The University of Iowa
Department of Ophthalmology and Visual Sciences
March 14, 2017
This is Mark Wilkinson from the University of Iowa Department of Ophthalmology & Visual Sciences. In this presentation I will discuss sighted guide techniques that should be used by individuals who are blind or visually impaired, to help them travel safely in any environment.
Additionally, the information we will be discussing can be used to teach family members and friends how they can function as a sighted guide.
Using a sighted guide allows individuals who are blind or visual impairment a comfortable way to travel safely in any environment.
The sighted guide technique is felt to be the most efficient way for a person who is blind or visual impairment to travel with a sighted person.
To offer your services as a sighted guide, approach the person who is blind or visually impaired, introduce yourself and ask if they would like your help.
Do not grab, push or pull a person with vision loss, regardless of their age. This can be particularly terrifying for a child as well as an unsteady older adult.
If they indicate they would like your assistance, verbally offer your arm and brush it against their hand or arm.
The person being guided should lightly grasp the guide's arm, thumb out, just above their elbow.
Right elbow of the guide will be grasped by the left hand of the person being guided, and vice versa. The left elbow of the guide will be grasped by the right hand of the person being guided.
For children, have them grasp your wrist or hold your hand.
When an individual acts as a human guide, they should walk a half step ahead of the person they are guiding.
When approaching a narrow area or doorway, the sighted guide will move their forearm and hand to rest against the lower portion of their back, palm facing outward.
The person being guiding should slide their hand down to their guide's wrist and move directly behind the guide, at arm's length.
The guide should approach curbs, stairs and doorways squarely, never at an angle.
At doorways, the guide should tell the person being guided which way the door opens so the person being guided can hold the door as both pass through.
The guide should let the person know when they are approaching steps.
At steps, the guide should inform the person they are guiding whether the steps go up or down and how many steps there are.
The guide should position the person so their free hand is closest to the rail.
The guide should pause at the first step and at each landing.
When approaching a seat, the guide should tell the person they are guiding that they are in front of or beside the seat.
The guide will then place their guide arm hand on the chair back or chair arm and allow the guided person to follow the guide's arm down to the seat.
The guide does not need to help the person they are guiding to sit down, unless the person being guided is frail or unsteady.
A white cane can be a very helpful tool for individuals who are blind or visually impaired.
Often, a white cane is used as a mobility tool for independent travel purposes. However, the white cane can also be used as an identification tool for others who may not realize the individual has a visual impairment.
When reviewing the functional problems my patients are having, I often learn that they will bump into people or objects when not using sighted guide technique. They may also mention missing steps or curbs as well as objects on the floor. When I mention using a white cane as a mobility aid or identifier, many are reluctant to do this because they know they are not blind, they just have trouble seeing detail and/or have trouble with their low light vision or peripheral vision.
I tell my patients who are visually impaired, when you look in the mirror, you do not see someone with a vision problem. In that same way, when others look at you, they don't see someone with a vision problem. With this in mind, they may consider you rude or even worse if you bump into them. The white cane helps to clear a path and let others know, who don't understand vision loss, that you have a vision problem.
With this in mind, even if you, a family member or your friend is using sighted guide technique, a white cane can add another level of safety and security when moving in both familiar and unfamiliar setting.
It is important to know that when a white cane is used for independent travel purposes, proper training by a qualified orientation and mobility specialist is required.
Now you know how to use or act as a sighted guide. You also know how to teach others to serve as a sighted guide. Remember, the use of the sighted guide technique will help individuals with vision loss move safely and efficiently in all environments.
See also: Vision Rehabilitation Overview
Wilkinson ME. Guiding the Blind or Visually Impaired: Techniques for Sighted Guides. EyeRounds.org. posted March 14, 2016; Available from: https://eyerounds.org/tutorials/sighted-guide-technique.htm