Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Issue 2: What Approach is needed to develop “Guidelines”?

Comment by Jeanne Halloin: There’s another important issue here, though, and Marsha mentioned how much time that these new regulations or guidelines are put out for us to react to, and a lot of us don’t take the time. Eunice usually prods me to taking the time.

But I mean, we have a period of time that we can get in there and say why something isn’t making sense or why something is making sense. And so we do have a chance to get in and get involved [as] the guidelines become standards. And I think more of us have to take that responsibility.

Question by [Participant]: I guess one question I have, too, is, when a guideline comes out and it would appear to have some connection with vision, do you have a set of consultants that you go to and say, okay, what do you think about this? Maybe FAB is one organization [that] would be someone you would go to. But do you have a set of experts?

And again, you know, if it came to me, I’d say, fine, I’ll do the search, and I’ll do my research, and I’ll come up with this, and I can give you my two cents’ worth. But unless I can come up and cite chapter and verse in the research literature, I’m not sure it’s going to have much impact on the development of your [guideline].

Response by [Participant]: Well, that’s why some of us [who] worked on [the] documents – there are published documents that were research based – are the ones that should be getting involved in it.

Response by Marsha Mazz: We would not publish a guideline if we didn’t have some research to support that guideline. That’s cart before the horse. We have to have research that will support the claims that the guidelines make. I mean, after all, the whole intent of any of these guidelines is to provide greater accessibility. If it’s not going to achieve the intended goal, then it’s a true waste of money.

Comment by Fred Krimgold: Can I make a point before we take that next question? What worries me is, we’re going to sit here, and let’s say we do come up with some consensus and some guidelines. The other thing to keep in mind is, when you talk about lighting, for example, no two people are the same. We talk about low-vision patients; Dennis will tell you, sometimes that [he] issues a 60-watt incandescent bulb and bring it close. Sometimes it’s a big [magnifying glass] – can you see these new little lights, these LEDs? They’re bright. I take them to the restaurant all the time, they work great for me.

So I think we have to be careful that we’re not going to be able to find a blanket sort of recommendation that’s going to work in every situation, because every individual with low vision is going to be a little bit different.

Question by Marsha Mazz: And I was going to ask you that very question. When I’m asked what can you do for me, I usually say improve the lighting, the illumination, the lumens for everybody, and I’ll benefit. But that’s true for me. I don’t know if there are people who have vision loss whose needs differ greatly from the needs of the population of people who don’t have vision loss.

Response by Dennis Siemsen: They do differ. And I think with the three of you here with low vision, I think each of you would have a unique preference to type of lighting, positioning of lighting and how much glare and things you could tolerate. And I think this is why we do this on an individual basis with each patient and try to adapt the patient to the environment.

Because we’ll say, like, you produce those filters but we would certainly prescribe different types of filters for different situations to try to cope with that kind of situation.

Question by Greg Knoop: How useful is it the term low vision from the perspective of trying to modify the environment, because as you’ve said, there are very different demands. I had a discussion with the ADA people at Washington Metro. And they said, well, what’s good for some is bad for others, so we’re not going to change anything.

Response by [Participant]: That’s Metro’s answer to everything.

That’s right. But how serious is that? Does low vision identify a common set of needs to which we can respond? Or do we need to differentiate that somehow? And how do we balance this individual modification to environmental modification?

Response by Bob Massof: I think it’s very difficult. And I think we can come up with some general rules. You know, we took this inverse-square law, for example, which is a neat law because, like Dennis said, you bring the light source down twice as close; you can get four times as much light.

It may be that we have to think more in terms of, how do we individually be able to shield that light? So just like we’ve sat in this room or I sit in my car now and my wife can have a different air conditioning than I can have, even though we’re sitting in the same car. It may be that each of us sits down in a room like this, and he might say, I want to back-illuminate the system like my iPad to look at the presentation on the screen. Somebody else might say, I want it projected, but not a screen like that, a screen like this.

It may be we have to figure out, is there a way of designing lighting systems, is there a system you implement into a building, which give individuals the ability to adjust lighting, whether we adjust the height of our chair to where we’re sitting, we have to have some type of maybe lamps on the table where it’s a gooseneck and we bring it down and it has a choice of lighting perhaps –

Question by Greg Knoop: Are there useful subdivisions of the concept of low vision that are reasonably similar and consistent?

Response by Dennis Siemsen: Consistent? Boy, I think that’s something that we struggle with a lot, even within our professional organizations. We’re members of the section on low vision in the American Academy of Optometry, okay, so that means something to the doctors that are in the academy. But it doesn’t for other people, low vision could mean anything from, if I take my glasses off, I can’t see the paper, to someone who is totally blind. And we can substitute other terms like vision impairment or [disability] – severe, profound, blah, blah, blah. But again, that doesn’t help the person who only has general knowledge or no knowledge of vision loss.

Comment by Vijay Gupta: I think there are two separate issues. One is the workstation and one is the public space. I think [the] work place is very clear, all these [workstation] or other issues. Then there are the public space types of issues. I mean, we can at least modify a workstation to suit an individual, right? Whereas in a public space, we’re at the mercy of –

Comment by Dave Munson: [For a] GSA project several years ago, they put out the requirements of footcandles and ESI and VCP and all these technical terms. And then after the job was completed, they wrote a paper called “Lessons Learned.” The problem was, in order to meet the guidelines, the lights were spread so far that by the time you put the workstation in, there was no light in the workstations. So everybody added all workstation lighting. Guess what? Twice as much energy being consumed by the lighting. But if it was an overhead system, it was lighting each individual space.

Question by Jim Woods: I want to pick a little bit up on what Fred was saying and maybe twist it just a bit. Since we’ve got practitioners at the table, what would you like to see from the design profession that is going to help you the most?

Response by Dennis Siemens: I think consistency would be one thing. Because what we are faced with is, we have no clue when a patient comes and says to us, I’m having a problem getting to work because of lighting. I don’t know really what the lighting in the building is. I don’t do site visits, so I don’t know what’s sort of the minimum standard with which they’re working. I can relate to the Metro, because I take the Metro, so I definitely know what the issue is in the Metro station.

But because there is no consistency, I guess, you know, I didn’t know I’d walk into this room and there would be lights like this. How do we as practitioners – that’s why I went back to that original thing, that all we’re able to do is to try to adapt the individual to the situation. In other words, you throw the situation at us, and we’ll go, okay, yeah, what do you think?

And it’s trial and error. I wish I could say it was more scientific, but it’s not.

Question by Jim Woods: So is that what you need, then, is a scientific base from the environmental standpoint to help you make decisions?

Response by Dennis Siemsen: Some consistency. I think if we knew that all hallways have this amount of luminance and this amount of glare and this is what it would be like, then I think it’s certainly easier to work with.

Question by [Participant]: What color?

Response by [Participant]: In the Labor Department, we got sued many times, not because we didn’t have enough illumination, it’s because we didn’t have enough luminance.

That’s where [there were] dark, dark, dark, dark, dark green walls. Some of the light, we couldn’t get quite 50 footcandles in the toilet and the cost for not having open enough [lighting], because you couldn’t get an occupancy permit, gets really expensive. So it’s a total environmental issue. It’s not just lighting, it’s not just interior design, it’s a coordination of all of this. And the architects with the clear glass and the, you know – it’s a very complicated problem. There’s not just one solution.