IF BLINDNESS COMES Large Type Edition Kenneth Jernigan Editor published by NATIONAL FEDERATION OF THE BLIND Copyright 1994 by the National Federation of the Blind All Rights Reserved. Printed in the United States of America Table of Contents Questions and Answers p.1 Who Is Blind? p.73 BrailleþWhat is It? What Does It Mean to the Blind? p.83 Independent Travel p.93 Cooking Techniques p.105 Sewing Techniques p.137 Marking Dials and Tactile Labeling p.143 Shopping Ideas p.149 Older Blind and Visually Impaired Persons p.153 Common Eye Conditions and Causes of Blindness in the United States p.173 Who are the Blind Who Lead the Blind p.213 This Book is for You If you are blind or have a family member or friend who is blind, this book is for you. If you are losing your sight or know someone who is, this book is for you. If you are a teacher, a social worker, a counselor, a librarian, or a minister, this book is for you. It is meant to provide information about where to get things and how to learn new techniques. Even more important, it is meant to instill confidence and allay fear. Contrary to popular belief, the real problem of blindness is not the loss of eyesight but the misunderstanding and misconceptions which exist. It is no longer theory but fact that with reasonable training and opportunity the average blind person can compete on terms of equality with the average sighted person similarly situated. This book is a manual and a þhow toþ guideþnot only for the blind but also for those losing sight and for the members of their families. It is meant for senior citizens, for young adults, and for those in between. It is also meant for parents of blind children and for professionals in the field. It proclaims that loss of sight need not be a tragedy but that it can beþand probably will unless correct information is available. The simple statement that it is respectable to be blind is our thesis, and that thesis (though undramatic) is revolutionary. It points the way to new hope and unexpected opportunity for those who are blind or are losing their sight. So read on, and contact us if you need our help. Why Large Type? The type size used in this book is 14 Point for two important reasons: One, because typesetting of 14 Point or larger complies with federal standards for the printing of materials for visually impaired readers, and we wanted to show you what type size is helpful for people with limited sight. The second reason is that many of our friends and supporters have asked us to print our paperback books in 14þpoint type so they too can easily read them. Many people with limited sight do not use Braille. We hope that by printing this book in a larger type than customary, many more people will be able to benefit from it. Contact Us! Throughout this book we invite you to contact us for information. To do so write to: National Federation of the Blind 1800 Johnson Street Baltimore, Maryland 21230 What is the National Federation of the Blind? The National Federation of the Blind is the largest organization of the blind in America. Interested sighted persons also join. Founded in 1940, the Federation has grown to include more than fifty thousand of the nation's blind. The Federation is organized in every state and has local chapters in almost every community of any size in the nation. Where there is no local chapter there are members-at-large. Each year the National Convention of the Federation is attended by approximately 2,500 blind personsþthe largest gathering of blind people in the history of the world and growing each year. The Federation is a vehicle for joint action by the blind and parents of blind children. In other words, the National Federation of the Blind is the voice of the blind. It is the blind speaking for themselves. How do you help people who are becoming blind? The newly blinded person faces a difficult adjustment. One of the best medicines is to meet other blind people and learn of their jobs and the techniques they use in doing things without sight. Membership in the National Federation of the Blind provides this common meeting ground and, even more important, a sense of participation and restoration of confidence. Members of the NFB contact newly blinded persons to help them with problems of adjustment and orientation. Information is also given concerning available services from governmental and private agencies, as well as facts about laws and regulations concerning the blind. What is the National Center for the Blind? The National Center for the Blind (NCB), located at 1800 Johnson Street, Baltimore, Maryland, was established in 1978 and has come to be the focal point of a great deal of the work being done to assist blind people throughout the country and the world. As can be seen from the picture on the front of this book, the Center is housed in a renovated, turn-of-the-century manufacturing facility, giving it ample space for handling the many activities relating to blindness which occur there. The headquarters of the National Federation of the Blind is located at the National Center for the Blind, as is the International Braille and Technology Center for the Blind and Job Opportunities for the Blind. Other organizations located at the NCB include the American Action Fund for Blind Children and Adults and the National Organization of Parents of Blind Children. It is convenient and efficient to have major programs assisting the blind located in the same physical facility. The concept is much the same as is found in many medical centers, where medical specialists, medical testing laboratories, and pharmacies are housed together in one facility for the mutual benefit of all concerned. What is the American Action Fund for Blind Children and Adults? The American Action Fund for Blind Children and Adults is a service agency which specializes in providing help to blind people which is not readily available to them from government programs or other existing service systems. The services of the American Action Fund for Blind Children and Adults are provided free and are available especially to blind children, the elderly blind, and the deaf-blind. The Action Fund maintains a free lending library of Braille and Twin Vision books for blind children. It publishes and distributes to deaf-blind persons a free, weekly newspaper in Braille. The Action Fund also distributes free Braille calendars to blind and deaf-blind people throughout the country, gives scholarships and other needed assistance, and provides information to senior citizens to help them deal with vision loss in their later years. What is the International Braille and Technology Center for the Blind (IBTC)? The International Braille and Technology Center for the Blind was opened on November 16, 1990, the fiftieth birthday of the National Federation of the Blind. The IBTC is the only facility of its kind in the world. It houses at least one each of every type of Braille-producing, computer-driven Braille printer currently on the market, as well as computers with refreshable Braille displays, raised-line drawing equipment of various sorts, optical character recognition equipment used to transform printed characters into electronically produced speech or Braille, and a growing array of voice output computer screen reading systems. The International Braille and Technology Center for the Blind provides a central location where individualsþblind or sighted, employers or potential employeesþcan come to experience first hand the various types of Braille and speech synthesis equipment available. Blind job seekers, blind employees, potential and actual employers of blind individuals, and the general public are welcome to come to the IBTC to tour, observe, and test the equipment. The capabilitiesþadvantages as well as disadvantagesþof each device can be evaluated in a setting that is completely independent of manufacturers and salespeople. The Center can be used as a tool to enable blind job seekers to become trained in the technology necessary to obtain gainful employment or to enable blind employees to sample and select equipment which would enable them to compete and advance in their current jobs. The Technology Center also provides an opportunity for employers to view and test the various types of equipment available. What are the mail campaigns of the National Federation of the Blind, and why are they conducted? The mail campaigns of the National Federation of the Blind help finance the organization, but their basic purpose is to inform the general public about blindness and to let those who need our services know how to find us. Through our mailings the name, address, and service messages of the National Federation of the Blind appear on millions of objects: calendars, pencils, packages of seeds, magnifying glasses, and especially our Kernel Books. We are striving for the day when the name, address, and service messages of the National Federation of the Blind will be on enough items in the home of every American that anybody who needs our help will know how to reach us and that correct information about blindness will have completely replaced outworn notions. You can help us achieve this goal by carefully reading all of our material that reaches you and by passing it on to others. We answer thousands of inquiries each year and to the extent of our resources will respond to every question we get. Much of our public education program is carried out through our mail campaigns. What are the Kernel Books? Each Kernel Book is a paperback volume of true stories told by blind persons about how they have dealt with problems and achieved goals. One or two new Kernel Books are issued each year as part of the ongoing series. They are readable and interesting, giving the general public an opportunity to know what blindness is really like and how the people who live it on a daily basis feel. The message of the Kernel Books is that it is respectable to be blind, that (with opportunity and appropriate training) blind people can have as much fun and lead as full lives as others, and that the blind are capable of full participation in society. Let us know if you would like to have any of the Kernel Books. We would be happy to send them without charge. Some of the books in the series are: What Color Is the Sun, The Freedom Bell, As the Twig Is Bent, Making Hay, and The Journey. Why are your contribution envelopes addressed in care of ADM Security Services in Baltimore, Maryland? Mail containing donations to us addressed to ADM Security Services is opened and processed for us by an accounting service under very tightly supervised conditions. Deposits are then made directly into our bank account. We believe that this system offers the best possible security for your gifts since many of the donations we receive come in small amounts and in cash. Do you comply with the standards of the Better Business Bureau? Yes. We submit detailed financial and program information to the Philanthropic Advisory Service of the National Council of Better Business Bureaus on an annual basis. We have been continuously listed as complying with all standards for charitable solicitations in the Better Business Bureau's publication Give But Give Wisely for many years. Local Better Business Bureaus can obtain any information they wish from their national office. For this reason we do not go to the expense of filling out the individual forms of the hundreds of local Better Business Bureau offices throughout the country. How is the National Federation of the Blind funded? The National Federation of the Blind is funded primarily in two ways. Our blind members themselves (even though many are unemployed and exist on very small incomes) give what they can to support their own organization. Many give on a regular monthly basis at substantial personal sacrifice. Although these contributions from blind people come to a considerable amount, we could not begin to do the work we do without the generous support of the thousands who contribute through our mail campaignsþagain, frequently at personal sacrifice. In short, our funding comes largely from individuals, who believe in what we are doing and are willing to help us do it. How much do you spend on fundraising expenses? The actual amount varies some from year to year, but over the last several years our fundraising costs as a percentage of public support have not exceeded ten percent. Are contributions to the National Federation of the Blind taxþdeductible? Yes. The National Federation of the Blind holds 50l(c)(3) taxþexempt status with the Internal Revenue Service. Can I make a gift to the National Federation of the Blind in my will? You certainly can, and we hope you do! As a matter of fact many individuals who have come to know us through our mail campaigns have done so. All you have to do is to place the following language in your will: "I give, devise, and bequeath unto National Federation of the Blind, 1800 Johnson Street, Baltimore, Maryland 21230, a District of Columbia nonprofit corporation, the sum of $_________ (or "_____ percent of my net estate" or "The following stocks and bonds: ______") to be used for its worthy purposes on behalf of blind persons." If you care to let us know that you have made a gift to us in your will, it is helpful. What can volunteers do to help the blind? If you would like to provide direct volunteer assistance to blind individuals, please contact us for information about locating blind people in your area. People who can provide transportation, help with shopping, or do reading are especially needed. It is also important to help in the effort to change public attitudes about blindness and make information available. By reading the materials we distribute in our mail campaigns you inform yourself and can share what you learn with others. Many blind people do not know what services exist to help them. You can make this information available by distributing our materials to schools, church groups, libraries, nursing homes, senior citizens' centers, retirement villages, doctors' offices, low vision clinics, and other community organizations. These are just a few ideas for very much needed volunteer assistance. However, you may have skills or talents that you want to use in a particular way. If another project is better suited to your talents and the time you have available, please let us know. Can you give me help relating to my specific eye problem? We are not medical experts. We can help you with problems you have because you cannot see well, and we can provide general information about eye diseases and causes of blindness. For specific medical problems relating to your eyes, you should see an eye doctor or other medical professional. Do you conduct medical research relating to eye diseases? If so, do you use animals in your research? The answer to both questions is no. The last section in this book gives information about common eye conditions and causes of blindness in the United States. If you need more specific information we suggest that you contact a medical facility specializing in eye diseases. One such facility with an outstanding reputation is the Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Room B-20, Baltimore, Maryland 21205, (410) 955-9653. What are your þState Resource Lists?þ We have prepared a fact sheet giving specific information (including addresses and telephone numbers) for services available in each state. A local contact person for the National Federation of the Blind is always given. We hope you will get in touch with our local leaders for further help. What financial help can a blind person receive? There are two main sources of cash financial assistance for blind people. They are regular Social Security benefits, also called OASDI payments, and Supplemental Security Income (SSI). Both programs are administered by the federal government through its system of local Social Security offices. To be eligible for regular Social Security benefits a blind individual has to have had some employment. To be eligible for SSI payments an individual does not need ever to have had any employment but must have limited income and savings. The rules which apply to blind people are often different from the rules for sighted people. The amount of the monthly cash payment is determined individually, and annual increases occur each January. You may qualify for one or both of these programs. In any case the monthly amount will not be lower than approximately $450 for an individual or $670 for a couple. To apply for either program contact your local Social Security office. We also encourage you to contact us at the National Federation of the Blind if you have any problem understanding the regulations relating to blindness, feel you have been unjustly denied benefits, or have other problems about which we may be able to provide information and guidance. Are blind people eligible for medical assistance? Yes. A blind person who is under age 65 and who receives Social Security disability benefits is covered under Medicare after a twoþyear waiting period. There is no waiting period for Medicare benefits after age 65. A blind person who receives Supplemental Security Income payments is eligible for state administered Medicaid assistance without any waiting period. If an individual receives only a very small Social Security disability payment, he or she may also receive Supplemental Security Income payments. In this case the individual would also be eligible for Medicaid benefits immediately. We can provide further information upon request. What library services are available to people who are blind or who have poor eyesight? Every state has free library reading materials for blind individuals provided through the National Library Service for the Blind and Physically Handicapped of the Library of Congress. Books and magazines are available on loan and free of charge in Braille and on cassette and records (called talking books). Special cassette machines and record players for use in listening to recorded reading matter are also loaned without cost to blind and visually impaired library users. For details about where and how to apply for services you may contact us or your local public library or call the toll-free library service telephone number: (800) 424-9100. Who is eligible to get books and magazines through the program of the National Library Service for the Blind and Physically Handicapped of the Library of Congress? If you cannot read ordinary print because of poor eyesight or because of a physical handicap such as being unable to turn a page, you are eligible to get Braille or recorded books through this service. It is not necessary for you to be totally blind or classified as legally blind. However, it is necessary for someone recognized by the library system as competent to do so to certify that you are eligible for the service. An officer or local leader of the National Federation of the Blind can help you with certification for library services. Where can I get books, magazines, or newspapers in large print? A number of libraries for the blind distribute large print books. Those libraries which do not handle large print directly usually can refer you to local sources of large print material. Most regular public libraries have a small collection of large print books. They can order other titles for you by borrowing them from other public libraries. The New York Times publishes a large print weekly summary of its columns and features. You can order it by contacting the New York Times directly at P. O. Box 5792, New York, New York 10087-5792, telephone (800) 631-2580. Reader's Digest Large Type Edition is available by contacting P. O. Box 241, Mount Morris, Illinois 61054, telephone (800) 877-5293. There is also a weekly large type news magazine entitled The World At Large. Contact The World At Large, P.O. Box 190330, Brooklyn, New York 11219, telephone (800) 285-2743. If you want to buy books, check with your local bookstore. Most of the bookstores carry a few large print titles. They also have catalogs from publishers and can order books especially for you. You may also want to request the free catalog available from The Large Print Book Club, G. K. Hall & Company, 70 Lincoln Street, Boston, Massachusetts 02111. For a comprehensive list of materials which are available in large print, contact the National Library Service for the Blind and Physically Handicapped of the Library of Congress for their reference circular entitled þReading Materials in Large Print.þ This circular is available free of charge from the National Library Service for the Blind and Physically Handicapped, Library of Congress; 1291 Taylor Street, N.W.; Washington, D.C. 20542; telephone (202) 707-5100 or (800) 424-9100. Where can I get a Bible in Braille, large print, or in recorded form? There are many sources. Here are some of them: American Bible Society 1865 Broadway New York, New York 10023 Phone: (212) 581-7400 Christian Fellowship for the Blind International, Inc. Post Office Box 26 South Pasadena, California 91030 Phone: (818) 799-3935 (These Bibles are free of charge to blind and visually impaired persons.) National Library Service for the Blind and Physically Handicapped of the Library of Congress 1291 Taylor Street, N.W. Washington, D.C. 20542 Phone: (202) 707-5100 (Will provide you with information on Bibles and other religious material available in Braille, large print, or on cassette.) Can books for the blind and other specialized items for the blind be mailed without paying postage? Recorded, Braille, and large print reading matter (including library books and magazines) may be mailed to and from blind persons free of charge if the words "Free Matter for the Blind" are written or stamped on the envelope or package. Braille watches, white canes, and other special appliances for the blind are included in this privilege. We will be happy to answer questions about the Free Reading Matter mail privilege. Where can I get a good magnifier? You may want to contact a low-vision center in your own community. When you visit them, you can try magnifiers until you find the one that works best for you. Donegan Optical Company, Inc., 15549 West 108th Street, Post Office Box 14308, Lenexa, Kansas 66215, (913) 492-2500 manufactures a large selection of magnifying equipment. Donegan does not sell directly to individuals but will be glad to refer you to a distributor in your area. Can an older person who is losing sight continue to live independently? Yes, usually. There is no reason why an older person who is losing sight cannot learn the techniques to live independentlyþmanaging a home, doing cooking, and handling the activities of daily living. It is a matter of self-confidence and having some help in acquiring skills. Many of the things we think require sight really don't. They can be done visually, but they can usually be done in other ways as well. In every state there are governmental agencies that have responsibility for assisting older persons who are losing eyesight in acquiring needed skills, but the quality of the services varies widely. Some state programs are excellent, and others are virtually useless. We can provide a resource list and the names of contacts. Are there special nursing or retirement homes for elderly blind people? Almost none. In the early part of this century, homes for the blind were quite common, but very few of them are left. Any good nursing home or retirement center can accommodate blind people adequately. For more details on this issue read the section þOlder Blind and Visually Impaired Personsþ in this book. What are some common devices and pieces of equipment that people with limited eyesight find helpful? Some useful items are: needle threaders and self-threading needles; talking alarm clocks and watches; Braille alarm clocks and watches; white canes; large print and Braille playing cards and other games; talking calculators; talking clinical thermometers; print writing aids such as signature guides; check writing guides and grooved writing boards; and Braille writing equipment and supplies. These items, as well as a great many more, can be obtained from the National Federation of the Blind. Can I continue to play cards now that I am losing my sight? Yes. There are decks of cards with greatly enlarged numbers. If you can't see well enough to use these, or even if you can, it will be quite easy to learn enough Braille to read the cards by touch. Only a few symbols have to be memorized, and with a little practice you should find it easy and fun. A deck of Braille cards is simply an ordinary deck of cards with Braille markings added. You will be able to play cards with the same people you have always played with. You can get cards by contacting us. Are there other games that have been adapted for people who are blind or have limited sight? Yes. Checkers, chess, scrabble, and others. Regular dominoes can ordinarily be played by touch instead of sight by most persons. How does a blind person identify money? Coins can be identified by touch. There are only two times when you need to identify billsþwhen you are receiving them, and when you are spending them. When you are getting money changed or otherwise receiving bills, there is ordinarily no trouble in getting somebody to tell you what they are. Fold them differently, or put them in different pockets. If you have done this, there will be no problem in knowing what bills you are spending. Some blind persons keep oneþ dollar bills loose in a pocket and fold fives, tens, twenties, etc. differently and place them in a wallet. The important thing to keep in mind is that handling money is no real problem. For blind persons who operate businesses and receive large amounts of cash on a regular basis from strangers, there is a talking paper money identifier. However, this device costs several hundred dollars and is not regarded as necessary by most blind or visually impaired persons in their daily lives. How can I read the markings on stoves and other appliances? There are many ways to do it. Some blind persons cut notches that they can feel. Some use tape. Some use a glob of glue or other plastic substance. We make available a plastic marking substance called Hi-Marks. It doesn't matter how you do it. The important thing is to know that you can, and then use ingenuity. What measuring devices do blind people use? Braille rulers and adapted tape measures are used for ordinary measuring. When greater precision is required, a tool called a Rotomatic permits measurements to be made to an accuracy greater than one sixty-fourth of an inch. If even more precision is needed, a Braille micrometer can be used to obtain measurements accurate to oneþthousandth of an inch. Where can blind people get specialized training? There are a number of regional training centers affiliated with the National Federation of the Blind which provide excellent help. There are also some state government-operated centers and private centers. Ask for our state resource list to obtain information about our regional training center serving your state and about your state government services. Are there government programs to help the blind in my state? The government of every state operates a program of training and job placement for blind and visually impaired persons. These programs are largely funded under the federal rehabilitation act. They are administered and staffed by the state but governed by federal regulations and guidelines. These rehabilitation programs vary greatly in quality from state to state. Generally the better ones are those administered by separate agencies for the blind as opposed to those that try to lump the blind in with all other disability groups. Even the best of the government programs fall far short of being able to provide all of the assistance that is needed. Through these programs blind persons who want to find or prepare for employment may be able to get financial assistance to attend college or vocational training courses and may be able to get help in going into business or finding a job. What jobs can blind people do? Contrary to general belief, there really are very few jobs which blindness itself rules out. There are blind persons working as electricians, auto mechanics, attorneys, carpenters, dishwashers, secretaries, office and corporate managers, teachers and professors, real estate agents, plumbers, computer and technology specialists, actors, and broadcasters and producers, and in thousands of other jobs. Even though this is true, most (about 70%) of blind persons of employable age are either unemployed or severely underemployed. This is so for two main reasons. First, most blind people have not received the kind of training in specialized skills (especially Braille and mobility) which is necessary for a blind person to be a competent employee. Second, and equally important, blind people themselves, employers, and members of the general public do not believe that a blind employee can do work as productively as a sighted person can. The employment situation for blind people will only improve to the extent that good training is received and beliefs and attitudes are changed. This, of course, is what the National Federation of the Blind is working to accomplish. Can blind people use computers? Yes. Blind people use computers that have been adapted so that the material shown on the screen can be converted to speech. Such computers are referred to as "talking computers." Material which can be printed from a computer in inkprint can also be obtained from the computer in Braille format. Can I make a computer I already have into a "talking computer?" Yes. You will need two things. The first is a speech synthesizer. This is the hardware or device that actually produces the sounds you hear. The second is software called a screen review program or "screen reader" program. This is software that runs on a computer that gives a blind person the tools to use off-the-shelf computer programs. It allows you to get the system to repeat the information on the screen, read by character, line, sentence, paragraph, screen, page, etc. It also is how you control the speech, speed, tone, pitch, volume, and silence. Without such software a computer would be impossible to use. Speech synthesizers come in both internal and external models. The internal kind is an "expansion card" that goes inside of your computer. The external type is a box that hooks to a serial or parallel output port on your computer. The internal variety is generally more responsive and less expensive but takes up an expansion slot in your computer and is more difficult to move and install. The external variety is generally more expensive but is easy to move from computer to computer. Screen review software costs from $75 to $750. Speech synthesizers cost from $100 to $1500. In general, the more expensive models of the synthesizers have more human-like speech. There are over a dozen each of programs and synthesizers on the market. You are welcome to visit the International Braille and Technology Center for the Blind to try out for yourself the various equipment which exists. Do you have a list of specialized computer-related equipment for the blind? Yes. Ask for our "Computer Resource List." It lists most such equipment on the market today and gives a brief description; cost; and the name, address, and telephone number of the distributor. The list is free and is available in large print. What is Job Opportunities for the Blind? Job Opportunities for the Blind (JOB) is a joint project of the U.S. Department of Labor in partnership with the National Federation of the Blind. JOB offers free services to U.S. residents who are blind and looking for work in the United States. Services include a nationwide reference and job referral service, a job hunter's magazine on cassette (the JOB Recorded Bulletin), recorded job information literature, print materials for employer education, local and national career-planning seminars, consultation on low vision aids and appliances, and introductions to blind peers employed in the jobs of interest to the job seeker. For a sample JOB packet, call (800) 638-7518. JOB offers additional free services and assistance to high schools with programs on transition to the world of work, to counselors of legally blind clients, and to other persons assisting a blind applicant. JOB's volunteers are available in every state. JOB offers employers free, nationwide job listings to locate competent workers who are blind, free consultation on cost-effective solutions for reasonable accommodation needs, and free educational seminars on hiring blind employees. Most employers do not want to be unfair to blind applicants or blind employees. Yet, many are over and over again without knowing it. Generally, employers do not treat the blind unfairly from a malicious will to cause trouble or keep blind persons down and out. They do it because they believe blindness is a tragic condition for anyone. They think blindness takes away most of a person's ability to do most of the things that are needed for most jobs. Although it is not true, employers and others often think blindness causes general incompetence. The average sighted person with little experience regarding blindness tends to think: þIf I were blind, I would not be able to drive a car or read books, magazines or newspapers. If I were blind, I would be afraid to walk around, especially in areas with which I was not familiar. If I were blind, I would not be able to recognize people and things visually. [And this reasoning continues] If I were blind, I would not be able to function the way I do. If I could not do my job the way I do without sight, then a blind person could not do it.þ With a little imagination one can apply this type of reasoning to almost any jobþprobably every job that exists. If this reasoning were sound, then blind people could not be competitive and should not try to compete for jobs. BUT IT IS NOT SOUND. Blind people can compete in a wide variety of jobs in virtually every type of business. The experience of blind persons is that, with proper training and opportunity, the average blind person can do the average job in the average place of businessþand do it as well as his or her sighted colleagues. Techniques and instruments have been developed that make it possible for blind individuals to do most activities for which sight is ordinarily considered necessary. This is not a matter of theory or speculation. The evidence is abundant and continues to accumulate at a rapid rate. Since World War II, employment opportunities for the blind and other opportunities for the blind have been improving. This change has been slow and gradual. For example, in the early 1950's the few blind persons who were even permitted to take and pass examinations for employment with the federal government were likely to have their names removed from the hiring lists because of blindness. Blind persons objected to this kind of treatment, and by the end of that decade, the policy had been changed. It was possible for blind persons to take some tests to qualify for employment with the federal government, and a fewþbut a very fewþwere beginning to be hired. For decades an ongoing effort has been made to develop more and better employment opportunities for the blind. Still, for the blind, work opportunities are limited. Often individuals responsible for hiring do not believe most blind persons can handle a given position, even though some blind persons are already doing it. Often promotions for blind persons do not come when they are deserved and when sighted colleagues in comparable situations receive them. Often supervisors do not give challenging assignments to blind employees. In other words, although progress for blind persons working over the past decades has been substantial, there is a long way to go. This is true of employment with the federal government, with state and local governments, and in private business. Blind people are working as farmers, lawyers, doctors, teachers, assembly workers, secretaries, and janitors. Blind people are social workers, engineers, librarians, printers, salespeople, machinists, dishwashers, managers, and writers. Blind people are a cross section of society; and, as such, they are doing the whole range of jobs. But, for every blind person who is competitively employed, there are nearly three who are equally well-qualified and eager to work but have not yet found an opportunity. Today it is often possible for blind persons to get the training and education they need to become competitive. It is often not yet possible for a blind person to get the opportunity to work in competitive employment. This is why JOB exists: to improve Job Opportunities for the Blind. Where can parents of blind children get help? The best source for such help is the National Organization of Parents of Blind Children. This organization, headquartered at the National Center for the Blind, 1800 Johnson Street, Baltimore, Maryland 21230 is a national organization of parents and friends of blind children reaching out to each other to give vital support, encouragement, and information. Parents, relatives, educators, blind adults, and anyone interested in promoting opportunities for blind children may join. Local parent support groups are also welcome to affiliate. The goals of the organization are: 1. To create a climate of opportunity for blind children in home and society. 2. To provide information and support to parents of blind children. 3. To facilitate the sharing of experience and concerns among parents of blind children. 4. To develop and expand resources available to parents and their blind children. 5. To help parents of blind children gain understanding and perspective through partnership and contact with blind adults. 6. To achieve for the blind security, equality, and opportunity. In order to accomplish these goals, the National Organization of Parents of Blind Children sponsors national, state, and local workshops for parents; distributes free literature about blindness; co-sponsors (with the National Association to Promote the Use of Braille) a national Braille reading contest; coordinates a number of networking services, including one for parents of blind multiply handicapped children; and provides information, advice, support, and independent evaluations for parents seeking the best services for their children. Why don't more blind people (especially those who have been blind from childhood) read Braille? Unfortunately a great many blind people (including most blind children in school today) have not been taught Braille. Many excuses are offered for this shameful neglect of the basic educational needs of the blind, but we believe that the real reason is that most teachers of blind children do not know Braille at all or do not know it well enough to teach it. In fact, the official statistics paint a grim picture. The number of blind children who can read Braille is declining. In 1968 forty percent of the blind students registered with the American Printing House for the Blind enrolled in elementary and secondary schools read Braille. In 1993 fewer than nine percent of the registered blind students could read Braille. This is a disgraceful situation, and we are doing all that we can do to change it. What are you doing to try to improve Braille instruction for blind children? We are working to require that all teachers who teach blind children must pass a Braille competency test developed and administered by the National Library Service for the Blind and Physically Handicapped of the Library of Congress. Is there a library where children's story books in Braille can be borrowed? The American Action Fund for Blind Children and Adults operates a national lending library for blind children with a large collection (more than 40,000 volumes) of children's Braille and Twin Vision books. Twin Vision books contain Braille and print pages side by side so that parents and children (regardless of which one is blind and which one is sighted) can read together. Library books are loaned free of charge to individuals and schools. For more information write to the American Action Fund for Blind Children and Adults, 1800 Johnson Street, Baltimore, Maryland 21230. Some local libraries for the blind also loan books appropriate for blind children. Most of these libraries are affiliated with the National Library Service for the Blind and Physically Handicapped of the Library of Congress; 1291 Taylor Street, N.W.; Washington, D.C. 20542. Ask for our "State Resource List." What is the Braille Readers are Leaders contest? This is an annual nationwide reading club involving thousands of blind children from kindergarten through high school. The program is jointly sponsored by the National Association to Promote the Use of Braille and the National Organization of Parents of Blind Children. Cash and other prizes are given for the amount of Braille reading done; children receive public recognition; and the attention of the general public is called to the importance and usefulness of Braille. Where can children's story books in Braille or combination print and Braille be purchased? Such books can be purchased from the following sources: Braille International, Inc. Attention: William A. Thomas Braille Bookstore 3290 Southeast Slater Street Stuart, Florida 34997 Telephone (407) 286-8366 or (800) 336-3142 National Braille Press 88 St. Stephen Street Boston, Massachusetts 02115 Telephone (617) 266-6160 Seedlings: Braille Books for Children P. O. Box 2395 Livonia, Michigan 48151-0395 Telephone (313) 427-8552 Where can I buy toys for a blind child? You can find many appropriate toys in your regular toy or department store. For a list of commercially available toys which are especially suitable for blind children or for sources of specially adapted toys and games, write to us at the National Federation of the Blind and ask for our þToy Resource List.þ What is the National Association to Promote the Use of Braille? The National Association to Promote the Use of Braille (NAPUB) is a nationwide organization of blind and interested sighted persons who want to strengthen Braille literacy among the blind. NAPUB has the following objectives: To raise awareness (among the blind as well as the sighted) concerning the importance of reading and writing Braille; to promote and support public and private efforts directed toward the establishment and enlargement of facilities for producing and distributing Braille materials; to seek changes in policies and practices in governmental and private agencies which would cause increases in the availability of Braille reading matter in schools, libraries, and the blind community at large; and to raise standards in the teaching of Braille and the training of those who teach it. In conjunction with the National Organization of Parents of Blind Children NAPUB seeks to encourage blind children to develop a proficiency in Braille reading skill, which will enhance their quest for knowledge and provide meaningful recreation. This is done through the sponsorship of a national annual Braille reading contest for school children from kindergarten through twelfth grade. How can blind adults learn Braille? Braille instruction for blind adults is offered by a number of training centers. Also many members of the National Federation of the Blind who are skilled Braille readers themselves are willing to help other blind people learn Braille. Regardless of where you live we will be glad to try to help make arrangements on an individual basis. Can older people who are losing their sight learn Brailleþand should they? Most can if they want to. They use Braille for telephone numbers, card games, personal notes, and labeling canned goods and similar items. Some use it for reading books or magazines. Others get information through different techniques: using a tape recorder for messages, reading books and magazines in recorded form, and learning to make efficient and comfortable use of sighted assistance. The important thing is to realize that there is no single right way. It depends on what works best and most efficiently for the individual. Braille can be fun and useful to the older person who is losing sight, but it should not be viewed as an obligation. How can a sighted person learn Braille? The best way is by taking the Braille transcription course offered through the National Library Service for the Blind and Physically Handicapped of the Library of Congress; 1291 Taylor Street, N.W.; Washington, D.C. 20542; telephone (202) 707-5100 or (800) 424-8567. Are there magazines of special interest to the blind and visually impaired? There are quite a number. The Braille Monitor is a monthly magazine published by the National Federation of the Blind in Braille, in print, on cassette, and on talking book record. The Braille Monitor keeps blind and interested sighted readers informed about issues, news, and events which have special significance to the blind and those who are losing sight. The National Organization of Parents of Blind Children publishes Future Reflections, a quarterly magazine in print and on cassette tape, which provides insight into all aspects of raising and educating blind and partially sighted children from infancy to adulthood. Contact us to receive without charge the special issue for new subscribers or for further information. The Diabetics Division of the National Federation of the Blind produces in newspaper format a free quarterly publication called the Voice of the Diabetic. Almost a hundred thousand copies are distributed to doctors' offices, hospitals, schools, libraries, social service agencies, and individuals to give information about the problems of diabetics who are experiencing loss of sight and how the problems are being met. Encouragement and facts are provided through personal, firsthand experience. For sample copies or to get on the mailing list of any of these publications contact the National Federation of the Blind, 1800 Johnson Street, Baltimore, Maryland 21230. Is there a special organization for blind or visually impaired students? Yes. The National Association of Blind Students has membership throughout the country and serves as a self-help group and source of information. It holds a meeting in July of each year in conjunction with the convention of the National Federation of the Blind, as well as regional and local meetings and seminars. It holds a national meeting and seminar each January in Washington, D.C. What scholarships are available to blind students? Blind students can take advantage of the same scholarship programs that are available to sighted students and should be encouraged to do so. However, there are also scholarships which are only available to blind students. The National Federation of the Blind, for example, awards over $75,000 a year in scholarships to worthy blind students. Contact us for further information. I have a dog that I would like to donate to the blind. Can you tell me how I can do this? A guide dog school may train several breeds of dogs to serve as working guide dogs, or it may train only one. In most cases, however, these schools prefer to breed their own dogs. In some instances the school will accept donations of dogs ranging from one to three years old. These dogs are rarely obtained from outside the community where the school is located. It is important for the schools to examine and observe the dog before accepting it to determine the health, temperament, and social interaction of the dog. Guide dog schools conduct what are known as þpuppy programs,þ or þfoster homeþ programs, in which puppies are placed to live with a family until they are one year old. These foster families are generally found within the school's local community since the families typically attend classes several times per month. While some schools have families who traditionally participate in the "puppy program," most of these foster homes are through local Lions or 4-H Clubs. Are there some things to keep in mind when you see a blind person using a guide dog? Yes, a few. Here they are: 1. Never call the dog's name, talk to the dog, or make distracting noises while it is in harness and working. 2. Never feed the dog since feeding it may make control of the dog difficult in a restaurant. 3. Never touch or play with the dog while it is working. 4. Never take hold of the person, the dog, or the dog's harness at any time. The blind person has been taught to listen to traffic patterns and to give the "forward" command when it is safe to cross. Although the dog is color blind, it avoids cars as it would any other obstacle. 5. Do not assume that the dog automatically knows where the blind person wants to go. The blind person must know where he or she is going in order to give the dog the appropriate directional commands. If the blind person is traveling in unfamiliar surroundings he or she may ask for directions just as a sighted person would. 6. When giving directions to a guide dog user, speak only to the person. Do not call the dog or try to get it to follow you. Be specific about where turns are to be made so that the blind person can direct the dog accordingly. 7. If assistance is requested by the blind person, allow the blind person to take your arm or the give the dog a command to follow you. The blind person should be the one to choose which method is best. Who were the pioneers in the organized blind movement? There were many, but two stand out: Newel Perry and Jacobus tenBroek. Newel Perry was born in Northern California in 1874. He became both blind and an orphan as a child and was taken to the California State School for the Blind at Berkeley. He was the first blind person ever to graduate from the University of California, where he majored in mathematics. By 1900 he was in Europe, working on a doctor's degree in mathematics. He returned to the United States in 1904 and spent ten years trying to find a job as a university professor, a position for which he was eminently qualified. Every door was closed. In 1914 he decided to return to the California School for the Blind as a teacher so that he might help the next generation of the blind have the opportunities that he had missed. During the next third of a century he trained and developed a remarkable group of successful blind personsþlawyers, administrators, a legislator, and a range of others in various walks of life. His most brilliant student was Jacobus tenBroek, who established the National Federation of the Blind in 1940. Totally blind, tenBroek earned five college degrees, including a doctorate from Harvard and another from the University of California at Berkeley. He wrote five full-length books on subjects of constitutional law and at least a hundred scholarly articles and monographs. He taught at the University of Chicago, was a professor at the University of California at Berkeley, and received many honors and awards. From the point of view of the blind, however, his most important contribution was his leadership in establishing and promoting the organized blind movement in the United States. He helped blind persons achieve hope and self-belief, and he left behind him a strong and enduring organization. The blind of the United States and the world would not have the opportunity and the prospect for full lives that they have today if it had not been for Newel Perry and Jacobus tenBroek. Was Helen Keller the first deaf-blind person in the United States to be educated? Contrary to popular belief, the answer is no. It was Laura Bridgeman, who was born in 1829 and died in 1889. She was a student of Dr. Samuel Howe, Director of Perkins School for the Blind. He worked with deaf-blind students and developed the basic methods of communication later used by Anne Sullivan in her work with Helen Keller. Laura Bridgeman lost her sight and hearing after an attack of scarlet fever when she was two. Her teacher began by taking such common objects as a key, spoon, and knife and pasting on each a label with the name of the object in raised letters. By learning to identify first the objects themselves and then the embossed words for them, she was subsequently able to match a correct unattached label with the appropriate object. Later, she was given the individual letters, which she learned to arrange into words. At first she performed these tasks by rote, until she finally perceived that each object had a name, and her understanding was awakened to the concept of communication through language. She was then given a set of metal types with raised letters at the end and a board with holes into which they would fit, so that they could be read with the finger. She never learned to speak but was taught the manual alphabet of the deaf with words spelled into her hand. This became her primary means of communication. In this manner she studied a variety of advanced subjects. What are some of the accomplishments of Helen Keller? Helen Keller was born in 1880 and died in 1968. She became deaf and blind at the age of 19 months through a damaging brain fever. In the beginning her only means of communication was through hysterical laughing or violent tantrums. Later with the help of her teacher, Anne Sullivan, Helen Keller learned to read and write Braille and eventually to speak. She gave lectures and did other public speaking and was the author of a number of books. She earned advanced college degrees, traveled to many countries, and became world renowned. WHO IS BLIND? by Kenneth Jernigan Before we can talk intelligently about the problems of blindness or the potentialities of blind people, we must have a workable definition of blindness. Most of us are likely familiar with the generally accepted legal definition: visual acuity of not greater than 20/200 in the better eye with correction or a field not subtending an angle greater than 20 degrees. But this is not really a satisfactory definition. It is, rather, a way of recognizing in medical and measurable terms something which must be defined not medically or physically but functionally. Putting to one side for a moment the medical terminology, what is blindness? Once I asked a group of high school students this question, and one of them repliedþapparently believing that he was making a rather obvious statementþthat a person is blind if he þcan't see.þ When the laughter subsided, I asked the student if he really meant what he said. He replied that he did. I then asked him whether he would consider a person blind who could see light but who could not see objectsþa person who would bump into things unless he used a cane, a dog, or some other travel aid and who would, if he depended solely on the use of his eyesight, walk directly into a telephone pole or fire plug. After some little hesitation the student said that he would consider such a person to be blind. I agreed with him and then went on to point out the obviousþthat he literally did not mean that the definition of blindness was to be unable to see. I next told this student of a man I had known who had þnormalþ (20/20) visual acuity in both eyes but who had such an extreme case of sensitivity to light that he literally could not keep his eyes open at all. The slightest amount of light caused such excruciating pain that the only way he could open his eyes was by prying them open with his fingers. Nevertheless, this person, despite the excruciating pain he felt while doing it, could read the eye chart without difficulty. The readings showed that he had þnormal sight.þ This individual applied to the local governmental agency for assistance and was duly examined by their ophthalmologist. The question I put to the student was this: "If you had been the ophthalmologist, would you have granted the aid or not?" His answer was, "Yes." "Remember," I told him, "under the law you are forbidden to give aid to any person who is not actually blind. Would you still have granted the assistance?" The student said that he would. Again, I agreed with him, but I pointed out that, far from his first facetious statement, what he was saying was this: It is possible for one to have "perfect sight" and still in the physical, literal sense of the word be blind. I then put a final question to the student. I asked him whether if a sighted person were put into a vault which was absolutely dark so that he could see nothing whatever, it would be accurate to refer to that sighted person as a blind man. After some hesitation and equivocation the student said, "No." For a third time I agreed with him. Then I asked him to examine what we had established: 1. To be blind does not mean that one cannot see. (Here again I must interrupt to say that I am not speaking in spiritual or figurative terms but in the most literal sense of the word.) 2. It is possible for an individual to have "perfect sight" and yet be physically and literally blind. 3. It is possible for an individual not to be able to see at all and still be a sighted person. What, then, in light of these seeming contradictions is the definition of blindness? In my way of thinking it is this: One is blind to the extent that he must devise alternative techniques to do efficiently those things which he would do with sight if he had normal vision. An individual may properly be said to be "blind" or a "blind person" when he has to devise so many alternative techniquesþthat is, if he is to function efficientlyþthat his pattern of daily living is substantially altered. It will be observed that I say alternative not substitute techniques, for the word substitute connotes inferiority, and the alternative techniques employed by the blind person need not be inferior to visual techniques. In fact, some of them are superior. The usually accepted legal definition of blindness already given (that is, visual acuity of less than 20/200 with correction or a field of less than 20 degrees) is simply one medical way of measuring and recognizing that anyone with better vision than the amount mentioned in the definition will (although he may have to devise some alternative techniques) likely not have to devise so many such techniques as to alter substantially his patterns of daily living. On the other hand, anyone with less vision than that mentioned in the legal definition will usually (I emphasize the word usually, for such is not always the case) need to devise so many such alternative techniques as to alter quite substantially his patterns of daily living. It may be of some interest to apply this standard to the three cases already discussed: First, what of the person who has light perception but sees little or nothing else? In at least one situation he can function as a sighted person. If, before going to bed, he wishes to know whether the lights are out in his home, he can simply walk through the house and "see." If he did not have light perception, he would have to use some alternative techniqueþtouch the bulb, tell by the position of the switch, have some sighted person give him the information, or devise some other method. However, this person is still quite properly referred to as a blind person. This one visual technique which he uses is such a small part of his overall pattern of daily living as to be negligible in the total picture. The patterns of his daily living are substantially altered. In the main he employs alternative techniques to do those things which he would do with sight if he had normal visionþthat is, he does if he functions efficiently. Next, let us consider the person who has normal visual acuity but cannot hold his eyes open because of his sensitivity to light. He must devise alternative techniques to do anything which he would do with sight if he had normal vision. He is quite properly considered to be a "blind person." Finally, what of the sighted person who is put into a vault which has no light? Even though he can see nothing at all, he is still quite properly considered to be a "sighted person." He uses the same techniques that any other sighted person would use in a similar situation. There are no visual techniques which can be used in such circumstances. In fact, if a blind person found himself in such a situation, he might very well have a variety of techniques to use. I repeat that, in my opinion, blindness can best be defined not physically or medically but functionally or sociologically. The alternative techniques which must be learned are the same for those born blind as for those who become blind as adults. They are quite similar (or should be) for those who are totally blind or nearly so and those who are "partially sighted" and yet are blind in the terms of the usually accepted legal definition. In other words, I believe that the complex distinctions which are often made between those who are totally blind, between those who have been blind from childhood and those who have become blind as adults are largely meaningless. In fact, they are often harmful since they place the wrong emphasis on blindness and its problems. Perhaps the greatest danger in the field of work for the blind today is the tendency to be hypnotized by jargon. BRAILLE WHAT IS IT? WHAT DOES IT MEAN TO THE BLIND? Braille was first developed about 1820 by a young Frenchman named Louis Braille. He created Braille by modifying a system of night writing which was intended for use on board ships. He did this work as a very young man and had it complete by the time he was about 18. He and his friends at the school for the blind he attended found that reading and writing dots was much faster than reading raised print letters which could not be written by hand at all. The development of this system by young Louis Braille is now recognized as the most important single development in making it possible for the blind to get a good education. It took more than a century, however, before people would accept Braille as an excellent way for the blind to read and write. Even today many people underestimate the effectiveness of Braille. While tapes and records are enjoyable, Braille is essential for note taking and helpful for studying such things as math, spelling, and foreign languages. Experienced Braille readers, however, read Braille at speeds comparable to print readersþ200 to 400 words a minute. Such Braille readers say that the only limitation of Braille is that there isn't enough material available. Braille consists of arrangements of dots which make up letters of the alphabet, numbers and punctuation marks. The basic Braille symbol is called the Braille cell and consists of six dots arranged in the formation of a rectangle, three dots high and two across. Other symbols consist of only some of these six dots. The six dots are commonly referred to by number according to their position in the cell. There are no different symbols for capital letters in Braille. Capitalization is accomplished by placing a dot 6 in the cell just before the letter that is capitalized. The first ten letters of the alphabet are used to make numbers. These are preceded by a number sign which is dots 3-4-5-6. Thus, 1 is number sign a; 2 is number sign b; 10 is number sign a-j and 193 is number sign a-i-c. Some abbreviations are used in standard American Braille in order to reduce its bulk. These must be memorized, but most Braille readers and writers find them convenient, rather than a problem. Braille is written on heavy paper, and the raised dots prevent the pages from lying smoothly together as they would in a print book. Therefore, Braille books are quite bulky. A Braille writing machine (comparable to a typewriter) has a keyboard of only six keys and a space bar, instead of one key for each letter of the alphabet. These keys can be pushed separately or altogether. If they are all pushed at the same time they will cause six dots to be raised on the paper in the formation of a Braille cell. Pushing various combinations of the keys on the Braille writer produces different letters of the alphabet and other Braille symbols. Writing Braille with a slate and stylus compares to writing print with a pen and pencil. The stylus is used to push dots down through the paper, while the slate serves as a guide. The Braille slate can be made of metal or plastic and is hinged so that there is a guide under the paper and on top of it. A person writing Braille with the slate and stylus begins at the right side of the paper and ends the line on the left, since the dots are being produced on the underside of the paper. Of course, the Braille reader reads from left to right, for the dots are then on the top side of the paper. Although this may seem a bit confusing, it need not be at all troublesome, since both reading and writing progress through words and sentences from beginning to end in the same manner. The speed of writing Braille with the slate and stylus is about the same as the speed of writing print with pen or pencil. Braille embossing devices can be attached to computers instead of or in addition to regular inkprint printers. A special computer program converts the print text to Braille. This gives blind people access to the same information sighted people get from computers. It is a matter of great concern to members of the National Federation of the Blind that fewer blind people now have the opportunity to become good Braille users than twenty-five years ago. A controversy now exists as to who should learn Braille and under what circumstances, but certain things are generally agreed upon. Blind children (and also adults) should make full use of computers, tape recorders, and any other available technology. Visually impaired children should be encouraged to make the best use of any eyesight they have, including learning to read print. But a legally blind child (one with less than ten percent of normal eyesight) cannot function efficiently using print alone. Sighted children have computers and recorders, but they still learn to read print. They use both eyes and ears to get information. Likewise, if a blind or severely visually impaired child is to compete, not only ears but also fingers should be used. Technology enhances but does not substitute for the printed word. Then why the controversy? Many of today's teachers of blind children take a single college course on how to teach Braille but cannot read or write it. Because of their lack of knowledge, they tend to think Braille is slow and inefficient. Being uncomfortable with what they don't know, they say that Braille is not needed and opt for expensive technology. There is also the fact that blindness still carries with it a stigma, and many (including some parents and teachers) want blind children to pretend to have sight they don't possess so as not to be considered blindþthe same thing blacks did fifty years ago when some tried to lighten their skins and straighten their hair to try to cross the color line. It didn't work and wasn't healthy for the blacks. The same is true for the blind. The National Federation of the Blind believes it is respectable to be blind, and we don't try to hide it. Thousands of blind people read Braille at four hundred words per minute. There's no substitute for Braille in taking notes, reading a speech, looking up words in a dictionary, studying a complicated text, or just having the fun of reading for yourself. Talk of forcing blind children to learn Braille shows the prejudice. Nobody talks of forcing sighted children to learn print. It is taken for granted as a right, a necessary part of education; so it should be with Braille and blind children. The National Federation of the Blind is asking state licensing officials to require teachers of the blind and visually handicapped to be competent in reading and writing Braille and to require that instruction in Braille be available to every visually handicapped child if parents want it. The National Federation of the Blind believes that no child is hurt by learning Braille, print, or any other skill. The federal act often cited as the excuse for not making Braille universally available to the blind is misquoted. The requirement that each child's individual needs be met was never meant as a cop-out for teachers and an excuse for illiteracy. Just as with the sighted, we the blind need every skill we can get to compete in today's world. With proper training we can hold our own with the best. INDEPENDENT TRAVEL When you think about traveling, it is a good idea to start with what you know best. You know a great deal about your own homeþyour house or apartment. You know the arrangement of the furniture, the shape and size of the rooms, the location of stair steps. If blindness were to occur suddenly, you might move about slowly and cautiously at first. But you would still have the same knowledge of your surroundings. When blindness comes to a person, that person must use different techniques to get the same information. Although the techniques are different from those used by the sighted, they are just as effective and just as easy to use. Your surroundings haven't changed, and you already know a lot about where you live. Using common sense to learn about your environment, you as a blind person can discover what you need to know and get around efficiently and gracefully without much trouble at all. In the initial stages of blindness, family members will often want to help you to get about in your home. It is desirable that you learn to do this without assistance as quickly as possible. With a little practice you will be able to find your way by yourself, and it will help you gain confidence in yourself as a blind person. All people (blind or sighted) bump into doorways or knock their heads on open cabinet doors occasionally. This may be annoying, but it is nothing to get upset about. The family pet will learn to get out of your way. You will be obliged to learn to manage with the other obstacles that are not able to see you comingþthe chairs, the footstools, the coffee table, and the vacuum cleaner. For a person who has recently become blind, the problem about dealing with furniture in the middle of the room may seem to be a major concern. However, with a little experience, managing day-to-day activities in your own home becomes a matter of routine. It is often assumed that a blind person cannot go anywhere alone. Tens of thousands of blind people travel alone every day to work, to civic functions, to recreational facilities, and to shopping areas. The long white cane or the guide dog are the tools most often used for independent travel. The white cane is a long, thin object usually reaching from the ground to shoulder height. It is often made of fiber glass, carbon fiber, or metal. Some people, blind or otherwise, who have trouble walking need support canesþthe sturdy waist-high kind with a hook-shaped handle on top. These support canes are much shorter than the travel canes used by the blind. Both white support canes and white travel canes may be purchased from the National Federation of the Blind. Either a long white cane or a guide dog can be used to find out all that is necessary to know about sidewalks, streets, steps, and obstacles. When you travel as a blind person you must get information about traffic movement by listening to it. Inexperienced blind travelers must practice in order to learn to use the information obtained in this way as effectively as they used the information provided by eyesight in the past. Traveling without vision is a new skill, but one that can easily be learned in a few months. It is not unusual for a newly blinded person to be very frightened at the idea of walking alone on the street with only a white cane. With experience and practice, this fear will diminish, and you will enjoy your new accomplishment. If you are walking with a friend or relative, it is a good idea to take the cane along also because you will want to get the same information from your cane that you would when traveling alone. Carrying your cane also gives you maximum flexibility. You may want to split up for a time from your friends and meet again later. When the cane is being used during travel it should be long enough that the tip rests on the ground a step and a half or two steps in front of you when you hold the handle slightly above your waist at the center of your body. The handle of the cane should remain centered in front of you and should be held with your hand cupped beneath it and your fingers grasping it. The tip of your cane should be swung back and forth from one side of your body to the other, using wrist motion to move it. Your arm should not move back and forth. This enables you to protect yourself from obstacles in front and on both sides of you. It also gives you needed information about steps and obstacles in time to make use of it. Generally, it is desirable for you to tap the cane each time you take a step. As you step with your right foot, tap your cane on the left-hand side of the path that you intend to travel about two inches farther out than your left shoulder will go. As the left foot moves forward, move your cane to the right. This motion becomes automatic, and with practice you will react instantly and easily to information supplied by the cane. The technique for traveling with a white cane is simple and can be learned in a few minutes. You should tailor your use of the cane to the situation at hand. For example, in a crowd you will want to keep the cane closer to your body to avoid tripping people ahead of you. When climbing up steps, you will probably want to hold your cane vertically, letting the tip bump the step ahead of you. At these times you will want to hold the cane at a point below its handle because the cane is too long to grasp its top. When the cane does not bump a step, you will know you have reached the top of the flight of steps. Similarly, you will probably wish to let the tip of the cane touch each step ahead of you as you descend a flight of steps. You will find other situations in which you may wish to use the cane somewhat differently. For example if you are baking a cake in your kitchen, and if you drop a cup measure on the floor, you may discover that it is faster to locate the lost cup measure by putting your cane flat on the floor and sliding it from side to side until it hits the cup. Your cane is meant to be a tool, and you are the best person to know how to use it to get the information you need. A white cane can vary in length from 24 to 69 inches. The length you choose will depend on your height and the speed at which you wish to travel. Taller people and those who walk faster need longer canes than shorter, more slow-moving folks. Probably the most satisfactory cane is one which is rigid and flexible. There are a number of folding or telescoping canes. These will work if they are rigid but flexible when fully extended. Blind travelers often find the landmark system of travel to be quite effective. If you know that there is a bakery on the corner, the smell of freshly fried doughnuts will tell you that you're getting close to it. The aroma of a shoe store, the sound of a particular revolving door or escalator, the noise of a school bell, a particular piece of rough pavementþthese can all be indicators which help to pinpoint your location. These are only a few suggestions. There are many other ways to gain the information you need. You can ask a passerby to read a sign or tell you what businesses are nearby. Blind travelers are also frequent users of public transportationþtrains, buses, and subways. Most transportation systems have a telephone number to call for information about routes of travel and times of departure. If you are using public transportation, you may need to be told where to catch the bus or subway. For a newly-blinded traveler, major transportation hubs may seem confusing at first. The National Federation of the Blind has chapters in almost every city of any size. We may be able to help you locate a blind traveler who can give you tips about public transit. Perhaps a person familiar with the area can help. Whether you travel with a guide dog or a cane, approach independent travel as an adventure. Blind people are often told that we should stay at home. Quite the opposite is true. The blind (just as others) should be a part of the world in which we live. We can be full participants in the mainstream of our culture. We can, that is, if we travel. For fun, for work, for the discharge of civic duty, for essential errands, for social occasions, travel is necessary and the blind can do it independently. If you would like more information about using a long white cane ask for our book, The Care and Feeding of the Long White Cane. We will be glad to send you a large print copy of this book without charge. Cooking Techniques A cook who becomes blind still has a lifetime of experience and knowledge about foodþa resource to be prized. There is no reason for a blind person to be frightened of hot stoves, electric mixers, sharp knives, or anything else in the kitchen. It is important to take the same good-sense precautions you always did: don't leave cloth potholders on the stove; don't stack glasses in the sink, and so forth. Accidents occur because of carelessness, whether the cook is blind or sighted. First of all, it does not hurt food to touch it if your hands are clean. You can measure a cup or a half cup of milk by touch. When the liquid reaches the halfþcup line or the top of the cup, you can feel the milk there. The best way to be sure that all the lumps are out of a stiff cookie dough is to finish mixing it with your hands. A light, quick touch with your finger will help you determine whether hamburger or steak or biscuits are brown. When brown they will be rougher and dryer than when raw. It is also possible to tell by touch when pie crust or pizza dough is smooth and when all the holes have been removed. You can tell by touch if cake frosting covers the entire cake and is smooth or if brownie dough in the pan is level. You can tell by touch when a bowl is scraped clean. These things require that the blind cook wash his or her hands often, but they work and the food is good. In most situations no special equipment is necessary; all that is needed is to use the other senses well, as in listening for when the carrots begin to boil. Many items of equipment designed for the sighted are especially appropriate for the blind as wellþpie-cutting guides and metal measuring cups, for example. The kitchen timer which is sold on the regular market but happens to have well-placed raised markings is another example. Plan the storage of your equipment and utensils so that you will not waste time unnecessarily in looking around for them. At the same time, however, you should realize that your plans will not always work perfectly in practice; you should be able to hunt around if necessary and find an item which someone else has put away in a different place. Many helpful tools and appliances are available. However, in most situations it is a matter of personal choice as to whether to buy a special appliance or to use another approach (such as adapting a regular tool or appliance or using a different method). Avoid over-dependence on special tools or rigidly defined techniques. The blind person often uses the sense of touch to gain information that a sighted person would probably gain through sight. The experienced blind cook can abide by any requirements of sanitation and formality as necessary. He or she is able to avoid directly touching any of the food with the fingers, by such means as wearing thin plastic gloves or using a utensil or appliance. Whenever we speak of touching something, it should be assumed that the experienced cook can find a way to avoid using unprotected fingers if circumstances so require. Recipes Braille and large print cookbooks are available on loan from many libraries for the blind. A few cookbooks in recorded form also exist; these may be helpful to those who have severe circulatory problems or other special difficulties in learning Braille. If you do not know the location of your local library for the blind, you may inquire of us; your regular local public library; or the National Library Service for the Blind and Physically Handicapped, Library of Congress; 1291 Taylor St., N.W.; Washington, D.C. 20542. Also, we can provide information about where cookbooks may be purchased. Braille recipe files may also be made. Although the user of an inkprint recipe file prefers to have the front of each card facing toward him, with the title at the top, most Braille readers prefer a different arrangement. You will probably prefer to insert the Braille cards with the top down, with the Brailled side of each card away from you; this way your fingers will reach the Braille most comfortably. Because of this, the title of each recipe should be placed below the recipe as it is written on the card; the titles will then be easily accessible as the bottoms of the cards appear at the top of the file box. Similarly, labels on file dividers should be placed upside down on the backs of the tabs. A frequently-used recipe will last longer if a plastic page or card is used. It is also helpful, while using a particular recipe, to tape it to the inside of a cupboard door, or in some other way support it so that it is not lying on the mixing surface, and thus keep it as clean as possible. Shopping You will select, from many good alternatives, the method of marketing that works best for you in a particular set of circumstances. Most grocery stores, especially during the less busy hours, are willing to assign an employee to accompany you around the store and assemble your order as you direct. Alternatively, you may choose to shop with a friend or relative. If you hire a reader or a driver, you may decide to use him or her as a shopping assistant on occasion. You may wish to telephone a store that will deliver. Be systematic as you place the groceries on your shelves at home. Plan where to keep each kind of item, and be consistent. If containers cannot easily be distinguished by touch, label them in Braille. (Store clerks and delivery men should be willing to read the inkprint labels for you as necessary.) One way of labeling is to write the name of the item on a 3" x 5" card, and then attach the card to the container with a rubber band. Measuring Ingredients Metal measuring cups and spoons sold on the regular market are very convenient for the blind cook. Using measuring spoons with dry ingredients is no different for the blind cook than for the sighted. For liquids, however, we suggest that you bend the spoon so that the bowl is at right angles to the handle; keep each liquid ingredient in a wide-mouthed jar, so that the bent spoon may simply be lowered into it and then lifted out full. A popular convention is to bend the one-half teaspoon and one-tablespoon measures in each set, so that half of the spoons are adapted for liquids and so that the spoons can be told apart by touch very quickly and easily. Steel spoons can be easily bent without damage. It is very convenient to use nesting measuring cups and fill the appropriate measure completely full in the usual manner. A one-cup measuring cup with raised fractional markings on the inside may also be used, however. If a recipe calls for a measured amount of boiling water, we suggest that you measure the water before heating it. If you use the water immediately when it begins to boil, the evaporation loss will not be significant. Cutting, Grating, and Peeling The actual process of peeling, slicing, or grating is no different for the blind than for the sighted. As in all phases of cooking, safety depends upon competence and care rather than upon sight. It is much easier and more satisfactory to grate or cut into a large bowl rather than onto a flat surface. The food is then automatically collected and easily manageable. If you are a beginner who has had little or no experience in using a knife, you may find it easier and safer at first to cut downward toward a cutting board. The experienced cook uses a knife in various positions, however; and the newly blinded experienced cook will probably not change her ways of using a knife. A suggested method for chopping vegetables into small pieces is as follows: Slice the vegetables into a large bowl. Then use a þKwik-Kut Food Chopper,þ which resembles a round cookie or biscuit cutter but is very sharp on the bottom. (This cutter is available on the general market.) Chop the cutter up and down through the slices, moving around within the bowl and continuing until the pieces are the desired size and uniformity. Pouring, Draining, and Mixing If a tray or cookie sheet with raised edges is placed underneath the bowl while pouring and mixing, messiness and loss due to spillage can be minimized. A tray is also helpful for the same reason when carrying things which might spillþfor example, a custard pie or gelatin dessert which has not yet set. Place several small desserts or custards together on one tray in the oven or refrigerator. Whenever possible, avoid unnecessary carrying: for example, measure ingredients immediately beside the mixing bowl, and prepare gelatin near the refrigerator. You may even wish to place a piecrust on the oven shelf before pouring in the liquid filling. An "Oven Saver"þa round metal sheet with crimped edges and with a hole in the middle for heat circulationþis also good for prevention of spillage problems with pies both outside and inside the oven. This item is sold on the general market. There are many methods for pouring and draining. For large quantities, a nervous beginner may wish to dip with a cup or ladle; however, pouring from one container to another in the regular manner may be accomplished with some practice. You may keep one hand on the receiving container to keep track of its location. With practice it is relatively easy to learn to judge the fullness of a container by sound and weight. Depending on formality and other circumstances, you may determine when the desired level is reached by placing your finger over the lip of the container, counting the number of dips with your ladle, estimating, or using a liquid level indicator. With very thick mixtures such as cake batter, check that the level is even all across the pan. When filling an angel-food cake pan, cover the hole in the middle with a small plastic bag or a tiny jelly tin. Using a screw-top jar or other shaker to mix the flour with the liquid is helpful in making white sauce and gravies. Probably the easiest method of draining vegetables is to pour them into a colander or strainer: if the colander or strainer is placed over a bowl, any spilled vegetables will be retrievable. The experienced cook may prefer another method. There are several good methods for separating eggs. One way is to break the shell into two unequal parts; lift off and discard the small end; and then drain off the white. It is also possible to buy a special tool for separating eggs. Stirring by hand usually presents no particular problem. Use a bowl that is large enough to minimize splashing, and be sure to scrape the sides of the bowl as necessary. If the bowl slides around annoyingly, set it on a damp cloth or some other non-slippery surface. Although the beginner may feel nervous about an electric mixer, normal safety precautions make it as safe for the blind cook as for the sighted. The condition of the mixture may be observed and controlled by using a rubber spatula and/or by stopping the machine to check with the fingers. For methods in pouring coffee or tea, see the paragraphs on "Serving the Food." Plugging in an Appliance If you are a beginner who has not yet learned how to plug in an appliance safely, the following suggestions may be helpful: First locate the outlet tactually and observe the orientation of the holes. With your right hand holding the plug by the insulated portion, bring the plug up to the outlet, but do not begin to push it in. Checking with your left hand to see that the prongs are oriented in the same direction as the holes, bring the plug up so that the prongs are over the holes, but do not yet push the prongs in, even part way. Remove your left hand, and be sure that your right hand is touching only the insulated portion of the plug. Now push the plug into the outlet. Dials and controls Dials and controls may easily be adapted to use without sight. With experience, you will be able to obtain the necessary information quickly from the appliance salesman or some other sighted person and arrange a plan to operate the dials easily and accurately. For each dial or knob, you will need to define at least one reference point on the moving part and at least one reference point on the background behind it. You may have several reference points on the dial and just one on the background, or you may have several reference points on the background and just one on the dial. Look first for already-existing features which you can use. Following are several examples of settings which can be used without any added markings: (1) Turn the dial clockwise, or counterclockwise, as far as it will go. (2) Move the dial to the next clearly-defined "click." (3) Place the pointer straight up, straight down, etc. (4) Place the dial halfway between two clearly-defined positions. (5) Feel a screw, raised letter, or other tactual feature which happens to be on the dial already. When the existing features are not sufficient for accurate use by the blind, you will need to add one or more tactual markings. Ideas include: filing small notches; applying actual Braille dots or letters, as with a special Dymotape set; placing drops of glue, paint, etc.; and etching glass. (Glass may be etched by using a portable high-speed grinder with a V-shaped silicon carbide stone, or a vibrating engraving tool with a silicon carbide or diamond point.) Many knobs and dials can easily be removed to facilitate marking. Observe carefully before removing, however, so that you will be able to replace the dial correctly. The tactile markings need not necessarily be the same as the inkprint markings, as long as they produce the desired results. If the dial is particularly hard to mark, for example, it may be possible to do most of the marking on the background instead of on the dial. Use the minimum necessary marks, avoiding confusing clutter. Probably you will not mark nearly as many points as the inkprint dial has. On the heat control of a conventional oven, for example, marking every 100 degrees is entirely adequate. It is easy to set a dial one-fourth, one-half, or three-fourths of the way between two marks. Microwave Ovens On most traditional ovens, tactual labels can be placed in the obvious locations. On microwave ovens, however, sometimes there is a heat sensor behind the printed label. In this case, if Braille is placed in the same location as the print, the student searching for the correct control may inadvertently turn on several unwanted processes merely by gently touching certain spots. To deal with this problem, place Braille labels above, below, or beside the printed labels, in a strip or other consistent manner. The student can search for the correct label, and then move up or down to the actual control spot. As a further challenge, sometimes controls are so close together that there is no room even for adjacent labels. Consider these ideas, alone or in combination: þUse simple one- or two-symbol Braille labels. þExperiment to see how large the heat-sensitive spot actually is. It may be much smaller than the printed label. þPlace double labels next to one row, indicating both that row and the next one. þLabel one row, and memorize the row next to it. þIf there is no room for regular Braille symbols, place simple tactual marks and memorize the meaning. Using the Stove, Oven, or Electric Frying Pan Food may be placed in a pan, and the pan on a burner, before the heat is turned on; this way, the pan and burner may be examined tactually with safety. However, with experience you will rarely if ever need to turn off the heat in order to replace a pan on the burner. Similarly, if you are a beginner you may wish to examine a conventional oven carefully while it is cold. Once you are familiar with its arrangement, you will then be able to work confidently when the oven is hot, using a mitt or a potholder. It is usually better to pull out the oven shelf in order to insert or remove something; the danger of a hand burn is then minimized because you need not reach far inside the oven. Be sure that the shelves are properly attached so that they will not pull out too far or tip over. Although the beginner may feel hesitant about lighting a gas stove or oven, the blind cook need only follow normal safety precautions and observe the operation of the stove by means other than sight. Listen for the sound of the flame lighting. If necessary hold your hand above the burner or pilot light, at a safe distance, to see whether it is still burning. With experience you will be able to set the flame to the desired level by observing the position of the control and the amount of heat generated. If matches are required, the beginner may prefer large wooden ones and may need to practice lighting them; however, the experienced cook uses any available match. Usually you can tell when something starts to boil, by listening and/or by feeling the vibration of the pan handle. However, if the liquid is very thick, a Braille thermometer may be useful. A beginner may wish to have the mixture stop boiling temporarily before adding ingredients. Monitoring the cooking of a confection by placing a sample in cold water and checking for the þsoft ball stage,þ etc., is done by touch anyway, and should be no problem for the blind cook. If you use a pressure cooker, select a type which makes use of sounds (as with a jiggling weight), rather than an inkprint dial. Notches may be filed in a weight which has multiple settings. To turn meat which is frying, locate each piece by touch and flip it in the usual manner. If necessary, wad up a piece of paper toweling as a pad to protect your hand. (Especially at first, you may need to use your hand to find the piece of meat and/or to keep it in the right position while you are turning it over with a spatula.) A suggested method for frying chicken is as follows: Tuck the ends of each wing together for greater compactness and ease in handling. Plan your arrangement of the pieces in the skillet so that you remember where each one is. Arrange the chicken in a relatively cool skillet (warmed only enough to melt the fat); turn up the heat appropriately until the meat is ready to turn; then turn the heat off again while you are turning the pieces. In turning large pieces, it may be convenient to exchange two of them with each other. Since bacon is so thin and flimsy, a bacon decurler may be used to make turning unnecessary. This is a perforated metal plate with a small handle in the middle, available on the general market. The bacon cooks on both sides simultaneously when this device is placed on it. Alter the proper time has elapsed, touching the bacon with a spatula or lifting it up slightly will indicate its crispness. Scoop out the pieces with the spatula, pushing them against a paper towel to collect them. In frying pancakes, the beginner will probably start with just one in the middle of the pan; however the experienced cook can fry several in the same skillet. Ladle in the appropriate amount of batter for the size of cake desired; for a thinner cake, shake or tip the skillet slightly. The appropriate time for turning may be judged by time and by the consistency of the cake as the spatula is slipped under it. In preparing waffles, spread the batter around evenly as you dip it into the waffle iron. You will know when the waffle is done by observing such things as the amount of steam escaping, the odor, and whether the lid comes free easily. The beginner frying an egg, and the experienced cook frying several eggs separately in one pan, may use an egg ring for each egg. Remove both the top and bottom of a small tuna or pineapple can, leaving a metal ring about one and one-half inches high and three inches in diameter. This ring is placed in the pan and the egg is broken into it. When the egg becomes firm enough to keep its shape, the ring is removed. Time, touch, odor, taste, and/or sound will indicate when a product is done. Choice of Cooking Method Many people today, sighted and blind, regard the microwave oven as extremely convenient and "the modern way to cook." Nevertheless, large numbers of people still prefer conventional stoves and ovens for many procedures, and/or cannot afford a microwave oven. Others use the "more traditional" methods when visiting friends or relatives, volunteering in the church kitchen, etc. Home economics classes teach various methods of cookery, not just the use of microwave ovens. For all these reasons, the blind person needs to learn all the common means of cooking and baking. Do not permit the microwave oven to be the only method because "it is so much easier." Serving the Food Many aids are available for cutting cakes, pies, etc., into portions. From a restaurant supply house it is possible to buy a pie-cutting guide featuring slots for the knife. A different type of pie cutter, consisting of a wire frame with blades, is available from restaurant supply houses. A hexagonal-shaped pie pan may be bought on the regular market, and a straightedge may be laid across between opposite corners to guide the knife. A straightedge may also be used in a similar manner with any metal pan if notches are filed at appropriate places along the edges of the pan; cakes, desserts, and gelatin may be cut evenly in this manner. Setting the table usually presents no particular problem. If you have trouble spacing the place settings evenly, we suggest that you push each chair up close to the table in its proper place. Then you can center each place setting in front of the corresponding chair. A tray or cookie sheet helps in serving soup or other liquids. A filled bowl may be carried on a tray to minimize the problem of spillage. Alternatively, the bowls may be filled at the table just before the diners arrive, with the tray being placed under each bowl in turn as a precaution. Many blind hostesses prefer to serve food to their guests from a cart or sideboard. If each serving dish is passed around and then returned to this location, the hostess easily finds out when a dish becomes empty. The popular modern custom of a self-service buffet style meal is particularly convenient for the blind hostess, as it is for the sighted. The hostess need only arrange all the necessary items appropriately, and then replenish empty serving dishes as necessary. The beginner may experience difficulty in pouring from a coffeepot. We suggest the following: Set the cup near the edge of the table. Lift the coffeepot completely off the table, and lower it so that the bottom of the pot is lower than the surface of the table. Then place the spout so that it touches the lip of the cup and reaches inside. (With experience, you may or may not come to prefer some other method.) To determine when the cup is full, you may place your finger over the lip of the cup; estimate the amount of liquid, according to sound, volume, time, etc.; or use a liquid level indicator. Cleanup Much of the need for cleaning up spots and spills can be prevented by careful work habits. As mentioned above, a tray is extremely helpful in catching spills. Unpleasant accidents, such as dropping a pie or placing one tray of unbaked cookies on top of another, can usually be prevented by care and thought. For example: Remove spills from the floor at once before someone slips. Check the oven shelf to be sure it is clear. Replace lids tightly onto the proper jars. Put utensils and appliances back into their proper places, and always turn off appliances rather than merely unplugging them. Plan ahead in all respects rather than proceeding haphazardly. (All of these precautions apply to the sighted as well; however, the blind person learning new techniques may need to be reminded.) Often the need for cleaning or washing can be felt tactually. It is important, however, to anticipate dirt which may not be so readily noticed and to do routine general cleaning such as wiping off the entire counter after mixing on it. In cleaning a surface such as the counter or floor, a planned approach is very important: clean in strips rather than random strokes here and there. Dishwashing usually presents no particular problems. Cleanliness and neatness should be considered at every stage of the food preparation procedure. Organize equipment and supplies beforehand; keep your hands thoroughly clean; plan carefully; clean up spills when they occur; wash all utensils and wipe off the entire cooking area afterwards. Doubleþcheck after the cleanup is completed, to be sure nothing was missed. Conclusion A positive attitude is essential to success. If you really believe that the blind cook necessarily takes many safety risks, needs a great deal of special equipment, has only a limited repertoire, and produces questionable productsþthen you will do a poor job. If you really believe that the blind cook may choose among many good methods to work with all kinds of food and produce high-quality productsþthen you will find a way to succeed. Sewing Techniques A blind person can and should continue to do whatever kind of sewing he or she did as a sighted person. Many people sew very little today. Some even arrange to have the laundry or dry cleaner do mending for them. Others very much enjoy sewing and do a great deal of it. Whether you are blind or sighted need not affect your success in sewing or your preference to avoid it. Three or four tips about sewing will be useful to a newly blinded person. A needle threader consisting of a small piece of metal and wire loop which can be put into the eye of a needle and used to draw the end of the thread through the needle is very useful for threading needles, whether you are sewing by hand or with a sewing machine. If you are tense, it will seem impossible to do this. If you relax and practice, threading a needle in this way can become quick and easy. Needle threaders can be ordered from us and can often be purchased in fabric stores. Self-threading needles are also available. There is a tiny division at the large end of a self-threading needle through which the thread can be pulled. If your fingers are somewhat stiff or numb you may prefer these needles for sewing by hand. When sewing with the machine, you may use the presser foot or a seam guide to line up the material and keep your seams or topstitching straight. Two types of machine guides are also available for sewing machines: a magnetic guide which adheres to the metal of the machine just to the right of the presser foot or a metal guide that can be screwed onto the machine table in the same place. If your machine has the hole or holes for the screw, this type of guide is much sturdier and more reliable than the magnet. Some people like to use adhesive tape to mark a 5/8þinch seam allowance in front of the presser foot. The most reliable guide is the presser foot itself and it is safe to let your finger touch the front of it. As long as your finger is not on top of the presser foot and does not reach in from the side, the needle cannot hurt you. After a seam is sewn, you can feel the stitching line to tell how straight it is. Blind sewers, like sighted sewers, will need to make use of the ripper occasionally. If you like to make garments and other items, you will need to develop a new technique for cutting them out. You will probably want to get a friend to trim commercial patterns on the cutting line before you lay them on the fabric. You may wish to make some special markings of darts or arrows with tape when you have them trimmed. You can feel the edge of the tissue paper against the fabric well enough to cut along it quite neatly. You should loop your hand over the top blade of the scissors so that your thumb is on one side and your fingers on the other just where the two blades of the scissors come together when you are cutting. The edge of the pattern should not cross over the bottom blade of the scissors. Therefore your fingers should be against the pattern and your thumb against the fabric (or vice versa) as you cut. You will be able to feel the pattern edge against the fabric and the scissors best if your hand is relaxed and you touch it lightly. Of course, you will hold the scissors in the same hand you always did, using the other to guide them as described above. Sometimes labeling thread for color can be a problem. One solution to this problem is to obtain pill bottles with large tops from your local pharmacy and stick Braille labels on them. Braille labels glued to the spool of thread itself will be pushed off by the spindle if the spool is put on the machine. Sewing is like so many other activities for a blind person. The question is not whether it can be done. A newly blinded person needs to ask: How can I do it? not Can I do it? A few relatively simple techniques will make it possible for a blind person to do any kind of sewing he or she wishes to do. Practice will make these techniques simple and commonplace, although they may seem difficult or frustrating at first. Marking Dials and Tactile Labeling Raised markings can be put on dials in a variety of ways and may be helpful to a blind individual. Dials on the oven, stove burners, washing machine and dryer, electric mixer, dishwasher, electric skillet, etcetera may be set more exactly if some special markings are used. It is possible to take a sharp scratch awl and make lines on a plastic or metal surface around the outside of the dial, so that the pointer on the dial can be turned toward these marks. Small daubs of fingernail polish or glue or a commercial product called Hi-Marks can also be used. Notches or bumps of one kind or another can be used to mark almost any dial. It is not necessary to write words or numbers on the dials as is done in print. The blind person will decide what setting should be marked, so he or she will know what they mean. Furthermore, it is not necessary to have every possible dial setting marked. For example, it may be desirable to put Braille markings on an oven dial at 275, 350, 425, and broil. With these four settings marked, it is possible to set the oven dial between them for more accurate control. Many dials may not need special markings. If the dial clicks as it turns, or if a series of buttons are used for settings (in the fashion that is common on many blenders), no additional markings will be needed. In addition, many dials can be set accurately by a blind person even though there are no special markings. An example of this would be the dial for a gas stove burner which can be turned a half or oneþquarter turn from off to high flame. As the dial is gradually turned, the flame gets higher or lower. Sometimes a blind person can feel printing on a dial. Even though you cannot read these letters by touch, the roughness of the print and the spacing between the letters or words may be an adequate guide for a blind person in setting the dial. Plastic tape may be used to mark a dial, but other kinds of tape are likely to pull off or wear out quickly. Some appliances and other devices have been marked in Braille or adapted especially for the blind by the manufacturer. In most cases, however, you can use whatever you have on hand just as well as something that has been adapted for use by the blind. For example, a kitchen timer has been adapted for the blind with raised dots on it to show how many minutes it is set for. At most hardware stores, it is possible to purchase for less money kitchen timers that have raised numerals. These can be felt and the timer can be set very accurately. If you already have a kitchen timer with print numerals that are not raised, you can probably still set it accurately. On a 60þminute timer, when the pointer is straight down, it is set for 30 minutes; straight to the right is 15 minutes; halfway between 15 and straight up is 7 1/2 minutes. This timer can be marked with a scratch awl or fingernail polish at 15, 30, and 45 or in some other way. However, many blind people would be able to use it without any special markings. It is largely a matter of personal preference. Other examples similar to this could be given, but the kitchen timer shows why you may not need a special device for the blind, even if you hear it advertised. If a blind person knows some Braille and wishes to make markings with Braille letters this can be done by using Braille dymo tape. Braille dymo tape can be used to mark records, canned goods and other firm surfaces. Canned goods can also be sorted by location on the shelf, or Braille magnetic labels can be purchased. Packages of frozen food can be labeled in Braille, the label held against the package with a rubber band. Plastic Braille labels of this kind can be reused. Of course, it is adequate for many people simply to sort frozen items by arranging them in a certain order in the freezer. Generally, clothes do not need special markings. You can identify shirts, slacks, sweaters, jackets, skirts, dresses, etcetera, by the feel of the fabric, the style, buttons, and other features that vary from one garment to the next. Exceptions to this may be t-shirts or socks. If t-shirts of different colors are otherwise identical, the simplest means of distinguishing one from the other is to tear out the tag on one, leaving it in the other. It would also be possible to sew a small piece of fabric at the back of the neck. Some blind people prefer to wear primarily one color of socks, all black, all white, all blue. In many dime stores it is possible to buy small rings to use when doing the laundry to keep socks mated together. This makes sorting several colors of socks simple, since they should not get mixed together. If you have a slip or undergarment that contrasts with several that are a different color or shade you may wish to mark it in the same way you would mark a t-shirt, so you don't inadvertently wear it under something light-colored or sheer. Although it is possible to label almost anything in Braille or with raised markings, do not let yourself become a slave to such markings. You may find you really don't need very many. Shopping Ideas Blind people use as many different techniques for shopping as sighted people do, and everyone will use a variety of different techniques for different occasions. The following is a list of methods available. None of these methods will always be satisfactory, but a combination of them will enable a blind person to get the things he or she needs and wants: 1. Walk to the store, ask a clerk for assistance in finding items. This generally works well when only a few items are needed. If the store is too far away from home to walk, a city bus may be used. If you go to the same store regularly, you may not always need assistance in finding items. 2. Telephone the store with a list of items needed: then go to the store in a taxicab to pay for the items and bring them home. Grocery shopping can be done in this way, especially if you know some of the people at the grocery store and if you ask for this help when the store is not too busy. 3. Hire someone to drive you to the store and help you find the things you need when you get there. 4. Shop with a friend or neighbor who is doing his or her own shopping at the same time. 5. Find a volunteer from church or a civic club who will set aside an hour or two occasionally to help you shop. 6. Ask a friend or neighbor to pick up a few items when he or she is out running errands. 7. Often large department stores have a shopping service which can be arranged for in advance. You can go to the store, meet the þshopper,þ and find the items you need. This is generally used when you wish to purchase quite a few items at one store in one day. 8. Find a senior citizens program that sends a van or bus to a shopping center occasionally, and make use of it. 9. Order items from a mailþorder catalogue by telephone. 10. Many companies do business primarily at your home. Jewel T, Amway, Shacklee, Avon, and Fuller Brush send salespeople door-to-door and deliver. If you like these products and are at home during the day, this is indeed a convenient way to shop. Products such as Tupperware and Stanley are purchased at parties, but can be ordered through the sales representative, as well. Many blind persons arrange to shop repeatedly with someone whose judgment they know and trust, especially for clothing, furniture, or decorative items. You will probably enjoy shopping or dislike it as much as you did before you lost your sight. Your shopping techniques will vary according to your health, travel methods, preferences, and the occasion. Older Blind and Visually Impaired Persons Over half of all blind people in this country are 65 years of age or older. When blindness or visual loss occurs later in life, it can be extremely frustrating. But more importantly, assistance with the necessary adjustment to blindness is often much more difficult to obtain than it is for younger persons. Every state has a governmentþfunded rehabilitation program, with many states having separate agencies for the blind. These programs are mainly established to help people get back to work. If a person is of retirement age and is not looking for employment, he or she may not be eligible to receive services from these programs. Some states have established independent living programs to provide services to older blind individuals. Often a newly blinded person does not know where to go to find out about how to continue functioning as a blind person. Many people do not know about tools and methods which exist to make it possible for blind senior citizens to remain in their own homes and continue to be contributing members of society. Here are some of the most frequently asked questions we receive about older blind persons, along with our answers. "My mother is going blind. Where should she live?" A blind person can live comfortably and safely almost anywhere he or she chooses to live. Certainly, the same choices about living quarters should be available to the blind as are available to sighted individuals. In recent years thousands of older citizens have found it desirable to move into senior citizens' villages, apartment buildings, mobile home parks, or clusters of houses reserved for retired people. Some of these include group dining rooms and recreation facilities, while others have very few special services. Undoubtedly, some blind people will find arrangements such as these desirable. Some will not. Blind people should have the opportunity to live in these senior citizen villages along with everyone else. Assuming that the blind person does not have health problems that make nursing home care necessary, elderly blind individuals should be able to learn alternative skills to care for themselves and live in whatever type of housing situation they prefer. "My mother is losing her vision. What is available to her and what can I do to help her feel useful again?" It is not necessary for a blind person to be helpless or dependent. With proper training, encouragement, and opportunities, a blind individual can be active, self-sufficient, and productive. The most important thing for your mother to do now is to gather information about how blind people function effectively in the world. This includes the use of daily living skills and work-related skills. Most alternative methods that blind individuals use are very simple, commonþsense methods. There is not much special equipment that is required. You will find many suggestions and ideas throughout this book. Your mother may want to consider learning Braille. She may find it very helpful. Even while the skills of reading and writing Braille are being learned, she can make use of Braille in labeling canned goods and medicines. While she doesn't need to have labels on everything, she will enjoy the ease of life around the house as she is able to know what spices are on the rack, what kinds of soups are on the shelf, etc. She will also be able to note phone numbers and addresses without difficulty. The place to start in looking for activities that will help your mother feel useful and productive is with the things that she has enjoyed all of her life. Just because a person loses vision doesn't mean that she can no longer do the things that have interested her. There are a few simple techniques and devices that can allow people to continue doing most things. If your mother enjoys sewing, there are needle threaders and self-threading needles which make this possible. Sewing techniques useful to blind persons are discussed elsewhere in this book. We know blind people who knit, crochet, make latch-hook rugs, or make their own clothes. If your mother enjoys knitting, crocheting, crafts, or macrame, she can still do these things. It is just a matter of learning to perform certain tasks by touch rather than by sight. Encourage your mother to experiment with things she has always enjoyed doing. Another easily learned craft is making latch-hook rugs. If you purchase rugs that have large areas of the same color, and if you can work with her some on marking points where colors change, latch-hook can be very enjoyable. If gardening is something that holds an interest for her, there is no reason why she can't continue to garden. There are ways to perform all the gardening tasks by touch rather than by sight. If your mother was active in church groups or clubs, there are still many things she can do to contribute. We realize that transportation may be a problem. However, there may be someone who could offer her a ride to some of the activities in exchange for help with the gasoline purchase. Often, there is a real need for people to do telephone calling from their homes for church activities. The most important element in getting started on some of these things after a person loses vision is believing that it can be done. Learning to do things in a different way can initially be frustrating, but if you already have the skill, it does not take long to learn to do things by touch. Please encourage your mother to try some of these things. Throughout the country there are libraries that lend to blind individuals books and magazines that have been recorded on records or tapes, as well as Braille materials. The libraries also provide record players (talking book machines) and specially adapted cassette players without charge. Any person who is unable to read standard print is eligible to borrow these materials. The materials can be sent through the mail to and from the library free of charge, so this service does not cost the blind borrower anything. The service is provided by state and federal funds. Library services are available upon application from the library for the blind in your state. Most of these libraries are part of the network of the National Library Service for the Blind and Physically Handicapped of the Library of Congress. We have found that one of the most useful things for newly blind people is to meet and interact with other competent blind individuals. We can get your mother in touch with the local chapter of the National Federation of the Blind nearest her. It is very important that you encourage your mother to be active and to do as many things for herself as she can. "Can an older blind person learn Braille?" Whether or not a blind person at an advanced age would benefit from learning Braille depends upon many factors. If the individual is mentally alert, has a reasonably good memory, and is able to feel and distinguish the dots, it may be beneficial for him or her to learn Braille. The older blind person may want to learn enough Braille to put labels on things or to write down telephone numbers. Numbers in Braille are the same as the first ten letters of the alphabet with a number symbol placed before the letter. If you know the numbers and a few other letters, it is possible to use Braille playing cards. "Are there any games that are adapted for the blind?" Many games do not require adaptations. The use of a reader may be the only change that is required with others. You can obtain sets of checkers, chess, monopoly, cribbage, scrabble, and other games that have been adapted for use by the blind. In the case of checkers and chess, it is not necessary to know any Braille at all in order to use the adapted sets. The pieces are shaped differently so that one color can be distinguished from the other. The boards are adapted so that the pieces are not easily pushed out of place when the blind person uses his or her hands to find the location of the various pieces. "Can you recommend a nursing home for my father who is blind?" Any good nursing home can accommodate blind people adequately. It is essential for people to understand that just because a senior citizen becomes blind, that does NOT mean that nursing home care is necessary. Assuming that the blind person does not have health problems that make nursing home care necessary, elderly blind individuals should be able to learn methods to care for themselves and live in whatever type of housing situation they prefer. "My sister is blind and has other health problems that make nursing home care necessary. What should I look for to make sure she gets the care she needs?" Blindness, in and of itself, is not a sickness. Most people who are blind do not live in nursing homes. However, some people who need nursing home care for other reasons happen to be blind. Here are a few things to consider in choosing a nursing home suitable for a person who is blind: Are there other blind people living in the home? What do they do all day? Do they have talking books? If not, they may receive them without cost from the National Library Service for the Blind and Physically Handicapped of the Library of Congress. Are blind residents encouraged to travel independently around the home? Will staff members show new residents where to find the dining room, or is it automatically assumed that blind people must be taken everywhere they wish to go? Do blind residents participate in the regular activities of the home? They should. Are residents who want to learn Braille encouraged to do so? Do staff members speak to patients upon entering or leaving a room? Do staff move the personal belongings of residents without notifying them or asking their permission? Are blind residents who used to enjoy needlework encouraged to continue with this hobby and shown ways to do needlework as a blind person? Knitting, crocheting, weaving, and other such skills are truly þhandworkþ and do not require sight. Are large print or Braille bingo cards, playing cards, and scrabble sets available? Does the home have good lighting? Can people have high intensity lamps with low glare in their rooms? Are public areas well lit? Is attention paid to reducing glare? Are blind people in wheelchairs routinely told about their surroundings if they are being pushed from one place to another? It is sometimes hard, particularly if a person has a severe hearing loss, to tell very much about surroundings while sitting in a wheelchair. This purpose can be accomplished in the course of a general conversation. Ask the director of nursing if there has been a staff training session on blindness recently. If there has not, we can probably find a local blind person who would be glad to offer staff training. "I am over 65, and I am legally blind. Am I eligible for any financial or medical assistance other than Social Security and Medicare?" If you are 65 or older, you will not receive any additional money from Social Security just because you are blind. If you are under age 65, it is very important for the Social Security Office to know that you are blind. If you are eligible for Social Security Disability Insurance, you may continue to receive disability benefits (which may be higher) until you are age 65, at which time your payments will convert to Social Security based on the fact that you have attained age 65. Medicare pays hospital and doctor expenses under certain rules and limitations, but if your income is very low and/or you have some large medical bills, you may be eligible for some other medical assistance through your state or local programs. Depending on your financial circumstances, it may be possible to qualify for medical assistance through your State Department of Social Services. Most states also have what is called a "spend down program." If you are found eligible for this, you will pay a set amount of medical expenses for a six-month period of time, and the Department of Social Services will pay anything above this amount. Please check with your State Department of Social Services for further details. There are university hospitals in most states which are teaching hospitals for medical students. They are often able to provide medical services at a reduced rate. Other hospitals which have been constructed with federal funds are sometimes required, at least for a number of years, to provide some assistance to lowþincome individuals. Please check with hospitals in your area for this type of program. If you are a Medicare recipient, there are some doctors who will accept for payment the amount that Medicare will pay. Many hospitals have doctor referral services and can tell you which doctors will accept Medicare patients. If you are 65 or older, a U.S. citizen or legal resident, and you do not have access to an ophthalmologist that you have seen in the past, you may be eligible for the National Eye Care Project. If you think you may be eligible, call (800) 222-EYES (3937). Callers who meet the eligibility requirements are mailed the name of a participating ophthalmologist near their home. Participating doctors provide medical eye exams and treatment for conditions or diseases if necessary. Qualified callers will receive treatment at no out-of-pocket expense for the doctor's services. Eyeglasses, prescriptions, hospital services, and other medical services are not covered under the program. Doctors accept insurance assignment as payment in full. It is the responsibility of the agency on aging in your state to act as a referral agency for older citizens. There is also a state rehabilitation agency for the blind in your state which should be able to give you information. There may be other state or local services for which you may be eligible. The most important thing for you to remember is that you have a lifetime of experience to offer your family, friends, and the rest of the world. Just because you have lost your vision, does not mean that you don't still have a lot to offer to other people. Some new techniques, such as the ones discussed elsewhere in this book, are required. Learning to read and write Braille takes time and motivation. Using records and tapes instead of reading with your eyes takes some getting used to. Finding and learning to work with readers is a skill to be developed. Budgeting money to pay readers or finding volunteers is a new approach. Using public transportation and arranging for drivers are also changes. These new activities are skills that require new attitudes. You must come to understand that everyone has needs and that those of the blind are not necessarily greater than those of others. All people must find ways of giving to others, as well as getting others to help them. You probably will not feel OK about blindness until you realize that you still have a lot to offer to others. It is easy to become overwhelmed by your own needs and forget that the greatest need of all is to continue giving. Do you knit or crochet for your grandchildren? Do you tell entertaining stories? Do you bake good cookies? Do you make quilts or wooden toys? Do you teach Bible study lessons? Do you take flowers to friends who are ill? Some of these things may seem unlikely for a blind person, but they aren't. We know many blind people who do all of these things and more. Believing that it is possible is the first step. The next step is using imagination, initiative, and persistence. When you need encouragement or support, be sure to contact other, more experienced, blind people. They will undoubtedly be happy to talk to you. Common Eye Conditions and Causes of Blindness in the United States (The material in this article was produced in collaboration with Daniel Finkelstein, M.D., Associate Professor of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.) This article includes information on only the most commonly encountered eye conditions, and it reduces a great deal of medical and technical detail to language understandable to the lay inquirer. Many medical facts have, in the interest of clarity and brevity, been simplified; therefore, this text is not in any way intended as a basis for self-diagnosis or lay diagnosis of anyone's eye condition, a job which belongs to the eye doctor. If you are wondering whether anything is wrong with your eyes, we urge you to see an eye doctor at once. If you cannot afford to pay, there are many agencies and funds which can help you. Some of the conditions described below are hereditary (passed on from one generation to another through genes and chromosomes), but there are many patterns of heredity, even for a single disorder. Specific questions about the inheritance of a particular characteristic in an individual or family should be directed to a genetic specialist. A family physician can usually provide the proper referral. Following are descriptions of the specific eye conditions about which we receive the most frequent questions. A longer list is treated in our free publication Blindness and Disorders of the Eye. Generally we have not attempted to rank causes by percentages or numbers of cases since such statistics are constantly changing, and the analysis of them is a complex matter. Albinism Albinism is a hereditary condition in which there is a lack of normal pigment in part or all of the body. The hair is white, the skin very fair, and the iris of the eye white or pinkish. The person with albinism usually has poor vision, an imperfectly developed retina, oversensitivity to light, and nystagmus (abnormal muscle movement causing constant twitching or jerking of the eyes). Specially treated lenses can improve vision and can also lessen discomfort by reducing the amount of light entering the eye. There is no cure for albinism. Amblyopia The general term amblyopia applies to poor vision which is not due to any observable disease and which cannot be corrected by glasses. It may be congenital (present at birth) or may develop later. Sometimes the cause is unknown; however, blindness can often be prevented if proper steps are taken. A common example is þlazy eyeþ or amblyopia ex anopsia, affecting perhaps one to two percent of children. This condition occurs in a young child if one eye becomes so dominant that the other is suppressed and deteriorates through lack of use. This is likely to happen if the two eyes focus differently because of strabismus (see below) or because one eye is much more nearsighted than the other. One eye may fall into disuse as the person relies on images from the other. However, the eye may appear perfectly normal to others. If this problem is discovered and treated early enough (generally before the age of six or seven), often the unused, weak eye will regain its strength. Otherwise permanent loss of vision may result. Many service organizations provide free preschool screening tests in an effort to find and refer these children before the vision of one eye is completely lost. Treatment generally consists of correcting the basic inequality of the eyes through surgery or corrective lenses and/or putting a patch over the strong eye temporarily to force the weak one to work again. Eye examinations at birth and again by three years of age are recommended to increase chances of early detection and effective treatment. Cataracts The lens of the human eye is comparable to the lens of a camera or magnifying glass, and for obvious reasons it needs to be transparent and free of flaws. The development of what are called cataracts, or opacities and clouding of the eye's lens, blocks the passage of light through the eye. Various forms of cataract make up one of the leading causes of blindness in this country today. Although some cataracts are congenital (present at birth), likelihood of developing them increases with age. Chemical changes in the lens and diabetes have also been associated with development of cataracts, and chemical burns and heredity may cause them. All of the causes, however, are not known. Like the majority of eye conditions, they are not contagious. Cataracts are not painful. In fact the only symptom as far as the patient is concerned is from very slight to virtually total interference with vision. Cataracts may be manifested in dimmed, blurred, or double vision or a need for frequent changes of glasses. Typically a person with cataracts experiences difficulty in satisfactorily adjusting light for activities like reading while at the same time having to avoid glare. Driving at night may for this reason become very difficult. Not all cataracts require surgery, some being small enough that they do not seriously affect vision. For those large enough to cause visual problems, medication does not help; and the only effective treatment is surgery to remove the affected lens, implantation of an intraocular lens, and the subsequent wearing of conventional eyeglasses or strong contact lenses. Much progress has been made recently in the development of improved forms of cataract surgery, including use of freezing probes and ultrasonic (not to be confused with laser) devices which make possible removal of the lens through a small opening in a process called phacoemulsification. The decision about whether and when to operate is dependent on factors such as the patient's age and occupation. The likelihood of regaining useful sight is generally good, with some estimates placing it as high as 95%, although complications may prevent successful treatment in some cases. It is no longer necessary to wait for cataracts to þripenþ before operating, and convalescence from the surgery is faster and safer than ever before. Color Blindness This familiar condition is predominant in males (in about 8% as opposed to around 0.5% of females) and most commonly is a sex-linked inherited characteristic transmitted through the male chromosome, although it may also result from poisoning or retinal disease. Generally affecting both eyes, it most often takes the form of a loss of perception of one or two fundamental colors (red-green color blindness is the most common congenital variety), but occasionally it is complete, so that the individual literally sees only in black and white. The exact mechanism of color blindness has not been fully explained, but some writers simply attribute it to an absence of one or more of the cone pigments or an abnormal presence of a mixture of two of the color-sensitive pigments in one cone. In any event, use of various charts to test for color blindness is commonly included as part of an eye examination, especially for drivers and workers in industry and transportation, where the ability to distinguish colored signals is important. One of the most familiar tests consists of a circle containing dots of different colors, in which the subject with normal color vision is supposed to discern one number, while a person with defective color vision is likely to see another. Some have found the pattern of inheritance for this recessive characteristic confusing. To put the matter simply, a female will usually not be color-blind herself unless there is an abnormal gene for color blindness on both of the X chromosomes carried by all females. On the other hand a male, who carries only one X chromosome, will be color-blind if it contains an abnormal gene. Moreover, the female with only one abnormal gene inherited from her father can become a "carrier" and pass the trait on to a male offspring without being color-blind herself. There is no treatment for color blindness, and it cannot be overcome through any type of eye exercises. Congenital Eye Defects The term congenital means "present at birth"; hence, this term includes some or all cases of many conditions listed under other headings in this publication. Some congenital eye conditions like retinoblastoma are truly hereditary (passed on through the genes and chromosomes), while others are the result of a disease or deficiency during pregnancyþfor instance, German measles (rubella). Often the exact cause of a congenital defect is unknown. Following are examples of conditions which may be seen at birth as a developmental deficiency of unknown cause: aniridiaþabsence or near absence of the iris microphthalmosþan abnormally small eye, usually with poor vision megalophthalmosþan abnormally large eye present at birth anophthalmosþabsence of the eyeball (an artificial eye can usually be worn, and the eyelids are usually present.) colobomaþa cleft or slot in the iris and/or retina, as a result of incomplete growth. Corneal Disease and Corneal Transplants The cornea, a transparent layer over the front of the eye, functions as a refracting and protective "window" membrane through which light rays pass on the way to the retina. While there are no blood vessels in the cornea, there are many pain fibers, so that most injuries do cause severe pain. In addition, blurred vision results from injury to or disorder within the cornea. Problems in this area, resulting as they can in permanently blurred vision or blindness, are extremely serious and should receive immediate attention from an eye specialist. Corneal ulcersþScarring or perforation due to corneal ulceration is a major cause of blindness throughout the world. Usually such ulcers can be treated if attended to quickly. Ulceration may be caused by bacteria such as streptococcus, viruses (herpes simplex keratitis being one of the most common), fungi, vitamin A deficiency, or other disorders. New drugs have aided the treatment of many of these conditions. Degenerative corneal conditionsþKeratoconus, a rare degenerative condition which is inherited, causes a general thinning and an abnormal protrusion of the central cornea, as well as some scarring. Blurred vision results, and in advanced cases there may even be perforation of the cornea. While contact lenses (especially the new soft types) can aid vision in the early stages, corneal transplants are sometimes performed before extreme thinning takes place, and in such cases reading vision can usually be obtained. Other degenerative conditions include corneal dystrophy and arcus senilis, an extremely common condition in elderly people. Other types of corneal disorders may be indicated by pain, irritation, or blurred vision; however, some corneal ailments can be detected only by a trained eye specialist. Corneal Transplant (Keratoplasty)þWhen the cornea becomes scarred, hazy, or opaque or when there is danger of perforation of a corneal ulcer, an ophthalmic surgeon may remove the affected cornea and replace it with a healthy one taken from a donor. In many states it is easy for one to donate eyes for this purpose at death. Only the cornea is used in such cases. There is no immediate prospect of successful whole eye transplants. Surgeons would prefer to use the donated cornea immediately, but it may be used within sixty to seventy hours after death if handled properly. New techniques for this procedure involving surgery under a microscope and use of finer suture material have constituted a major advance in treatment of corneal disorders. Ordinarily using a knife called the trephine, which functions rather like a cookie cutter, the surgeon performs what is called a "penetrating keratoplasty." The defective cornea is cut with the knife and lifted out. A matching piece of the donor cornea is cut with the same knife , used to replace the excised piece of the defective cornea , and held in place by very fine sutures. The convalescence from this surgery is relatively brief and uncomplicated these days. Best vision returns when the sutures are removed about one year after surgery. Chances of rejection of the new cornea are rated by most authorities at from one to five percent. Diabetic Retinopathy This eye condition, a very common complication of diabetes, rivals glaucoma and cataracts as a leading cause of blindness in this country. Its incidence is rising as a result of the increased lifespan of diabetics, which has been made possible by improved medical technology and particularly by the synthesis of insulin in the early years of the twentieth century. The likelihood of retinopathy increases with the length of time a given person has had diabetes, so that many who have been diabetics for twenty or more years do become blind. Long-term diabetes often brings about changes in the tiny blood vessels in the retina (the lining of the back of the eye). There are two forms of diabetic retinopathy. The milder form, background or nonproliferative, is the more common. It involves development of microaneurisms in retinal capillary blood vessels, which usually do not cause serious vision loss. A relatively small number of diabetics develop the more severe, or proliferative, form of retinopathy, which can cause blindness. With its onset new, abnormal blood vessels may be formed; blood vessels may become engorged with too much blood and burst, or the retina may break loose from the back of the eye. In addition to the direct interference with vision caused by these events, blood from the burst vessels enters the vitreous (jelly-like) part of the eye and makes it cloudy instead of transparent. Modern medical treatment administered as early as possible in the course of the disorder can often slow the course of diabetic retinopathy. Laser treatments sometimes can seal or þweldþ broken blood vessels or seal a detached portion of the retina back into place. Photocoagulation treatment consists of scattering hundreds of small, quick flashes of intense laser light across the retina in order to seal or dry up new blood vessels. It must, however, be undertaken before there is bleeding into the vitreous or detachment of the retina. Although in many cases these kinds of treatment are wholly or partially unsuccessful, the techniques are continually being refined. Medical science does not yet fully understand just what characteristics of diabetes bring about retinopathy. Although good adherence to a diet, regular administration of insulin, and other prescribed regimens will improve the patient's general health and help to lower the likelihood of complications in general, the most careful and conscientious patient may still become blind. On the other hand, some people have severe diabetes for many years and never develop eye problems. German Measles (Rubella) Many readers may be surprised to find that German measles is associated with blindness since it is commonly thought of as a very minor disease. Neither child nor adult is likely to be harmed permanently by a case of German measles, but an unborn baby may be very much affected. If an expectant mother has the disease during the first three months of pregnancy, she herself will probably hardly feel sick at all, but the disease is likely to infect her unborn child through the placenta, with serious results. Many of these babies are born mentally retarded, and they also are likely to have physical problems. Heart disease, hearing disorders, and respiratory difficulties are particularly common. Many rubella children have cataracts or other eye problems like glaucoma, abnormally small eyes, or defects in the iris or retina. A number of preventive efforts have been made to minimize this threat to the unborn. Childrenþespecially girlsþshould be exposed to the disease or vaccinated if possible so that they may have mild symptoms and develop resistance to German measles for the future. Women who might be in the early stages of pregnancy should avoid contact with cases of German measles. Glaucoma Glaucoma is another of the leading causes of blindness in the United States, perhaps accounting for one in every seven or eight cases. In this condition, the transparent fluid inside the forward part of the eye does not drain normally, and excess pressure is built up within the eye. If the pressure is not controlled, the delicate structure of the eye is increasingly damaged, resulting in blurred vision, a narrowed field of sight, and eventually total blindness. Symptoms may include intermittent blurred vision, nausea, inability to adjust eyes to darkened rooms, seeing colored halos around lights, and reduced side vision. The causes of glaucoma are not fully understood. Some cases are hereditary, while others arise as complications of other eye disorders. Glaucoma, not a contagious condition, is most common after the age of thirty-five. The acute type of glaucoma appears as a sudden attack, characterized by great pain and discomfort as the eye pressure rises quickly from blockage of drainage canals. Such an episode can damage the eyes severely in a short time. More common, however, is the chronic type (affecting perhaps 2.5 million Americans), in which there is no pain and in which the damage to vision is so slow that it may not be noticed by the patient for a long time. The intraocular pressure rises because the drainage canals are blocked and the fluid cannot drain properly. Many cases are controlled by medication which relaxes and unblocks the drainage channels for the eye fluid. Sometimes surgery is necessary. In many cases, although not all, modern medical treatment can control the disease completely. As with other eye conditions, early detection and treatment to stop the progress of the disorder are important. Many sources recommend an eye examination every two or three years, especially for those over thirty-five. Developments such as optic disk topography mapping, the laser scanning ophthalmoscope, and color perimetry may assist in early detection and treatment of this disorder. Injury (Trauma) and Burns In an era when cures for disease are constantly being developed, injury remains a prominent cause of disability, and eye injuries are no exception. Preventable accidents injure the eyes of approximately 500,000 Americans each year. Adequate protective eye guards (not just any goggles or eyeglasses) should always be worn during welding, in factories and laboratories, and in any other situation where the danger of burns or other injury exists. Children must be effectively taught not to point arrows, BB guns, or other sharp or dangerous objects toward the face. Farmers using anhydrous ammonia or other chemicals must observe suitable safety precautions since chemical burns are an important cause of injury on farms. Everyone should know the basic principles of emergency first aid in case an injury does occur. In case of a chemical burn, the eyes should immediately be rinsed thoroughly with water for at least fifteen minutes, and emergency medical care should be secured at once. For other injuries, it is generally best to leave the eye alone or if necessary to cover it with a loose bandage while securing emergency medical care. Hyphema, a hemorrhaging into the anterior chamber, is a sign of serious injury. In such a case blood will be visible through the cornea, and a doctor's help should be sought at once. In addition to direct damage due to the injury itself, the danger of infection is always present and may be even more serious. Moreover, injury to a single eye may result in pathologic symptoms in the other, a condition called sympathetic ophthalmia, which in the past often meant that total blindness ultimately resulted from injury to a single eye. Although the exact cause of sympathetic ophthalmia is not fully understood, it can usually be prevented today by prompt medical care. We do not have the power to foresee and prevent all injuries. With proper precautions, however, a great many accidents can be prevented, and the effects of those which do occur can be minimized. Macular Degeneration As the inner surface or lining at the back of the eye, the retina serves a function similar to that of the film in a camera. The macula (the proverbial "apple" of the eye) is the part of the retina which forms the center of the "picture" and the sharpest image. Degeneration or breakdown of the macula may come from many causes. Some cases are hereditary, and others are caused by diseases such as arteriosclerosis. The course of the deterioration may be slow or rapid; however, the patient generally keeps good peripheral visionþthat is, he can still see well around the edges of his visual field, although his central vision is blurred. The most common form of this condition occurs in the elderly. In severe form this is called "age-related macular degeneration" (AMD), which occurs mostly in people over fifty years old. While a person with macular degeneration may retain substantial peripheral vision, the ability to read, sew, or drive may be seriously impaired. Magnifiers may help, and a small percentage of cases of a rare form of AMD may be candidates for laser treatment to seal off blood vessels which have grown beneath the retina or to repair the macula's weak spots by removing worn-out tissue and allowing new tissue growth. Myopia (Nearsightedness) Myopia results when the eyeball is longer than normal or when there is some change in the eyeball which causes the light rays to be bent abnormally. In either case when a distant object is observed, the parallel light rays passing through the lens into the eye tend to be focused in front of the retina rather than on it, and the result is a fuzzy image. Rays coming from nearby objects are more easily brought into focus, and thus the person is described as "nearsighted." Most nearsighted people need only wear properly prescribed corrective lenses in order to see normally. These people are said to have simple myopia, which hardly ever causes blindness. A much less common condition, generally hereditary, is degenerative (or progressive) myopia. Persons with this condition may not see well even with glasses. Complications such as retinal detachment, cataracts, or secondary glaucoma may appear with degenerative myopia. Nystagmus Continuous jerky, involuntary movements of the eye muscles are called nystagmus. These oscillations may be in any or all directions, but are usually more pronounced in some directions than others and are usually fairly consistent in a particular individual. Sometimes dizziness is associated with nystagmus. The person with nystagmus has reduced visual acuity from being unable to maintain steady fixation on objects. The exact cause of nystagmus is not fully understood, but it seems to be associated with poor vision in a kind of "vicious cycle"þthat is, nystagmus makes it more difficult to see, while at the same time poor vision increases the likelihood of nystagmus. Usually this disorder cannot be cured. The individual may find he or she is more comfortable and sees better if the head is tilted or moved slightly to compensate for the involuntary movements, and often this will be done unconsciously. Ophthalmia Neonatorum The well-chosen name of this disease means "inflammation in the eyes of the newborn." Once a dreaded and very common cause of blindness, it is now preventable by means of modern hygiene and medical care. Ophthalmia neonatorum appears soon after birth, but it is not hereditary. It is caused by the entrance of bacteria from the mother's birth canal into the baby's eyes. Inflammation appears in the eyelids and cornea and may spread further if not treated. Often the bacteria are those of gonorrhea, but other bacteria (such as staphylococcus) may be the cause as well. A successful treatment to prevent the development of this disease was discovered in 1880, and this treatment or its equivalent is now required by law. The eyelids of every newborn baby are cleansed, and drops of a silver nitrate solution (sometimes penicillin and other antibiotics) are put into the eyes. Effort is also directed, of course, to promoting good health on the part of the expectant mother so that she will not transmit harmful germs to her baby. Optic Nerve Atrophy and Optic Nerve Hypoplasia These two conditions of the optic nerve have become a special concern of those who work with young children. In optic nerve atrophy the problem is damage to or degeneration of the optic nerve. Generally it results from a condition occurring after birth, but it can also be hereditary. Frequently, it results from pressure against the optic nerve and resultant loss of blood supply to it, for example from hydrocephaly or tumors. Without blood the nerve cells die from lack of nourishment. In optic nerve hydroplasia there is a congenital deficiency of optic nerve fibers, which may exist independently or in association with other disabilities or defects. There is some evidence to suggest that this disorder is related to alcohol or drug use by mothers during their pregnancies, but in many cases the cause is unknown. Retinal Breaks and Detachment Sometimes as part of the aging process, sometimes through inheritance of a predisposition toward them, and sometimes from other causes, people may develop breaks in the retina which often lead ultimately to detachment of the various layers of the retina from each other. As with other eye conditions, early detection and treatment of these problems can help prevent blindness. Sometimes there are not dramatic symptoms associated with breaks in the retina; however, such symptoms as "floaters," haziness or smokiness, or light flashes in the eye may indicate retinal problems. An immediate examination by an eye doctor is recommended. Treatment for retinal breaks involves use of cryotherapy or lasers. In the former, a freezing probe is applied to the surface of the eye over the point of the retinal break. Only the area around the break is frozen, prompting the growth of scar tissue and reattachment of the separated retinal layers at the edges of the break. Lasers are used to burn tissue selectively so as to reattach the separated retinal layers in a process similar to welding. Retinitis Pigmentosa This condition is characterized by degeneration of the retina and the choroid, usually involving an abnormal development of excess pigment. It is hereditary, with a variety of patterns of inheritance and development. The most common pattern of development is as follows: At approximately age ten or twelve, the youngster begins to experience some difficulty in seeing at night and in poorly lighted areas. His visual field also begins to narrow, although he may not realize this at first. The visual loss is progressive, so that the individual usually becomes legally blind by young adulthood and slowly loses more and more vision thereafter. Many adults with retinitis pigmentosa have a very tiny field of vision in which they see well under a good light but which is so small as to be of little use. Total blindness often results. There may or may not be additional problems, such as cataracts. There is no known treatment. Retinopathy of Prematurity Retinopathy of prematurity (ROP), which sometimes advances to a condition known as retrolental fibroplasia (RLF), was thought for a long time to be caused by exposing a newborn (frequently premature) baby to a high concentration of oxygen in an incubator, but there is now less agreement and certainty about the cause. In any case, an abnormal proliferation of blood vessels in the eye occurs, and there may be subsequent development of scar tissue , with bleeding and detachment of the retina. Total blindness may result. Glaucoma, uveitis, cataract, and degenerative lesions of the eye may occur months to years after onset of the RLF stage. Strabismus and myopia are commonly associated with cases in which the blood vessels partially heal. In the large majority of ROP cases (about 80%) abnormal blood vessels heal completely in the first year of life. In other cases scars from incompletely healed ROP result in either mild or severe RLF. In the most severe cases (about 5%) retinal detachment results from formation of scar tissue and the resultant pulling loose of the retina from the normal position in the back of the eye. Recently cryotherapy (freezing part of the retina while it is immature) has drawn some interest as a possible treatment for ROP and is currently under study. The history of ROP/RLF has affected the education of blind children in the United States. Because of the surge of RLF cases in the 1950's, large numbers of blind children reached school age at a time when social sentiment began increasingly to favor the þmainstreamþ placement of children with disabilities in the regular classroom. The parents of many RLF children worked successfully to arrange for education in the regular public schools, a trend which continues today. Strabismus Commonly called "crossed eyes" when the eyes turn in and "wall eyes" when they turn out, this condition is frequently due to muscle inequality. It can also result from trauma at birth, hereditary factors, or other disorders. It must be treatedþ usually with corrective glasses, medication, surgery, patching of one eye, orthoptic exercises, or some combination of these. Trachoma Trachoma is a contagious disease, caused by a virus, which affects the eyelids and the cornea. Though still common in many less developed countries, it has become rare in the United States. It can be prevented through modern sanitation and medical care. The exact pattern of development varies with the individual, but the following symptoms are typical: The eye becomes painful, with burning sensations and oversensitivity to light. Vision is disturbed (or in some advanced cases destroyed) as the cornea becomes more and more opaque. An excess of tears is produced, and often an additional discharge. The eyelids develop muscle spasms; and the eyelashes may be turned inward, further irritating the cornea. In its early stages a case of trachoma can usually be cured by administration of suitable drugs and improved cleanliness and general health. Surgery is helpful in some cases. However, if the case is far advanced or if complications have set in, successful treatment may be impossible. The best way to control this disorder is of course through prevention. Tumors Not all tumors and growths are cancer. A "benign" or "nonmalignant" tumor is not much different from the surrounding tissue. It stops growing after it reaches a certain size and does not spread to other areas of the body. Some benign tumors in or near the eye cause no trouble at all. Others, however, do interfere with sight or cause pain. Such a tumor may be removed surgically, and in many cases the eye recovers to become completely normal. A cancerous tumor is much more threatening than a benign tumor. It is greatly different from surrounding tissue, grows rapidly without stopping, and often spreads through the lymph system to sprout growths in other parts of the body. There are many different kinds of cancers which may appear in or around the eye. The most common is melanoma, a malignant spot of color. (Note: Some benign tumors are also called "melanomas.") Retinoblastoma is a cancer of the retina. Usually hereditary, it appears in very young children and is believed to be present at birth in an incipient stage. If any history of this disease is known in a family, it is vital that each baby be examined frequently by an ophthalmologist. The eye specialist can detect the cancer before it is visible to the layman and before it causes any discomfort to the child. If the condition is untreated, the cancer will spread to the brain and elsewhere, causing death. Successful treatment of a tumor is always much more likely if it is begun early. Radiation, drugs, and/or surgery may be used, but frequently complete removal of the eye and any other affected tissue may be necessary. Usher's Syndrome An inherited disorder present at birth or early in life, Usher's Syndrome involves hearing loss and a progressive loss of vision caused by retinitis pigmentosa (discussed above). The hearing loss associated with this disorder, which may be from mild to profound, usually does not progress. The retinitis pigmentosa, however, follows the usual pattern of progressive lossþfirst of night vision and gradually of peripheral vision. The incidence of Usher's Syndrome is estimated by the RP Foundation at about 1 in 15,000 to 30,000 births. There is no treatment for this disorder, but there has been some benefit from cochlear implants for those with severe hearing loss. Uveitis Inflammation of the uvea, the middle layer of the eye between the sclera and the retina, is called uveitis. Symptoms include light sensitivity, blurring of vision, pain, and redness of the eye. This condition can affect other parts of the eyeþcornea, retina, sclera, for exampleþand may be serious enough to lead to loss of vision. It may come on slowly with little pain but with blurring of vision, or it may appear suddenly, accompanied by pain and redness of the eye. WHO ARE THE BLIND WHO LEAD THE BLIND The National Federation of the Blind has become by far the most significant force in the affairs of the blind today, and its actions have had an impact on many other groups and programs. The Federation's President, Marc Maurer, radiates confidence and persuasiveness. He says, "If I can find twenty people who care about a thing, then we can get it done. And if there are two hundred, two thousand, or twenty thousandþwell, that's even better." The National Federation of the Blind is a civil rights movement with all that the term implies. President Maurer says, "You can't expect to obtain freedom by having somebody else hand it to you. You have to do the job yourself. The French could not have won the American Revolution for us. That would merely have shifted the governing authority from one colonial power to another. So, too, we the blind are the only ones who can win freedom for the blind, which is both frightening and reassuring. If we don't get out and do what we must, there is no one to blame but ourselves. We have control of the essential elements." Although there are in the United States at the present time many organizations and agencies for the blind, there is only one National Federation of the blind. This organization was established in 1940 when the blind of seven statesþMinnesota, Wisconsin, Illinois, Ohio, Pennsylvania, Missouri, and Californiaþsent delegates to its first convention at Wilkes-Barre, Pennsylvania. Since that time progress has been rapid and steady. The Federation is recognized by blind men and women throughout the entire country as their primary means of joint expression; and todayþwith active affiliates in every state, the District of Columbia, and Puerto Ricoþit is the primary voice of the nation's blind. To explain this spectacular growth, three questions must be asked and answered: (1) What are the conditions in the general environment of the blind which have impelled them to organize? (2) What are the purpose, the belief, and the philosophy of the National Federation of the Blind? (3) Who are its leaders, and what are their qualifications to understand and solve the problems of blindness? Even a brief answer to these questions is instructive. When the Federation came into being in 1940, the outlook for the blind was certainly not bright. The nation's welfare system was so discouraging to individual initiative that those who were forced to accept public assistance had little hope of ever achieving self-support again, and those who sought competitive employment in regular industry or the professions found most of the doors barred against them. The universal good will expressed toward the blind was not the wholesome good will of respect felt toward equals; it was the misguided goodwill of pity felt toward inferiors. In effect the system said to the blind, "Sit on the sidelines of life. This game is not for you. If you have creative talents, we are sorry, but we cannot use them." The Federation came into being to combat these expressions of discrimination and to promote new ways of thought concerning blindness. Although great progress has been made toward the achievement of these goals, much still remains to be done. The Federation believes that blind people are essentially normal and that blindness in itself is not a mental or psychological handicap. It can be reduced to the level of a mere physical nuisance. Legal, economic, and social discrimination based upon the false assumption that the blind are somehow different from the sighted must be abolished, and equality of opportunity must be made available to blind people. Because of their personal experience with blindness, the blind themselves are best qualified to lead the way in solving their own problems, but the general public should be asked to participate in finding solutions. Upon these fundamentals the National Federation of the Blind predicates its philosophy. As for the leadership of the organization, all of the officers and members of the Board of Directors are blind, and all give generously of their time and resources in promoting the work of the Federation. The Board consists of seventeen elected members, five of whom are the constitutional officers of the organization. These members of the Board of Directors represent a wide cross section of the blind population of the United States. Their backgrounds are different, and their experiences vary widely; but they are drawn together by the common bond of having met blindness individually and successfully in their own lives and by their united desire to see other blind people have the opportunity to do likewise. A profile of the leadership of the organization shows why it is so effective and demonstrates the progress made by blind people during the past half centuryþfor in the story of the lives of these leaders can be found the greatest testimonial to the soundness of the Federation's philosophy. The cumulative record of their individual achievements is an overwhelming proof, leading to an inescapable conclusion. DR. JACOBUS tenBROEK - Author, Jurist, Professor, Founder of the National Federation of the Blind The moving force in the founding of the National Federation of the Blind (and its spiritual and intellectual father) was Jacobus tenBroek. Born in 1911, young tenBroek (the son of a prairie homesteader in Canada) lost the sight of one eye as the result of a bow-and-arrow accident at the age of seven. His remaining eyesight deteriorated until at the age of fourteen he was totally blind. Shortly afterward he and his family traveled to Berkeley so that he could attend the California School for the Blind. Within three years he was an active part of the local organization of the blind. By 1934 he had joined with Dr. Newel Perry and others to form the California Council of the Blind, which later became the National Federation of the Blind of California. This organization was a prototype for the nationwide federation that tenBroek would form six years later. Even a cursory glance at his professional career shows the absurdity of the idea that blindness means incapacity. The same year the Federation was founded (1940) Jacobus tenBroek received his doctorate in jurisprudence from the University of California, completed a year as Brandeis Research Fellow at Harvard Law School, and was appointed to the faculty of the University of Chicago Law School. Two years later he began his teaching career at the University of California at Berkeley, moving steadily up through the ranks to become full professor in 1953 and chairman of the department of speech in 1955. In 1963 he accepted an appointment as professor of political science. During this period Professor tenBroek published several books and more than fifty articles and monographs in the fields of welfare, government, and lawþestablishing a reputation as one of the nation's foremost scholars on matters of constitutional law. One of his books, Prejudice, War, and the Constitution, won the Woodrow Wilson Award of the American Political Science Association in 1955 as the best book of the year on government and democracy. Other books are California's Dual System of Family Law (1964), Hope Deferred: Public Welfare and the Blind (1959), The Antislavery Origins of the Fourteenth Amendment (1951)þrevised and republished in 1965 as Equal Under Law, and The Law of the Poor (edited in 1966). In the course of his academic career Professor tenBroek was a fellow at the Center for Advanced Study in the Behavioral Sciences at Palo Alto and was twice the recipient of fellowships from the Guggenheim Foundation. In 1947 he earned the degree of S.J.D. from Harvard Law School. In addition, he was awarded honorary degrees by two institutions of higher learning. Dr. tenBroek's lifelong companion was his devoted wife Hazel. Together they raised three children and worked inseparably on research, writing, and academic and Federation concerns. Mrs. tenBroek still continues as an active member of the organized blind movement. In 1950 Dr. tenBroek was made a member of the California State Board of Social Welfare by Governor Earl Warren. Later reappointed to the board three times, he was elected its chairman in 1960 and served in that capacity until 1963. The brilliance of Jacobus tenBroek's career led some skeptics to suggest that his achievements were beyond the reach of what they called the "ordinary blind person." What tenBroek recognized in himself was not that he was exceptional, but that he was normalþthat his blindness had nothing to do with whether he could be a successful husband and father, do scholarly research, write a book, make a speech, guide students engaged in social action movements and causes, or otherwise lead a productive life. In any case, the skeptics' theory has been refuted by the success of the thousands of blind men and women who have put this philosophy of normality to work in their own lives during the past fifty years. Jacobus tenBroek died of cancer at the age of fifty-six in 1968. His successor, Kenneth Jernigan, in a memorial address, said truly of him: "The relationship of this man to the organized blind movement, which he brought into being in the United States and around the world, was such that it would be equally accurate to say that the man was the embodiment of the movement or that the movement was the expression of the man. "For tens of thousands of blind Americans over more than a quarter of a century, he was leader, mentor, spokesman, and philosopher. He gave to the organized blind movement the force of his intellect and the shape of his dreams. He made it the symbol of a cause barely imagined before his coming: the cause of self-expression, self-direction, and self-sufficiency on the part of blind people. Step by step, year by year, action by action, he made that cause succeed." KENNETH JERNIGAN - Teacher, Writer, Administrator Kenneth Jernigan has been a leader in the National Federation of the Blind for more than thirty-five years. He was President (with one brief interruption) from 1968 until July of 1986. Although Jernigan is no longer President of the Federation, he continues to be one of its principal leaders. He works closely with the President, and he continues to be loved and respected by tens of thousandsþmembers and non-members of the Federation, both blind and sighted. Born in 1926, Kenneth Jernigan grew up on a farm in central Tennessee. He received his elementary and secondary education at the school for the blind in Nashville. After high school Jernigan managed a furniture shop in Beech Grove, Tennessee, making all furniture and operating the business. In the fall of 1945 Jernigan matriculated at Tennessee Technological University in Cookeville. Active in campus affairs from the outset, he was soon elected to office in his class and to important positions in other student organizations. Jernigan graduated with honors in 1948 with a B.S. degree in social science. In 1949 he received a master's degree in English from Peabody College in Nashville, where he subsequently completed additional graduate study. While at Peabody he was a staff writer for the school newspaper, co-founder of an independent literary magazine, and a member of the Writers Club. In 1949 he received the Captain Charles W. Browne Award, at that time presented annually by the American Foundation for the Blind to the nation's outstanding blind student. Jernigan then spent four years as a teacher of English at the Tennessee School for the Blind. During this period he became active in the Tennessee Association of the Blind (now the National Federation of the Blind of Tennessee). He was elected to the vice presidency of the organization in 1950 and to the presidency in 1951. In that position he planned the 1952 annual convention of the National Federation of the Blind, which was held in Nashville, and he has been planning National Conventions for the Federation ever since. It was in 1952 that Jernigan was first elected to the NFB Board of Directors. In 1953 he was appointed to the faculty of the California Orientation Center for the Blind in Oakland, where he played a major role in developing the best program of its kind then in existence. From 1958 until 1978, he served as Director of the Iowa State Commission for the Blind. In this capacity he was responsible for administering state programs of rehabilitation, home teaching, home industries, an orientation and adjustment center, and library services for the blind and physically handicapped. The improvements made in services to the blind of Iowa under the Jernigan administration have never before or since been equaled anywhere in the country. In 1960 the Federation presented Jernigan with its Newel Perry Award for outstanding accomplishment in services for the blind. In 1968 Jernigan was given a Special Citation by the President of the United States. Harold Russell, the chairman of the President's Committee on Employment of the Handicapped, came to Des Moines to present the award. He said: "If a person must be blind, it is better to be blind in Iowa than anywhere else in the nation or in the world. This statement," the citation went on to say, "sums up the story of the Iowa Commission for the Blind during the Jernigan years and more pertinently of its Director, Kenneth Jernigan. That narrative is much more than a success story. It is the story of high aspiration magnificently accomplishedþof an impossible dream become reality." Jernigan has received too many honors and awards to enumerate individually, including honorary doctorates from three institutions of higher education. He has also been asked to serve as a special consultant to or member of numerous boards and advisory bodies. The most notable among these are: member of the National Advisory Committee on Services for the Blind and Physically Handicapped (appointed by the Secretary of Health, Education, and Welfare), special consultant on Services for the Blind (appointed by the Federal Commissioner of Rehabilitation), advisor on museum programs for blind visitors to the Smithsonian Institution, and special advisor to the White House Conference on Library and Information Services (appointed by President Gerald Ford). In July of 1990 Jernigan received an award for distinguished service from the President of the United States. Kenneth Jernigan's writings and speeches on blindness are better known and have touched more lives than those of any other individual writing today. On July 23, 1975, he spoke before the National Press Club in Washington, D.C., and his address was broadcast live throughout the nation on National Public Radio. Through the years he has appeared repeatedly on network radio and television interview programsþincluding the "Today Show," the "Tomorrow Show," and the "Larry King Show." In 1978 Jernigan moved to Baltimore to become Director of the National Center for the Blind. As President of the National Federation of the Blind at that time, he led the organization through the most impressive period of growth in its history. The creation and development of the National Center for the Blind and the expansion of the NFB into the position of being the most influential voice and force in the affairs of the blind stand as the culmination of Kenneth Jernigan's lifework and a tribute to his brilliance and commitment to the blind of this nation. Jernigan's dynamic wife Mary Ellen is an active member of the Federation. Although sighted, she works with dedication in the movement and is known and loved by thousands of Federationists throughout the country. Speaking at a convention of the National Federation of the Blind, Jernigan said of the organization and its philosophy (and also of his own philosophy): As we look ahead, the world holds more hope than gloom for usþand, best of all, the future is in our own hands. For the first time in history we can be our own masters and do with our lives what we will; and the sighted (as they learn who we are and what we are) can and will work with us as equals and partners. In other words we are capable of full membership in society, and the sighted are capable of accepting us as suchþand, for the most part, they want to.. We want no Uncle Tomsþno sellouts, no apologists, no rationalizers; but we also want no militant hell-raisers or unbudging radicals. One will hurt our cause as much as the other. We must win true equality in society, but we must not dehumanize ourselves in the process; and we must not forget the graces and amenities, the compassions and courtesies which comprise civilization itself and distinguish people from animals and life from existence. Let people call us what they will and say what they please about our motives and our movement. There is only one way for the blind to achieve first-class citizenship and true equality. It must be done through collective action and concerted effort; and that means the National Federation of the Blind. There is no other way, and those who say otherwise are either uninformed or unwilling to face the facts. We are the strongest force in the affairs of the blind today, and we must also recognize the responsibilities of power and the fact that we must build a world that is worth living in when the war is overþand, for that matter, while we are fighting it. In short, we must use both love and a club, and we must have sense enough to know when to do whichþlong on compassion, short on hatred; and, above all, not using our philosophy as a cop-out for cowardice or inaction or rationalization. We know who we are and what we must doþand we will never go back. The public is not against us. Our determination proclaims it; our gains confirm it; our humanity demands it. MARC MAURER - Attorney and Executive Born in 1951, Marc Maurer was the second in a family of six children. His blindness was caused by overexposure to oxygen after his premature birth, but he and his parents were determined that this should not prevent him from living a full and normal life. He began his education at the Iowa Braille and Sight Saving School, where he became an avid Braille reader. In the fifth grade he returned home to Boone, Iowa, where he attended parochial schools. During high school (having taken all the courses in the curriculum) he simultaneously took classes at the junior college. Maurer ran three different businesses before finishing high school: a paper route, a lawn care business, and an enterprise producing and marketing maternity garter belts designed by his mother. This last venture was so successful that his younger brother took over the business when Maurer left home. In the summer of 1969, after graduating from high school, Maurer enrolled as a student at the Orientation and Adjustment Center of the Iowa Commission for the Blind and attended his first convention of the NFB. He was delighted to discover in both places that blind people and what they thought mattered. This was a new phenomenon in his experience, and it changed his life. Kenneth Jernigan was Director of the Iowa Commission for the Blind at the time, and Maurer soon grew to admire and respect him. When Maurer expressed an interest in overhauling a car engine, the Commission for the Blind purchased the necessary equipment. Maurer completed that project and actually worked for a time as an automobile mechanic. He believes today that mastering engine repair played an important part in changing his attitudes about blindness. Maurer graduated cum laude from the University of Notre Dame in 1974. As an undergraduate he took an active part in campus life, including election to the Honor Society. Then he enrolled at the University of Indiana School of Law, where he received his Doctor of Jurisprudence in 1977. Marc Maurer was elected President of the Student Division of the National Federation of the Blind in 1971 and re-elected in 1973 and 1975. Also in 1971 (at the age of twenty) he was elected Vice President of the National Federation of the Blind of Indiana. He was elected President in 1973 and re-elected in 1975. During law school Maurer worked summers for the office of the Secretary of State of Indiana. After graduation he moved to Toledo, Ohio, to accept a position as the Director of the Senior Legal Assistance Project operated by ABLE (Advocates for Basic Legal Equality). In 1978 Maurer moved to Washington, D.C., to become an attorney with the Rates and Routes Division in the office of the General Counsel of the Civil Aeronautics Board. Initially he worked on rates cases but soon advanced to dealing with international matters and then to doing research and writing opinions on constitutional issues and Board action. He wrote opinions for the Chairman and made appearances before the full Board to discuss those opinions. In 1981 he went into private practice in Baltimore, Maryland, where he specialized in civil litigation and property matters. But increasingly he concentrated on representing blind individuals and groups in the courts. He has now become one of the most experienced and knowledgeable attorneys in the country regarding the laws, precedents, and administrative rulings concerning civil rights and discrimination against the blind. He is a member of the Bar in Indiana, Ohio, Iowa, and Maryland; and he is a member of the Bar of the Supreme Court of the United States. Maurer has always been active in civic and political affairs, having run for public office in Baltimore and having been elected to the board of directors of the Tenants Association in his apartment complex shortly after his arrival. Later he was elected to the board of his community association when he became a home owner. From 1984 until 1986 he served with distinction as President of the National Federation of the Blind of Maryland. An important companion in Maurer's activities (and a leader in her own right) is his wife Patricia. The Maurers were married in 1973, and they have two childrenþDavid Patrick, born March 10, 1984, and Dianna Marie, born July 12, 1987. At the 1985 convention in Louisville, Kentucky, Dr. Kenneth Jernigan announced that he would not stand for re-election as President of the National Federation of the Blind the following year, and he recommended Marc Maurer as his successor. In Kansas City in 1986, the convention elected Maurer by resounding acclamation, and he has capably served as President ever since. National Federation of the Blind You can help us spread the word... ...about our Braille Readers Are Leaders contest for blind school children, a project which encourages blind children to achieve literacy through Braille. ...about our scholarships for deserving blind college students. ...about Job Opportunities for the Blind, a program that matches capable blind people with employers who need their skills. ...about where to turn for accurate information about blindness and the abilities of the blind. Most importantly, you can help us by sharing what you've learned about blindness in these pages with your family and friends. If you know anyone who needs our assistance please contact us. Other Ways You Can Help... Donations in MemoryþWhen a loved one dies, many persons like to make contributions to a nonprofit organization such as the National Federation of the Blind as a living memorial to the deceased. In this case, you may wish to print the name and address of the NFB in the obituary and have it announced at the funeral services. Matching GiftsþSome employers will match all or a percentage of an employee's donation to a charitable organization. We participate in such programs and can comply with any paperwork and guidelines requested by your employer. Bequests in a WillþYou can remember the National Federation of the Blind in your will by employing the following language: "I give, devise, and bequeath unto National Federation of the Blind, 1800 Johnson Street, Baltimore, Maryland 21230, a District of Columbia nonprofit corporation, the sum of $__________ (or "_______ percent of my net estate" or "The following stocks and bonds: _______") to be used for its worthy purposes on behalf of blind persons." Combined Federal CampaignþIf you are a federal employee you may designate the National Federation of the Blind to receive your CFC contribution. You will find us listed in the Independent Charities of America Section. Our CFC designation number is 1205. Helpful Products Here are a few of our most frequently requested items. If you wish any of these products, please send payment with your order. For a complete listing of everything we carry ask for our "Aids and Appliances Order Form." Cane (White wooden support - 39 inches) $9.00 Cane (White, Lightweight Fiberglass, Non-Support, 53 inches. Specify rigid or telescoping) $25.00 Kitchen Timer with Tactile Markings $8.75 LetterWritingGuide $1.00 Magnifier (3 lens, folding, pocket-size) $6.50 Needle Threader $1.25 Playing Cards Brailled, regular deck $6.00 Brailled, Pinochle $4.00 Large Print, single deck $3.50 Large Print, double deck $5.00 Large Print, Pinochle $2.00 Signature Guide $4.00 Talking Alarm Clock $20.00 Additional Resources Available from the National Federation of the Blind Catalogs Literature & Materials Order Form A listing of articles and speeches about blindness ranging from current legal issues to tips on daily living to information on Social Security. Aids & Appliances Order Form Descriptive listing of various aids and appliances. Contains a multitude of items, including canes, slates and styluses, Braille paper, 4-track cassette recorders, Braille watches, talking clocks and calculators, kitchen items, and games. Selected Literature for Blind Youth Order Form Brochures Blindness and Disorders of the Eye The Blind Child in the Regular Preschool Comments on Clothing Diabetes, Complications, Options Parents of Blind Children So You Don't Know Anything About Computers and You Might Like to Nibble Who are the Blind Who Lead the Blind * All of the above are available FREE from the National Federation of the Blind.