When I was in middle school, I noticed that it was easier to read text early in the morning compared to later in the day when my eyesight would be worse, not realizing this was due to fluctuating eyesight. As I got older and my vision continued to change, I found that my vision would sometimes change several times throughout one class period due to factors outside my control. I wasn’t sure how to tell my history teacher that I suddenly couldn’t read the board even though I could earlier, and I was certain my math teacher would question why I couldn’t read the large print that I could read easily earlier in the day.
Learning about fluctuating eyesight and how my vision changes due to different environmental factors has helped me a lot as an adult in the context of using assistive technology, as well as making sense of my visual experiences from when I was younger. Here are my tips for disability accommodations for fluctuating eyesight and ways to manage short-term vision changes with assistive technology.
Factors that contribute to fluctuating eyesight
In this context, fluctuating eyesight or fluctuating vision refers to vision clarity or vision performance that changes frequently, which may be described as having good or bad vision days, or more frequent vision changes/fluctuations throughout the day. This can be an issue for individuals with “stable” vision conditions that find it more challenging to use their vision in specific settings, or for individuals that have vision conditions that change over time.
Examples of factors that may contribute to fluctuating eyesight for visually impaired individuals include:
- Fatigue and eye strain, especially after performing visually demanding tasks
- Allergies
- Weather
- Heat or changes in temperature
- Indoor lighting
- Sunlight or bright lights
- Nighttime or dim/dark lighting
- Pain levels
- Illness
- Environmental layout
- Overstimulation or sensory overload
- Hormones or other internal experiences (e.g. hunger, anxiety)
- Additional disabilities or chronic illnesses that impact vision
- Availability of vision breaks or other opportunities to rest eyes
I use the term fluctuating eyesight to specifically refer to these short-term vision changes that impact how I use my “baseline” level of vision, and consider this separate from the vision changes I experience from a progressive condition. Unlike the long-term changes, these fluctuations vary from day to day and there are ways I can either predict them or help minimize their effects on my usable vision.
Related links
- Learning To Explain Usable Vision
- Lighting And Low Vision
- Ten Ways To Reduce Eye Strain From Screens With Technology
- Reduce Glare In The Classroom For Low Vision Students
- Activity Ideas For Vision Breaks
- Avoiding Flashing Lights On Social Media
How I explain my own fluctuating eyesight
In my case, I have vision loss from both an eye condition (ocular visual impairment) and a neurological condition, so both my eyes and brain play a role in how I use my vision in a particular environment. Some examples of how my fluctuating eyesight manifested in the classroom environment include:
- After taking a math test, I would have trouble focusing my eyes to read a book on my eReader, as the words would appear blurry and have a double image move across the page. I couldn’t focus my eyes on the page or recognize any text.
- Seasonal allergies can contribute to higher levels of eye pain, which can make it more challenging to use my vision effectively, especially when locating buildings on my college campus
- Barometric pressure changes can make it challenging to focus my eyes, and the glare from snow can make it challenging to walk outside safely.
- Hot temperatures can make it hard for me to read or focus my eyes, and my surroundings become more blurry or hard to distinguish.
- Bright lighting contributes to eye pain that can make it hard to make sense of my environment, or locate items or people. Dark environments can also be challenging as I often rely on color for visual landmarks, which may be more muted
- If I have a migraine coming on or if I’m dealing with higher pain levels, it is hard to focus on visual tasks and my surroundings will appear distorted
- In a crowded place, my eyes will have trouble focusing on any one particular item, and my surroundings will just appear to be a sea of colors, with no one object really standing out
- Hunger can make it challenging to focus my eyes or concentrate on visual tasks
- If I don’t have an opportunity to take vision breaks between visually demanding tasks or environments, it becomes much harder for me to use my vision which is incredibly stressful. If I get pushed to a point where I can’t use my vision at all, I “shut down” and have to rest my eyes by sleeping
Related links
- Adapting Page Layouts: Math Problems and Low Vision
- Walking In The Snow: College O&M
- Disability and Classroom Accommodations For Chiari Malformation
- Managing Chronic Migraines in College
- School Cafeterias and Low Vision
- Quiet Places At School For Students With Visual Impairments
- A to Z of Assistive Technology for Reading Digital Text
Accommodating fluctuating eyesight with assistive technology
While I may not have control over my environment or other factors, I can control how I access information visually or non-visually by accommodating fluctuating eyesight with assistive technology, which provides me with increased flexibility in how I interact with content. Some examples of how my fluctuating eyesight can impact my assistive technology preferences include:
- Adjusting the font size of text content or enabling additional settings such as a line guide or increased spacing that can make text easier to read. Simplified reading displays are a great tool for this!
- Turning on a high contrast display, invert colors, or dark mode to decrease the complexity of visual content and reduce bright light
- Downloading content in multiple file formats so I can choose one that best fits my access needs (e.g. PDF and HTML)
- Choosing applications that also support text-to-speech or a screen reader, which can read text out loud or assist with navigation. Choosing highly customizable apps makes it easy to adjust my preferences, as does having multiple apps that can be used for a task depending on how I want to use my vision
- Enabling specific accessibility settings for an application, or enabling tools like a screen reader or screen magnification for specific tasks
- Using virtual assistants like Alexa or Siri to look up information, or using a visual assistance app that can identify objects and read text
Another example that comes to mind is using different orientation and mobility (O&M) tools and strategies to navigate in different environments. If I am having a “bad vision day”, I might use human guides more frequently or get detailed instructions from an app to help me get from one place to another.
Related links
- A to Z of Assistive Technology for Reading Digital Text
- Simplified Reading Displays and Low Vision
- Choosing Between Light Mode and Dark Mode For Low Vision
- How To Use Invert Colors With Low Vision
- How I Read Research Sources With Assistive Technology
- Enabling Temporary Accessibility Settings For iPad
- App Accessibility Checklist for Low Vision
- All About Visual Assistance Apps For Visually Impaired
- Smartphone Apps For Orientation and Mobility
Disability accommodations for fluctuating eyesight
My disability accommodations have been written with my fluctuating eyesight in mind, and my teachers and professors are aware that I may not need to use every accommodation I have been approved for in their specific class. Examples of accommodations for fluctuating eyesight include:
- Providing copies of information presented on the board or in a meeting that I can view on my own device
- Favoring digital copies of assignments and content over print/physical copies, as I can adjust the font size and other display characteristics independently
- Requesting digital content in an adaptive file format that can support large print sizes and text-to-speech access if needed. DOCX (Word), HTML, and EPUB are examples of file formats that could be used in this context, compared to PDF that does not allow for customizing appearance of text
- Purchasing digital textbooks that support text-to-speech access
- Approving extended time for assessments to accommodate for vision breaks or use of assistive technology
- Allowing screen magnification or the use of video magnifiers for enlarging content
- Approving text-to-speech or screen readers for reading text out loud, or having permission to ask someone to read content out loud
- Wearing tinted glasses in the classroom to minimize bright lights
- Labeling items in more than one way, such as using a mix of text labels and color coding
- Providing audio description or supplemental transcripts/descriptions for movies or other videos with a lot of visual content
- Adding alt text or image descriptions to images that can help provide context for what someone is looking at
Some other examples of ways to accommodate fluctuating eyesight that go beyond classroom accommodations include:
- Not scheduling visually demanding classes back-to-back, such as math and science
- Providing students with permission to rest their eyes or leave the room after finishing an exam or visually demanding task, instead of having them switch to another visual task like reading a book
- Permission to leave class early or travel to different areas at off-peak times, which can help with minimizing time spent in crowds
- Identifying low-stimulation environments or locations that can be used for vision breaks if needed
- Learning how to use screen magnification, text-to-speech, and/or screen readers effectively for accessing content to reduce eyestrain
Above all, the most important tool for using disability accommodations and assistive technology for fluctuating eyesight is self-advocacy and being honest about access needs. Pretending to be able to see something is confusing for everyone, and admitting that something is difficult to access is the first step in finding a way to make it accessible.
Related links
- Learning to Self-Advocate
- Why I Prefer My Schoolwork Digitally: Updated Edition
- How To Make Things On The Board Easier To See
- File Formats For Low Vision and Print Disabilities
- All About Extended Time Accommodations
- A to Z of Assistive Technology For Low Vision
- College Scheduling Hacks For Students With Chronic Illness
- How I Use My eReader For School and Online Classes
- How To Write Alt Text For Educational Content
- How To Make Classroom Videos Easier To See
More resources on assistive technology for fluctuating eyesight
- Something that helped me explain vision changes in high school was editing pictures in PicsArt to reflect how I see things in different contexts. I share more examples in Using PicsArt To Simulate Low Vision
- My vision loss isn’t corrected by glasses, but I still wear prescription glasses at all times- learn more about my glasses in Veronica’s Four Eyes: All About My Glasses For Low Vision
- To learn more about assistive technology for low vision, browse Assistive Technology Archives | Veronica With Four Eyes (veroniiiica.com)
Published December 19, 2019. Updated January 2025