“Legally Blind” Doesn’t Mean “Blind As A Bat”

Amid the fallout of Eliot Spitzer’s prostitution scandal and subsequent resignation as Governor of New York comes a bit of ocular news. His successor, David Paterson, becomes the first legally blind governor in U.S. history.

There’s a lot of confusion out there over what exactly “legal blindness” means. I hear patients say all the time, “I’m legally blind without my glasses or contacts.” Well, no, actually you’re not. You’re only legally blind if you’re 20/200 or worse in your better eye with your glasses or contacts.

You can also be legally blind even if you have “perfect” 20/20 vision. That happens if your visual field is constricted to the point that you can only see 20 degrees total or less in your best and widest meridian (i.e., you have “tunnel vision.”). The normal individual, for instance, sees about 160 degrees of peripheral vision in the horizontal meridian, which is the one you use the most while driving.

This article has some good information on legal blindness and how the government and insurers go about its classification. However, I’m not aware of an exception for central or “cortical” blindness as the article states. That would be the type of vision loss that one might get from a stroke or other brain damage, and I have never known of anyone who had that type and met the qualifications who wasn’t eventually classified as legally blind. If there are any eye care professionals out there reading who have seen cortical blindness excluded, please let me know.

Bottom line, “legally blind” doesn’t mean “totally blind” or even “blind as a bat.” Many of my patients who are legally blind are able to live happy and productive lives with proper training, low vision aids, and a good attitude. I’m sure that Governor Paterson’s impaired eyesight will be of little hindrance to him as he attempts to right the New York ship of state.

Have a good weekend. Go Duke. And keep your eyes open–and healthy–out there.