then lead to changes in the individual’s sight. This is due to damage done to the retinal ganglion cells and their axons which can cause modifications to the optic nerve head as well as the surrounding retinal nerve fibre layer.

Optic neuropathy can be caused by a variety of factors, including trauma, drugs, and genetics. Nutritional optic neuropathy occurs when the body is deficient in certain nutrients due to the individual’s diet.

Although those who develop this type of optic neuropathy solely due to nutritional malpractice are rare (they are more commonly found in regions where famine is prevalent), lacking certain nutrients is often a big factor in the progression of other forms of this condition.

Some of the main deficiencies responsible for nutritional optic neuropathy include:

  • Vitamin B-12 (cyanocobalamin)
  • Vitamin B-1 (thiamine)
  • Vitamins B-2 (riboflavin)
  • Folate

In the case of the teenager mentioned above, his diet consisted of chips, crisps, white bread, and sausages, which left his body in need of more vitamin B-12, among other nutrients.

In the early stages of nutritional optic neuropathy, visual acuity is normally the first to worsen. At this stage, if treated correctly, it is possible to reverse the detriment done and recover lost sight. If left untreated, patients can lose central vision as well as the ability to distinguish colours.

Damage can be permanent so it is important to seek clinical advice as soon as any change in sight is noticed so that treatment can start. An improvement in diet as well as vitamin supplements can help with staving off the later stages of the condition.

It must be noted that due to the rarity of primarily nutritional optic neuropathy in developed countries, the selectiveness of the diet could be a symptom of avoidant restrictive food intake disorder (ARFID), an eating disorder that is not due to body image issues.

eyes of a baby

Luxturna gene therapy for sight loss on the NHS

This week, the BBC reported that gene therapy may become available on the NHS for those with visual impairments. With a commercial price of £613,410 per person, the NHS have managed to come to an agreement with global drug company Novartis over treatment with voretigene neparvovec (commercially known as Luxturna) and it is expected that treatment will be available from January 2020.

Let’s go through the main points:

  • Eligibility for the treatment is very specific – Voretigene neparvovec is targeted at those with inherited retinal dystrophies due to a mutation in the RPE65 gene, which aids the production of proteins vital to normal vision. The National Institute for Health and Care Excellence (NICE) estimate that approximately 86 people in England will be eligible.
  • Voretigene neparvovec aims to stabilise vision and prevent further sight loss – Unfortunately the treatment does not aim to restore vision that has already been lost.
  • Location may be important – NICE lists NHS England as the only NHS consultee for the proposed treatment. Furthermore, in reports, quotes from the NHS have come from Simon Stevens, the CEO of NHS England. This could suggest that the treatment will only be available to those living in England and Wales (who are legally obliged to fund NICE guidance). Those with the condition in Scotland and Northern Ireland will have to wait on separate decisions to be made. Additionally, according to a statement by NHS England, the treatment will initially be rolled out in three national specialist centres across the UK. Making it available to other hospitals later is an option and not mandatory.
  • Injections in the eye – The treatment is administered by a one-time injection under the retina of each eye. Normally, one eye will be treated first, with the other treated after at least 6 days. The injections aim to introduce a healthy version of the RPE65 gene which can then help production of the protein needed for normal vision.
  • Long-term effects are unclear – Studies have shown shorter term benefits (3 to 4 years) but longer term effects are uncertain. However, clinical experts feel that there is a “biological rationale” for the effects of the treatment to remain.
  • There are side effects – As with most treatments, there are potential side effects and these can be found on Luxturna’s website. Some of the more serious ones include eye infections, permanent decline in visual acuity or sharpness of central vision, as well as further sight loss due to various potential changes to the eye.
  • Not set in stone – This treatment is still currently in progress with final evaluation determination expected to conclude by 20th September 2019. It is still a possibility (admittedly a minute one) that the availability of Luxturna could be delayed. However, the NICE guidance is expected to be published on the 9th October 2019, which then gives NHS England three months to make it available “as an option”.

Please see the NICE website for full details and status of the treatment.

Primer on Diabetic Retinopathy

If you pool everyone with diabetes together and form a nation, they would be the third most populous country in the world.

Those with diabetes will normally find that they have increased levels of glucose in their blood. This can lead to nerve and blood vessel damage as well as an increased risk of cancer due to DNA harm.

Although, not everyone with diabetes will experience sight loss, diabetics will have a higher risk of developing certain visual impairments, such as cataracts and glaucoma.

One of the more common ones is diabetic retinopathy.

This is when the increase in blood sugar levels affect blood vessels at the back of the eye. This interferes with how the retina work and can lead to retinal vessels leaking or bleeding.

 

There are 4 main stages of diabetic retinopathy:

1. Background Retinopathy

This is when capillaries in the retina weaken and develop small areas of swelling. This can lead to small amounts of bleeding as well as the leaking of a fluid called exudate. Although this will normally not affect vision, if it is left untreated the condition can become worse and cause the condition to the next stage.

 

2. Non-Proliferative Retinopathy

Here we see more drastic damage to the capillaries in the retina and usually occurs after years of high blood sugar levels. Bleeding and leaking is more prominent and blood vessels are weakened, potentially losing the ability to transport blood which can cause the retina to malform. Eventually, blood vessels may be completely blocked, which will prompt the body to release growth factors to encourage the formation of new vessels.

 

3. Proliferative Retinopathy 

By now, new blood vessels have been formed to help supply blood. However, they are weak and are prone to haemorrhaging and leaking. They can also grow on the retinal surface or inside the vitreous gel. When blood or fluid is leaked, this can damage the retina or block vision when inside the vitreous gel. Scarring can also occur and an increase in scar tissue can cause the retina to detach which may lead to serious sight loss.

 

4. Diabetic Maculopathy

The more common cause of serious sight loss, diabetic maculopathy can occur with or without proliferative retinopathy [Pipe, D.M. & Rapley, L.J. (2008). “Abnormal Ocular Conditions: A Handbook for Dispensing Opticians”]. It occurs when haemorrhaging or leaking involves the macular area of the eye and can cause central vision loss.

 

Symptoms of diabetic retinopathy may not occur at the beginning and can start to appear as the condition advances. Typical manifestations include:

  • Blurred vision
  • Dark spots or patches
  • Eye pain or redness
  • Reduction in night vision
  • Sudden sight loss

Treatment for diabetic retinopathy can depend on how far it has progressed. Laser surgery can be done on a localised area to help reduce swelling and seal up blood vessels. For larger affected areas, pan-retinal laser surgery can be used to shrink abnormal blood vessels and inhibit the release of growth factors. Vitrectomies are used to treat severe bleeding into the vitreous gel. Vitreous is removed and replaced with a clear salt solution to maintain the pressure in the eye.

However, these treatment methods are more aimed at preserving sight rather than restoring. As with many diseases, prevention is just as (if not more) important as treatment. Maintaining a manageable blood sugar level is key and this includes exercise, diet, and generally living a healthy lifestyle.

Primer on Mobility Canes

Mobility canes. Some call them “white canes”. Others prefer the phrase “symbol cane”. Then there are those who use the word “stick” instead.

Whatever the nomenclature, mobility canes are a recognisable representation of sight impairment.

However, due to the various sizes and design they can come in, people may be confused as to what the differences are and if they are meant to convey different meanings.

Fortunately for you, OXSIGHT have a handy little primer to guide you through the varieties and what they represent.

 

Size Matters

The Symbol Cane – These canes are the shortest of all canes and are not meant for physical support. They are carried around to notify others that the individual may have a visual impairment. Often made out of lightweight aluminium, symbol canes are often collapsable into three or four segments so they can be folded up and stored conveniently away.

The Guide Cane – The next size up from symbol canes are guide canes. These are normally held diagonally in front of you body and used for basic protection, like detecting obstacles such as steps or kerbs. Like symbol canes, they are normally collapsable for easy storage. They may require training to use competently.

The Long Cane – The largest size of cane is the long cane. These extend out and are used by those with limited or no vision to feel the layout of the environment. Again they are collapsable, however they are normally made-to-measure to ensure maximum functionality for each individual. Training is required in order to safely operate long canes.

The Support Cane – Shorter and thicker than long canes, the support cane is used as an aid by providing physical support. They may have a handle on one end and are strong enough to support body weight which means that they are often heavier than the other types of canes. The end of a support cane will generally grip the floor to ensure that it does not slip when in use.

 

Just The Tip

Due to their functional nature, tips on the ends of guide, long, and support canes can be customised based on preferences and intended use.

Some tips may hold an advantage indoors, while others may be more suited to rugged terrain. They come in different shapes and sizes, and more may be introduced in the future as cane technology is further optimised.

Here are some of the more common ones:

Pencil Tip – A thin, straight piece of plastic which slightly extends the length of the cane, pencil tips are used in conjunction with the two-point touch technique. They are extremely lightweight so will not stress the wrist as much. However, due to their size, they are prone to being snagged in cracks and other hazards so are not as suitable for rough terrain.

Marshmallow Tip – Imagine a marshmallow on the end of a stick and that’s what you have. Their larger size provides a greater surface area of contact between the tip and the surroundings. This provides more feedback for the user. They will be slightly heavier due to the increase in bulk.

Ball Tip – One more size up is the ball tip. They are great for beginners and are suited to heavy or extended use as they wear down slower. Constant contact techniques are preferred over two-point touch when using ball tips due to their weight potentially straining the wrist. Their size means users will get alot of feedback and they are very suitable for rough terrain.

Roller Tip – These tips can come in different shapes, such as marshmallow, ball, or disk. They are capable of rolling and so making constant contact techniques easier to do as well as minimise the amount of wear the tip takes. They are good for urban environments but may struggle in more unconventional settings.

Flex Tip – Shaped like a bell, the flex tip does exactly that. When sweeping from side to side, the bell end will bounce over uneven surfaces, making it less prone to snagging. It is specifically designed for rough outdoors use.

Rover Free Wheeling Tip – Perhaps the most heavy duty tip, the rover free wheeling tip is a soft rubberised wheel attached to the end of the cane. It is designed to be rolled forwards and backwards and help navigation over really rough terrain.

Bundu Basher Tip – This tip looks like the end of thin hockey stick and was initially designed to aid navigation through the bush in South Africa. It curves up at the end to prevent it from snagging on rough terrain.

 

Once You Go White…

White – The most traditional and widely used colour for mobility canes. Instantly recognisable as an indicator of visual impairment.

Red Stripes – Often seen on top of white coloured canes, these red stripes indicate that the user also has a hearing impairment in addition to their sight loss.

Any other colour – Although non-traditional, it is possible to purchase canes in other colours. While they will not have the immediate effect of informing others of a visual impairment, they enable the user to display their own personality.

Glow in the dark – Mainly for navigation at night, these canes will not only help the user but also those around them as they can indicate where the user is. Usually, these canes do not require batteries as they will charge up in direct sunlight during the day.