Photosensitivity in the Classroom

This post is dedicated to Mr. S, who will never see a flashing light or a light switch the same way again.

In November 2011, two months into my freshman year of high school, I began getting chronic migraines, with one of the triggers being visual disturbances like flashing lights- not hallucinating flashing lights, actually seeing lights flash.  This is commonly referred to as photosensitivity or photophobia. I went on medication to help this, but the medication ended up making me even more sensitive to flashing lights, in a similar way to photosensitive epilepsy/photosensitive seizures (this has since been resolved).  As a result, my teachers, friends, and I frequently were watching for possible flashing light triggers, prepared to prevent them from happening. Here are ten of the triggers we all learned to watch for in the classroom, and why. Please note that I was undiagnosed in high school and received my diagnosis of Chiari Malformation after I graduated.

Fluorescent lights

These lights often flicker for what appears to be no reason at all. Watch for lights that frequently flicker, and turn them off if possible, or move away from them. When putting in a work order to fix the lights, note that there is a student with a medical issue connected to flashing lights.

Light switch

Sometimes, teachers flicker the lights to get the attention of the students. My teachers would warn me before flickering the lights, as well as when they would turn the light switch on or off. One of my teachers got so used to this, they found themselves thinking to warn me before they turned off a light switch in their home (sorry, Mr. S!).

PowerPoint animations

PowerPoint animations can have flashing effects, or rapid movement across the screen. Some teachers disabled all of the PowerPoint animations for my class, which I really appreciated. Other teachers would give me copies of the PowerPoint so I could disable the animations myself.

Instrument tuners

While this will only be a problem in a band or other music class, instrument tuners tend to rapidly strobe, usually with red or green lights, to show if an instrument is in tune or not. For tuners with small LED lights, the person next to me would cover the lights with their thumbs, and watch to see if I was in tune.

Projectors

Some projectors may flash or have a strobing effect as they turn on or adjust to the display. Warn the student ahead of time when a projector is being turned on, and wait until the display is stable to begin talking about what’s on the screen.

Flash photography

At school functions and when there were visitors in the classroom, my teachers would request no flash photography, as it can be harmful to the students. One of my teachers would go as far as to say a student had a medical condition triggered by flashing lights, but this wasn’t always necessary to disclose.  Here’s my rant on flash photography.

Videos

Before playing a video, check to see if there are any strobe or flashing lights. For one of my college classes, the teacher wrote down the time in the video that there were the flashing lights, and would warn all students thirty seconds before that there was going to be a flashing light. Another teacher wrote down the dialogue that would be said right before the light, and the dialogue directly after. For certain movies, the teachers would just send me out in the hallway to work on another assignment, saying there were too many flashing lights.

Routers

Computer routers in the classroom can have rapidly blinking blue, green, or red lights. Other classroom equipment, such as portable microphones, can have the same type of lights. My teachers would cover these lights with tape, removing and replacing the tape at the end of the week.

Fire alarms

I had a note in the nurse’s office that said I could be pulled ahead of time for fire drills. I would be called out of class about five minutes before, and went outside to sit with the nurse far away from the lights.  Here is how I handle fire alarms in college.

Mobile applications

Some mobile applications use strobe or flashing effects, and so can tools such as calculators. Check for flashing lights ahead of time, and find alternative applications if needed. Some applications use an “epilepsy mode” to disable flashing lights as well (Read more here about what makes an app accessible). Also, check to make sure the device being used is not filled with flashing lights- read more about my experiences with a strobing phone here.

Bonus- Substitute teachers

Make sure to remind substitute teachers, and write in the substitute plans, that there is a student that is sensitive to flashing lights.  I had a teacher write in bolded, 72 point font, at the bottom of the plans to not flicker the lights and to announce to the class when a projector or similar device was being turned on.  My fellow students were very protective of me and would frequently remind substitutes not to trigger any flashing lights.

While I have become less sensitive to flashing lights over time, my experiences with photosensitivity and photophobia gave me an increased awareness of how many flashing lights there are in the world. While I can’t assume all of the flashing lights will just disappear, or that people will stop using them so much, I always appreciate it when I have friends and teachers that can help me watch for these triggers, and help me avoid them completely when possible.

Two of Everything: My Life with Double Vision


Following John McCain’s diagnosis of glioblastoma, a form of brain cancer, a lot more people have been asking me about how double vision is managed, as glioblastoma can cause vision problems such as double and blurred vision, as well as a variety of other symptoms.   It is a fairly rare form of cancer, though other politicians such as Beau Biden and Ted Kennedy had the same type of cancer.  Here are a few things I have learned from my experiences with double vision as a result of a non life-threatening brain condition that heavily mimics glioblastoma in terms of vision loss.

Some background

I was diagnosed with accommodative esotropia at three years old, a common childhood eye problem that causes double vision, issues with depth perception, and reading.  It is characterized by crossed eyes, with one eye turning inward towards the nose, although vision issues can start before the eyes actually cross.  For a lot of children with this condition, glasses can correct vision to 100%, and the condition naturally goes away by age nine.  Unless there’s something else.

My vision got rapidly worse around when I turned nine years old- on my ninth birthday, I was unable to see a parade going on less than ten feet away.  My vision continued to sharply decline when I was eleven, and I had a one muscle eye surgery in 2008 to prevent my eyesight from getting worse.  Around when I was 14, I started to experience chronic migraines, chronic pain, worsening eyesight, and several other symptoms, and was diagnosed with Chiari Malformation at age 18, a congenital brain condition that often isn’t diagnosed until teenage years.  Because I had vision loss as a result of the accommodative esotropia as well as Chiari, I received the additional diagnosis of decompensated strabismus, meaning I have low vision issues originating from my eyes as well as my brain (read more about my eye surgery for this condition here and here).

What my glasses look like

My glasses prescription does not fully correct my eyesight, no prescription exists that can.  In the past, I wore thick prisms in my glasses, which are similar to magnifying lenses.  These are extremely common for people with double vision following brain injuries or other neurological conditions.  After my eye surgery, I no longer wear prisms.  My glasses are also tinted a dark gray color due to my photosensitivity.

It’s not always two separate images

Depending on how my eyes focus, I can see two distinctly separate images, or two images blended together.  If a person is standing in front of me, I may see two completely separate images, as if identical twins are standing in front of me.  Alternatively, the images may appear as a shadow, as if one image is floating above the other.  The most common for me is to see the images blended together side-by-side, so a person appears to have two heads and three arms/legs.

It can be hard to figure out which is the original image

Sometimes, I can figure out which image is actually there, and which is the mirror image.  However, my friends will tell you, I spend a lot of time grabbing onto thin air thinking I found something, when it is actually right next to whatever I’m grabbing.  I usually realize this within a second or two, mostly because I have had this vision issue all of my life.

Can you drive with double vision?

While a select number of people may be able to drive with double vision, I do not drive due to my other visual issues.  None of my other friends with double vision drive either.

Reading and double vision

With double vision, letters run into each other or form shadows, and I have difficulty reading long words as a result of this.  Thankfully, when processing information, the brain does not read every letter, and normally I can infer what the word is based on context clues.  It is more difficult if I am reading an unfamiliar word, or working on a math problem where every letter and number is crucial.  In addition to the double vision, I also have blurry vision that makes reading standard print sizes impossible.

What’s a print disability?

A print disability is the inability to read standard text, usually due to a learning or visual disability.  Some examples of accessible text include large print, weighted fonts, Braille, and audiobooks.  Read more about print disabilities here.

Large print

Large print helps my eyes to focus better and helps me understand words easier.  I typically ask for size 22 Arial font, as it is clear to read.  I had an IEP all through school to receive large print services- more on my print accommodations here.  All of my devices have large print on them as well- learn how to make Android accessible here, iPad accessible here, and Windows 10 accessible here.

Contrast

Sharp white paper with black text provides a large amount of glare and can make the double images seem much more intense and difficult to decipher.  I prefer to use tinted backgrounds to increase the readability of font, and actually did a science project on this to show which colors work best.

How I read

In high school, I received textbooks through AIM-VA, a state organization that provides accessible educational materials to students with print disabilities free of cost.  I receive other books through Bookshare, a national accessible library that allows people with diagnosed print disabilities to read almost any book they want, from New York Times Bestsellers to classic novels for school (it also receives federal funding).  For college, I purchase digital textbooks and carry them on my iPad.  I love living in a digital age where I can find accessible print for almost anything in an instant.  I don’t feel like I’m missing out on anything.

Assistive technology

I also use a few devices that are specifically designed for helping users with double vision/low vision.  Portable closed-circuit televisions, or portable CCTVs, are some of the most common high-tech devices used for low vision.  I have an E-Bot Pro that I use to read larger documents such as tests, and a smaller Eschenbach SmartLux that is the size of my cell phone.  So even if I am presented with a document that isn’t in large print, I can access it easily with these devices.

Double vision takes some adjusting, but it is in no way a catastrophic condition that will dramatically alter someone’s life.  Technology has come a long way, and people with double vision/low vision can easily continue to work as long as they have assistive technology and other accommodations.  Besides, sometimes it’s fun to see two of everything- after all, it’s better to see two ice cream cones than one!

How To Create A Disability Services File

I chose what college I was going to attend during my junior year of high school, a year before I even submitted my application (read more about how I made my choice here). The Office of Disability Services was/is very welcoming and answered all of my questions. They have a dedicated staff member that handles all the low vision/blindness cases, and they know exactly what accommodations I need and what to ask for. I am incredibly lucky to have so many resources available to me, and I was excited to be part of this university.

Since IEPs expire the moment the student graduates from high school, it’s important to meet with Disability Services before school starts to ensure that the student continues to receive services in college. Most of the accommodations listed in an IEP can continue to be used if the student adds them in their Disability Services file. One thing that does transfer to college is 504 plans, though you still will need to create a file to receive services. It is highly recommended that you convert your IEP to a 504 plan before you graduate, something I did two hours before my graduation (though giving your case manager advanced notice is a must). Here is how to create a Disability Services file with your school. This also applies to students attending community/junior colleges, though the plan might not transfer when the student moves.

Start Early

I investigated what services were available to me before I applied to the school. While visiting other colleges, I planned my visits around interviewing staff members from the Disability Services offices in a one on one setting, spending thirty minutes or more at each interview. If your accommodations will not be met, this is not the school for you. The important thing for the student is to be proactive, not reactive, and that is also true for the Disabilities Services office. Some colleges won’t help you until you are in trouble, and it’s better to avoid the problem than to have to figure out how to solve it later (read more about scheduling here). Don’t wait until there is a problem in a class to open a Disability Services file. I opened mine while I was still in high school after I had received my acceptance letter and committed to attending in the fall.

Get notes from your doctor prior to the Disability Services meeting

If you bring a doctor’s certification that you have a disability, you can set up the file at your first meeting with Disability Services. Usually you can find the forms the doctor needs to fill out on the school Disability Services website. My school required a recent ophthalmologist report, which I brought with me. Some schools may also require a physical, but mine did not.

Bring all documents you think might be important

I met with Disability Services in April to set up my file that would be used starting in the fall semester. I brought in my current IEP, my prior 504 plan from eighth grade (since I wasn’t converting to a 504 until the last day of school), and documents from my ophthalmologist that described my diagnosis- read more about collecting documentation here. Other helpful documents to bring, if available, include Department of Blind and Visually Impaired case files, assistive technology evaluations, orientation and mobility files, occupational therapy assessments, medical diagnosis from other doctors (i.e neurologist) and similar documents. All of my papers were in a giant binder so I could easily reference them during the meeting (pro tip- get a rolling backpack to carry everything around).

Know what accommodations you need the most

For me, having access to my assistive technology devices, receiving digital copies of assignments, and preferential seating were the most important accommodations. I made sure those were the first I mentioned to Disability Services. Other accommodations in my file include time and a half on tests, extended time on assignments when requested, copies of notes, using a word processor for written assignments, large print on handouts, and the ability to attend class remotely if needed. Once I was on campus and worked with Disability Services, I added additional accommodations, such as noting that I would be using a blindness cane (yes, I did encounter a professor who was very confused over my cane).

Ask if your school has a disability testing center

My school has a multiroom lab where students are able to take their tests in a quiet environment with their assistive technologies. I had to fill out a separate form for these accommodations. I receive time and a half on tests, a laptop with ZoomText and JAWS, use of my E-Bot Pro, reduced light, and use of a word processor as well as a calculator app on my phone. An accommodation made available to everyone is the use of earplugs during tests as well as a white noise machine to help drown out background noise. This testing center is invaluable to students with a range of disabilities, not just sensory ones.  Read more about the disability testing center here.

Ask about other services for students registered with Disability Services

My school offers a writing center for students with disabilities who need extra help. I have not needed it, but students who struggle with writing have greatly benefited from these services. Ask if there are other tutoring opportunities or groups that help students with disabilities.

Request special housing, if needed

The sooner you request this, the better! Housing arrangements tend to fill up quickly. My freshman year, I lived in a single room that was adjacent to the resident advisor’s room so I could reach her quickly if there was a problem. This year, I live in a handicapped accessible apartment (on campus) with my own bedroom and I am able to navigate easily around the apartment, as well as being able to get to my classes and, most importantly, the dining hall. In order to get special housing, my primary care doctor had to fill out a form to certify my disability, which was in addition to the form to certify me for Disability Services.  Read more about disability housing here.

Get a referral to the assistive technology specialist or department

At my school the Assistive Technology department is different than Disability Services. By receiving a referral, you can access services such as enlarged textbooks, assistive technologies, computer labs with built in accessibility software, and more. This is the most important department for me because while Disability Services can identify a problem, Assistive Technology solves it.  Read more about staff members to talk to before college starts here,

Make sure your file is ready for the first day of classes

Get copies of your accommodations sheet (which Disability Services will provide) as soon as possible to pass out to professors, and know how to explain the accommodations as well (post on that here). Be sure all your testing accommodations are set before the first exam. Don’t wait until you fail to set yourself up with the tools you need to succeed.