When I was nine years old, I got my eyes checked as part of the routine pre-school-year physical, and they were normal vision. Three months later I got my first set of glasses. I’ve always been one of those folks whose eyesight is fine until it suddenly falls off a cliff… one day I can read the street signs just fine, a few weeks later I’m asking my brother if that speed limit sign said 25 or 55.
(His answer, by the way, was “55, and when we get to the mall you’re going straight to Lenscrafters.”)
By the time I was in my 30s, my eyesight had somewhat leveled out at -6.00 diopter, which is worse than 20/400 if you prefer the snelling chart. What that means, in concrete terms is that I could not identify the big E at the top of the eye chart except that it’s always a big E. For me, it was a big black blur.
That is, until last Friday, when I had my vision corrected using LASIK surgery.
Now, a week later, I have 20/20 vision.
According to the American Academy of Ophthalmology, 150 million Americans use corrective eyewear in the United States as of 2015, which is just under half of us. Now, according to the Census Bureau in 2012, only 56.7 million Americans reported having a disability.
S0 150 million Americans can’t see at “normal” levels without correction, but only 56.7 million Americans self-report that they have a disability, and we can be pretty sure that they’re not all reporting myopia… really what we’re really saying here is that people who require vision correction don’t consider themselves disabled even though they require an accessibility device — glasses or contacts — to do their daily tasks.
This is why I refer to poor vision as a mainstreamed disability in my Alphabet of Accessibility talk. When your disability is so normal that half the people around you also have it and nobody even considers it a disability, well, that’s where we want disability recognition to be for everyone.
And no one says things like “We don’t build websites for people who are farsighted” or “We’re not designing for a web that includes glasses” or “Well how many glasses users do we have, anyway? Do we really need to support them?”
That’s not a perfectly honest comparison — screen readers or other accessibility tools are often in place not to correct a disability but to provide a second source of information in the cases where there is no accessibility tool that will give the user the same experience as a non-disabled user. Glasses, on the other hand, give the user the same experience.
But still, I’d be equally dishonest if I told you that I wore some kind of vision correction every single day from dusk til dawn since I was 9 years old and it was not an accessibility device. On the snelling chart, 20/200 is considered legally blind, and I was significantly worse than 20/400. I wasn’t just not legally allowed to drive without my glasses, I wasn’t able to walk around my house without my glasses. (Tiny dogs do not make this easier, by the way.)
And now I’m not legally blind anymore. I require no vision correction at all. And it is weeeeeeird.
Accessibility is only one half of disability. The other part is the culture, the history, the knowledge. When someone tries to group me under the label of accessibility, it makes me think they want my needs but they don't want my thoughts.
— Liz Jackson (@elizejackson) March 22, 2019
I didn’t realize I was living in a culture of people who wear glasses until I stopped being one of them sometime around let’s call it last Sunday. (The surgery was Friday and frankly, I didn’t cope well. Saturday was a lot of fuzziness and Sunday was the first day I really realized I could see.)
First of all, there was no point in keeping my old glasses anymore. See, when you’re in the glasses culture, there’s always a fear that you’re going to break your glasses or lose your contacts or rip a contact or something, so you always need to have a backup pair. But the surgery isn’t like a new pair of glasses. I can’t take it off. I can’t lose it. And if my eye rips, well I’ve got bigger problems than my old glasses will fix.
I discovered I had six pairs of glasses in the house. One in the car, two in a desk, two upstairs, and the pair that were my actual prescription as of a week ago. That’s about eight years of glasses. Realistically the oldest pair probably wasn’t even particularly clear anymore, but they would have still been better than a broken pair, so I kept them.
I also had about a two year supply of contacts on hand, for those days where I felt like shaving my legs and actually being able to see them at the same time. (Fun fact: most of the time most of us blind-as-a-bat glasses wearers shave by feel. Some of us wear contacts specifically for the purpose. My contacts didn’t correct my astigmatism, so I wore them mostly for swimming and showering, and tried to avoid them for driving.)
I also discovered that I didn’t understand what 20/20 vision was. When I was severely nearsighted, I held my phone within about five inches of my nose, because I could focus there, and the images were crystal clear. Now? Can’t see shit at that distance. My focal point has moved out to where it belongs, roughly half my arm’s length. I had no idea that 20/20 meant not seeing things up close the way I always had. I figured the whole distance from my nose to my arm’s length was clear for “people who could see”. Yeah, not so much. I’m constantly having to move things away from myself to see them, which is extremely unintuitive after 32 years of moving things closer to see them.
I have, in fact, poked myself in the nose multiple times trying to push up my glasses because a room was steamy and I thought my glasses needed to be moved back. No glasses, no adjusting the focal point manually.
I had to invest in protective eyewear for the yard. Can’t count on my coke-bottle glasses to protect me from rocks and sticks kicked out by the weed whacker anymore. (And yes I know I shouldn’t have been doing so before, but I did.) Similarly, I have to go buy sunglasses, and remember to take them with me places, because my trusty transition lenses are a thing of the past. I’ve bought sun glasses so rarely in the past I’m not even sure how to start. Do I get the cheap ones at the Rite Aid because I’ll be losing them constantly, or a good pair that will be a lot more comfortable but which I really don’t want to lose?
And I’m really worried that I’ll forget what it was like to not be able to see. I know that sounds a bit unintuitive – who wouldn’t be glad to be able to see so well they could forget what the bad days were like? But now that I’m not in the “shit vision” club, I’m worried I’ll start taking things for granted.
I mean, I don’t remember what it’s like to go to a hotel pool and be able to see all the way across the room, even in my contacts.
What if I lose my ability to empathize with the people who have the disability I had?
It’s all very weird.
I still have three weeks to go before my eyes are healed enough to say whether I’ll need reading glasses or not. I still see a noticeable difference in my vision from one day to the next. (Last Sunday, a pair of +1 reading glasses made using the computer much easier. Today, they’re way too strong and give me an instant headache.) My night vision is improving, I don’t have much dry eye — I have to remind myself to put in drops — and I’ve got to figure out how to get the “requires glasses” note removed from my driver’s license.
And while I knew I needed an accessibility device, I’ve also always been hyper-conscious that my shit vision and being legally blind, having low vision, having cataracts or glaucoma or any number of other conditions were significantly different from each other.
We’re all wearing different lenses on the world. Some are clearer than others. Some have a wider range than others. Some barely work at all.
And mine has changed… which isn’t just changing my vision, it’s changing my culture, my behavior, my self-identification, and the social groups for which I’m a member.
It has me thinking hard about what it means to acquire or lose a disability, what an adjustment period it is, and how, when we are designing for web accessibility we rarely ask:
- Does this person know how to be disabled in this way? Or is it all new to them?
- Do we know how a person’s culture and knowledge changes when they’re an “expert” blind person versus a “new” blind person?
- What aspects of user research and understanding are we neglecting because it’s easier to use the four “the blind person, the deaf person, the dyslexic, and the person with no arm” flat personas than it is to ask “so how do the actual people with disabilities use our site?
I’m hoping to get better about these things. As I learn, I hope you’ll come along for the ride.
Also published on Medium.