Blindness and Low Vision

Toolkit Table of Contents

• Definition(s)
• Quick Tips
• Overview
• Action Items
• Data
• Trends
• Resources for Librarians
• Resources for Patrons
• References

Definitions(s)

Blindness

Blindness encompasses a range of visual impairments, including legal blindness, where a person may only perceive light and dark or need to be very close to objects to see them. People who are blind often rely on mobility aids such as canes or guide dogs. It's important to note that blindness does not always mean total lack of vision.

Low Vision

Low vision refers to a condition where a person has some usable sight, but it is not sufficient for daily activities like reading or driving without assistance. Individuals with low vision may struggle with recognizing distant images or distinguishing between similar colors. They often benefit from large print materials, high-contrast signage, and well-lit environments.

Legal Blindness

Legal blindness, in the U.S., typically means visual acuity of 20/200 or worse in the better eye with corrective lenses, or a visual field of 20 degrees or less. This definition is important for determining eligibility for certain services and resources

Quick Tips

• Initial Interaction:
  • Speak in your normal tone of voice.
    Avoid yelling or speaking loudly—vision loss does not affect hearing.
  • Identify yourself and others with you.
    In a group setting, also identify the person you are addressing.
  • Announce your comings and goings.
    Don’t leave a blind person talking to an empty chair—say when you’re leaving or arriving.
  • Ask the patron, “How may I help you?”
    This opens the door for them to express their preferences or needs.
  • Speak directly to the patron, not through a sighted companion.
    Always address the person with vision loss directly.
• During Conversations or Meetings:
  • In a meeting, identify yourself when you begin speaking.
    This helps the person know who is talking.
• Guiding and Giving Directions:
  • When giving directions, use the clock face as a reference.
    For example: “The reference desk is about two feet ahead at three o’clock.”
  • Offer to escort the patron to their destination.
    Don’t assume—ask first.
  • When guiding a patron, offer your elbow.
    • Stand next to and slightly ahead of the patron.
    • Describe your path, including obstacles and changes in elevation.
    • If the path narrows, move your elbow back so they can walk behind you.
• Respecting Guide Dogs:
  • Do not touch or pet a guide dog.
    These dogs are working and should not be distracted.
• Library Environment and Accessibility:
  • Have materials available in a variety of formats.
    Ask for preferences—large print, Braille, or audio.
  • Ensure the library is well lit and signage is accessible.
    Use high contrast, large print, and Braille where possible.

Overview

The terms “blindness” and “low vision” cover a wide variety of experiences, including legal blindness, limited visual acuity, and color blindness. People with low vision, for example, have different challenges than people who are blind.

A person with low vision has some useful sight. However, low vision usually interferes with the performance of daily activities, such as reading or driving. Persons with low vision may prefer to read large print. A person with low vision may not recognize images at a distance or be able to differentiate between colors of similar hues. Those who are legally blind may only see light and dark images and may need to be inches away from objects to observe them properly.

Blind persons may use mobility aids, including canes and guide dogs. It is always best to ask the patron what you can do to assist, rather than assuming that help is needed.

Materials and Assistive Technology

• Large-print books and magazines that have a typeface greater than font size 14.
• Braille books and magazines (some with tactile graphics) available on loan from the National Library Service for the Blind and Physically Handicapped (see “Collection Development Resources,” below).
• Combination Print/Braille picture books that sighted individuals and Braille readers can enjoy together.
• Various audiobook formats, such as CDs, downloadable audiobooks, and eBooks.
• Audio-described television programs (formatted to include a narration of events which are happening for which there isn’t a dialogue) and movies on DVD.

Action Items

1. Conduct Accessibility Audits of Library Spaces and Services
   • Regularly evaluate the physical and digital accessibility of the library.
   • Ensure signage includes large print, high contrast, and Braille.
   • Check that lighting is adequate and that aisles are clear for safe navigation.
   • Review the library’s website and catalog for screen reader compatibility.
2. Offer Materials in Multiple Accessible Formats
   • Provide books and resources in large print, Braille, audio, and digital formats.
   • Partner with services like the National Library Service for the Blind and Print Disabled (NLS).
   • Ask patrons about their preferred format and keep a record to personalize future service.
3. Train Staff in Disability Etiquette and Assistive Technology
   • Host regular training on how to interact respectfully and effectively with blind and low-vision patrons.
   • Familiarize staff with assistive technologies like screen readers, magnifiers, and Braille displays.
   • Encourage staff to practice guiding techniques and communication strategies.

Data

Blindness and low vision affect millions of Americans across all age groups, with a particularly high prevalence among older adults. As of recent estimates, over 7 million people in the U.S. experience vision loss or blindness, and this number is projected to rise significantly due to aging demographics and chronic health conditions. Vision disability is one of the top ten disabilities among adults and is also common among children. Despite the high prevalence, many individuals do not receive timely eye care, often due to cost or lack of awareness. These statistics underscore the importance of accessible library services, including materials in alternative formats and staff trained in disability etiquette. Libraries play a vital role in bridging the information gap and supporting the independence and inclusion of blind and low-vision patrons.

• Over 7 million Americans live with vision loss or blindness. Of these, approximately 6 million have vision loss and 1 million are blind, based on best-corrected visual acuity.¹
• About 5.5% of U.S. adults have a vision disability, defined as blindness or serious difficulty seeing even when wearing glasses.²
• Vision impairment affects 12 million people aged 40 and over, and this number is expected to more than double by 2050 due to the aging population and chronic conditions like diabetes.³

Trends

1. Accessible Digital Collections and Platforms - Libraries are increasingly adopting screen reader-compatible eBook platforms, audiobook services, and accessible websites. Many now partner with services like Bookshare, BARD (Braille and Audio Reading Download), and OverDrive’s Libby app, which offer customizable text sizes, high contrast modes, and audio formats.
2. Inclusive Design in Library Spaces - Modern libraries are being redesigned with universal design principles in mind. This includes:
   • High-contrast signage with Braille
   • Tactile floor indicators
   • Adjustable lighting
   • Wayfinding apps that use audio cues or haptic feedback to help patrons navigate independently
3. Staff Training and Community Partnerships - Libraries are investing in ongoing staff training on disability etiquette and assistive technologies. They also collaborate with local organizations serving the blind and low-vision community to host adaptive technology demonstrations, support groups, and inclusive programming like tactile storytimes or audio-described film screenings.

Resources for Librarians

Collection Development Resources

Electronic, Digital Format

• Bookshare is an online library that makes reading accessible for people who cannot read standard print. A registration fee is required for persons who are not students at qualified United States schools.
• Canadian National Institute for the Blind Library supported by the Canadian Institute for the Blind, the library provides books, magazines, and newspapers in French, Spanish, and other languages. The library also provides an electronic meeting place for registered patrons, as well as books in large print and Braille.
• National Library Service for the Blind and Print Disabled (NLS) is a free braille and talking book library for people with temporary or permanent low vision, blindness, or a physical disability that prevents them from reading or holding the printed page. Through a national network of cooperating libraries, NLS circulates books and magazines in braille or audio formats, delivered by postage-free mail or as instant downloads.
• Learning Ally is a national non-profit organization that provides programs and technology to help students with print disabilities, including blindness, visual impairment and dyslexia.

Print/Braille Book Resources

• National Braille Press (NBP) publishes low-cost braille books for children and adults.
• Seedlings Braille Books for Children produces Braille books for children and young readers.
• Braille Institute Special Collection program provides blind and visually impaired children with free braille books and storybook kits.

Resource Technology

• American Foundation for the Blind (AFB) provides information, resources, and technology consulting services for the purpose of improving access for blind and visually impaired Americans.
• American Printing House for the Blind (APH) is the world’s largest nonprofit organization creating educational, workplace, and independent living products and services for people who are visually impaired.
• Media Access Group at WGBH provides instructions for audio description, as well as information about captioning and description for television shows, films, and videos.

Resources for Patrons

References

1. Centers for Disease Control and Prevention. (2024, May 15). VEHSS modeled estimates: Prevalence of vision loss and blindness. U.S. Department of Health & Human Services. https://www.cdc.gov/vision-health-data/prevalence-estimates/vision-loss-prevalence.html
2. Centers for Disease Control and Prevention. (2024, July 15). Disability impacts all of us infographic. U.S. Department of Health & Human Services. https://www.cdc.gov/disability-and-health/articles-documents/disability-impacts-all-of-us-infographic.html
3. Centers for Disease Control and Prevention. (2024, May 15). Fast facts: Vision loss. U.S. Department of Health & Human Services. https://www.cdc.gov/vision-health/data-research/vision-loss-facts/index.html 

Toolkit updated by the Lauren Kehoe, Accessibility Assembly, June 2025.