Through most of my life I have experienced huge fatigue when looking/reading for any length of time over two or three minutes. Low vision friends tell of similar experience. Even with the latest and best electronic  magnifiers, this fatigue does not go away although it is lessened to some extent. You quickly get to the stage where you want to rub your eyes, scream and just do something else, anything else that is not visual.

Crazily it took me years to really rely on speech output and listen rather than look when reading or writing. It’s as if your brain compels   you to keep looking while you have some sight. It’s so obvious, this low vision fatigue that I could not believe it needed academic research to prove its  existence but…here is a link to a Dutch research project which, if you can rise above the language of the experts, supports low vision  fatigue as a  reality.


My  precis  of the research and my precis of personal and professional experience and shared knowledge is that prolonged low vision looking is bloody tiring and we need to adopt a way of life which avoids it where possible’.

It is the language that causes the misunderstandings. Low vision fatigue used to be called eye strain. But it was and is not the eyes themselves that were strained. Rather it  is the mental processes involved that soon lead us to feel necked.  Eye strain has for several years been poopooed and we have been rightly urged to look look look, to use our vision rather than lose our remaining vision. But the fatigue, of course, continues because it is real. We allowed the language to become confusing.

My Hope is that, when professional awareness training is delivered,(sadly too often by seeing people), low vision fatigue will be listed amongst the major experiences.

I imagine that very few readers will want to read the whole research project; but I offer the abstract below for those wanting a little mor in-depth understanding. But, again, there is a language problem. First you have to get your head round cognitive and   first-level codes and the like; but its good stuff   and well worth reading. Remember the punchline, though: ‘Low vision looking/reading is bloody tiring’. And maybe a good coping strategy is to make the best and most  appropriate use of assistive technologies.

Webpage: Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study | BMJ Open

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Qualitative research


Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study

Wouter Schakel,

Christina Bode,

Hilde P A van der Aa,

Carel T J Hulshof,

Judith E Bosmans,

Gerardus H M B van Rens,,

Ruth M A van Nispen

Heading 2: Author affiliations

Heading 2: Abstract


 Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies.

Setting Two large Dutch low vision multidisciplinary rehabilitation organisations.

Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling.

Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top–down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding.

Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue.

Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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Heading 3: Strengths and limitations of this study

This qualitative study provides an in-depth exploration of the patient perspective of fatigue in visually impaired adults regarding symptoms of fatigue, causes, consequences and coping strategies.

Participants were selected from two Dutch low vision multidisciplinary rehabilitation centres through purposive sampling to reflect a range of demographic characteristics (gender, age and work status) and disease characteristics (ophthalmic diagnosis, visual acuity, visual field and disease duration).

Participant’s symptoms of self-reported fatigue were checked with a well-validated instrument to assess fatigue severity.

A random selection of 10% of the citations was matched to the existing coding scheme independently by a second researcher to improve reliability of the coding process.

Limitations include the relatively small sample size and the relatively young age and high amount of rare eye conditions in our sample which may limit the transferability of the findings to the total population of visually impaired adults.

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