What Is the Meaning of Legally Blind?

If you are deemed "legally blind" it means your central visual acuity—the part of your vision that allows you to see straight ahead—is 20/200 or less in your better eye when wearing corrective lenses or your field of vision is no more than 20 degrees.

With 20/200 vision, you can see at 20 feet what a person with 20/20 vision sees at 200 feet. If your field of vision is 20 or less, it means you can only see things right in front of you (not to the sides) when staring forward.

The criteria for legal blindness are particularly relevant when it comes to state driving laws and eligibility for Social Security disability benefits, tax exemptions, and other federal or state benefits.

This article explains what it takes to be declared legally blind in the United States. It also describes how people with low vision are tested, what causes the loss of vision, and how it can be treated.

Definition of Legal Blindness

To be considered legally blind, you must meet one of two criteria for visual acuity (sharpness of vision) and visual field (the entire scope of what you can see without moving your eyes):

• Visual acuity of 20/200 or less in the eye you can see out of best (while wearing corrective glasses or contacts)
• A visual field of no more than 20 degrees

The definition can be applied to people with total blindness as well as those who can see but with limitations that severely impact mobility, employment, and normal daily functioning.

That said, most people who are legally blind have some vision. Among those people living with an eye disorder, about 85% have some sight and 15% are totally blind.

Although the definition of legal blindness tends to be the same between states, there are variations in how "low vision" is defined. Some states allow drivers with 20/70 vision to drive with the appropriate eyewear or contact lenses, while others do not.

Visual Acuity

Visual acuity refers to how close a person needs to be to an object that's 20 feet away in order to see it in detail. Normal vision is measured as 20/20. If you had visual acuity of 20/80, it would mean that you would be able to see details from 20 feet away the same as a person with 20/20 vision could see from 80 feet away.

A legally blind person with 20/200 vision (with the best corrective lenses) would need to be 20 feet from an object in order to see it as well as someone with 20/20 vision could see it from 200 feet away.

Low vision is a visual acuity of 20/40 or worse while wearing corrective lenses.

Visual Field

If a person has a visual field of only 20 degrees, they can see things that are right in front of them without moving their eyes from side to side, but they can't see anything on either side (peripheral vision).

A visual field of 180 degrees is considered normal. A severely limited visual field sometimes is called tunnel vision. It makes it nearly impossible to drive safely.

Diagnosing Low Vision and Vision Loss

An eye doctor measures visual acuity and visual field to determine if a person is legally blind, and whether wearing glasses or contact lenses could improve their vision.

A common test for visual acuity is the Snellen eye chart. Someone who is legally blind would be able to read only the top line of the chart (a capital E) while wearing corrective lenses. The line below the big E is the line for 20/100.

There are also tests that can measure in between 20/200 and 20/100. Someone who cannot view the line for 20/100 but sees somewhere between 20/100 and 20/200 would still meet the government's standard of legal blindness, which is why it is listed as "20/200 or less."

Visual field testing often begins with a confrontational visual field test. An eye doctor has you cover one eye at a time. They then hold up one or more fingers in different quadrants of the visual field to find out if you can see them while keeping your eyes focused on a central point ahead.

There are also more comprehensive computerized tests that use flashing, flickering, or moving lights or images to measure your visual field. It involves pressing a button when you see the light or images.

Conditions Linked to Legal Blindness

There are many conditions that can lead to legal blindness, but the most common ones are age-related. In many cases, early diagnosis and treatment for these can prevent blindness. They include:

• Age-related macular degeneration
• Cataracts (cloudiness of the clear lens of the eye)
• Diabetic retinopathy (a complication of diabetes)
• Glaucoma

Eye trauma or injuries and genetic conditions, such as Usher syndrome, can also lead to legal blindness.

Treatment of Legal Blindness

Treatments for legal blindness vary depending on the cause and the stage of the disease that has caused the loss of vision. For age-related eye diseases, treatments typically involve prescription medications or eye procedures to try to delay or keep the vision from worsening.

The goal of treatment for glaucoma is to reduce eye pressure. This can be achieved with prescription eye drops or oral medications, laser procedures, and, in severe cases, surgery to try to prevent further damage. Careful monitoring of glaucoma and other age-related eye diseases is important; it can help determine if the treatment is working or needs to be adjusted.

Cataracts are the exception in that vision can be restored with surgery to remove the clouded lens and, in most cases, replaced with an implant.

Prevention of Vision Loss

The best way to prevent vision loss is to take care of your overall health (including your eyes). Seeing your healthcare provider regularly and getting your eyes examined can help alert you to conditions, like diabetes, that could impact your sight.

Other steps you can take to safeguard your sight include maintaining a healthy weight (which could put you at risk of developing diabetes), wearing eye protection for certain activities (such as sports), and eating a healthy diet rich in fruits and vegetables.

Summary

Most people who are legally blind have some vision. And to be deemed "legally blind," their vision must be bad enough that they meet one of two standards: They must have a visual acuity of 20/200 or less in the eye they can see out of best (while wearing corrective glasses or contacts) or have a visual field of no more than 20 degrees.

Ophthalmologists and optometrists have several tests at their disposal to confirm a diagnosis. Legal blindness can make you feel helpless, but unfortunately, some health issues that can lead to this condition simply become more commonplace as people get older.

Low vision or legal blindness can be limiting, but there are many resources and assistive devices to help you live your life with a spirit of independence. Depending on the cause of your vision loss, you may be able to benefit from eye exercises and strategies for participating in everyday activities.

You may also find that using a cane, talking calculator, special computer software, or other products designed to support people who are legally blind to be helpful.