Key Points

  • Age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy are the three most common causes of vision loss in older Australians, each creating distinct functional challenges at home
  • People under 65 with significant vision loss may access NDIS; those 65 and over who are not already NDIS participants access supports through My Aged Care
  • Falls risk is substantially elevated with vision loss: people with AMD have 1.8 times the fall rate of those with normal vision, making home safety modifications a clinical priority
  • The occupational therapist is the central provider for assessing functional impact and driving both home modification and assistive technology funding
  • Orientation and mobility (O&M) training from an accredited specialist is one of the most practically useful supports for people with significant vision loss
  • Vision Australia is a registered NDIS provider that offers assessments, AT training, and O&M services nationwide

How Vision Loss Changes Life at Home

Age-related vision loss is not a single uniform experience. The three most common conditions affect different parts of the visual field and produce different daily living challenges.

Macular degeneration destroys central vision. Reading, recognising faces, and seeing fine detail become impossible even with glasses. Peripheral vision remains, so the person is not entirely blind, but central tasks like reading medication labels, identifying food on a plate, or watching the stove become hazardous.

Glaucoma typically removes peripheral vision progressively. Central vision is often preserved until late stages, but the loss of peripheral field creates serious mobility hazards: people with glaucoma do not see obstacles approaching from the sides or below, making stair navigation and busy environments particularly dangerous.

Diabetic retinopathy causes variable, patchy vision loss with floaters and distortion. It is less predictable than the other two conditions, making it harder for the person to compensate because the functional impact changes over time.

Research published in the American Journal of Ophthalmology found that 44.7% of people with AMD experience disability in one or more instrumental activities of daily living, compared with 25% of people with glaucoma and 18.3% of controls with normal vision. At home, the most commonly affected activities are meal preparation, grocery management, and safe navigation between rooms.

This is not a condition that can be fully managed by family carers alone. A structured provider team with specific expertise in vision rehabilitation is what translates clinical diagnoses into practical home safety and daily function.

NDIS or My Aged Care: Which Pathway Applies?

The funding pathway depends on age at the time of first accessing formal support.

NDISMy Aged Care
AgeUnder 65 when accessing65 or older (50+ for Aboriginal and Torres Strait Islander people)
Vision thresholdCorrected acuity 6/60 or worse in both eyes, or visual field within 10 degreesFunctional assessment of daily living impact
Evidence requiredOphthalmologist report (not optometrist)GP referral and ACAT or RAS assessment
Home modificationsFunded as Capital Supports under NDISFunded through Home Care Package or CHSP
AT fundingCapital Supports budgetHome Care Package budget or CHSP
Continuity past 65Continues in NDIS if already enrolledSole pathway for new applicants over 65

If you are under 65 and meet the vision threshold, an ophthalmologist report is the first piece of evidence to gather for NDIS access. Vision Australia can assist with the access application process.

If you are 65 or older, call My Aged Care on 1800 200 422 or visit myagedcare.gov.au to register. A trained assessor will determine what services you are eligible for.

Provider Checklist for Low-Vision Supports

Use this checklist when building or reviewing a support team for age-related vision loss. Not every person will need every provider type, but this framework covers the full range of relevant supports.

Occupational Therapist (Low-Vision Specialist)

The OT is the anchor provider. Engage them first.

What they assess:

  • How vision loss affects specific daily tasks in your actual home environment
  • Lighting levels (measured in lux) and whether current lighting is sufficient for safe function
  • Hazards including trip risks, poorly lit stairways, and unmarked step edges
  • Assistive equipment needs: magnifiers, talking devices, adapted tools
  • Need for home modifications

What they produce:

  • Functional capacity assessment for NDIS or My Aged Care applications
  • Home modification report specifying exactly what changes are needed, to what standard, and at what estimated cost
  • Assistive technology prescription and recommendations

How to find one: Search the NDIS provider finder for OTs registered under Vision Impairment. Ask specifically whether the OT has experience in low-vision rehabilitation, not just general disability OT. Occupational Therapy Australia maintains a list of vision impairment practice specialists.

Orientation and Mobility Specialist

O&M specialists are accredited through the Orientation and Mobility Association of Australasia. They teach safe, independent navigation for people who can no longer rely on full vision.

What they teach:

  • White cane technique for detecting obstacles and navigation
  • Safe route learning for indoor and outdoor environments the person uses regularly
  • Strategies for unfamiliar environments (shopping centres, medical appointments, public transport)
  • Night navigation and low-light strategies

When to engage: As soon as vision loss begins to affect the person’s confidence or safety moving through the home or community. Waiting until a fall occurs is leaving it too late.

Funding: Under NDIS, O&M services are funded under Improved Daily Living or Capacity Building. Under My Aged Care, they can be included in a home care package.

Vision Rehabilitation Therapist

Distinct from OT and O&M, a vision rehabilitation therapist focuses on teaching non-visual techniques for daily tasks: cooking with residual vision, adapted reading methods, organisation systems that reduce reliance on sight.

What they teach:

  • Adapted cooking techniques: marking appliances with tactile indicators, organising food storage by touch
  • Medication management: labelling systems, dosette boxes, talking pill reminders
  • Personal care adaptations: organisation of bathroom items, adapted grooming techniques
  • Financial and correspondence management: adapted computer use, talking bank apps

Vision Australia employs vision rehabilitation therapists. Their services are available nationally and can be accessed by both NDIS participants and My Aged Care clients.

Home Modification Builder (NDIS Registered)

Once the OT has produced a modification report, a registered builder carries out the physical changes. The builder must be registered with the NDIS to be paid from NDIS funds.

What to look for:

  • NDIS registration as a home modification provider
  • Experience with vision-related modifications specifically (lighting upgrades, contrast markings, hazard removal)
  • Willingness to work from OT specifications without redesigning the scope
  • References from previous similar projects

Low-Vision Optometrist

Separate from the ophthalmologist who diagnoses and manages the condition medically, a low-vision optometrist assesses the remaining functional vision and prescribes optical aids: magnifiers, telescope aids, tinted lenses for glare sensitivity. They complement rather than replace the OT and vision rehabilitation therapist.

Support Worker (Community and Daily Living)

Where vision loss substantially limits daily living tasks, funded support worker hours may be included in an NDIS plan or home care package. Support workers assisting someone with vision loss should:

  • Understand that directing someone with vision loss requires clear verbal description of environments, not physical guiding without consent
  • Be familiar with the person’s specific AT devices and how they work
  • Know when tasks present a fall or injury risk and need more structured assistance rather than supervision

Home Safety Upgrades: Priority Areas

An OT will assess your specific home, but the following are the most common priority modifications for vision loss.

Lighting

Lighting is the single most impactful and cost-effective modification for people with residual low vision. Upgrading from dim or inconsistent lighting to high-lumen LED throughout the home improves functional vision more than many expensive AT devices.

Priority lighting upgrades:

  • Replace all globes with LED bulbs at 60 to 100 watts equivalent, prioritising kitchen, bathroom, and stairway areas
  • Install sensor-activated lighting on staircases, hallways, and the path between bedroom and bathroom (for night navigation)
  • Eliminate bare windows that create strong glare contrast with dim interior surfaces
  • Add under-cabinet lighting in the kitchen so worksurfaces are evenly lit

Stair and Step Safety

Stairs are the highest-risk area for falls with vision loss.

Priority modifications:

  • Fit handrails on both sides of all stair runs
  • Apply high-contrast, non-slip stair nosing strips to each step edge (contrasting colour makes steps visible to people with residual central vision)
  • Ensure adequate lighting at both the top and bottom of each stairway
  • Remove clutter from stairways entirely

Flooring and Pathways

  • Remove area rugs and loose floor mats throughout the home
  • Ensure clear defined pathways between frequently used rooms with no furniture encroaching
  • Use contrasting floor colour or a floor strip to mark transitions between rooms or surface types (carpet to hard floor)
  • Fix any uneven flooring or raised thresholds

Kitchen Safety

  • Mark stove burner positions with tactile raised dot stickers (heat-safe)
  • Use induction cooktops where possible: they have fewer burns risks as only the cookware gets hot
  • Organise pantry and refrigerator storage consistently so items are always in the same position
  • Use contrasting coloured chopping boards and crockery (dark board for light foods, light board for dark foods)

Bathroom Safety

  • Install grab rails beside the toilet and in the shower or bath
  • Use a shower chair or bench to eliminate the fall risk of standing on wet surfaces
  • Mark the hot tap clearly with a tactile indicator
  • Ensure the bathroom is well lit with no dark corners

For a room-by-room guide to falls prevention modifications, see our article on falls prevention home modifications for older Australians.

Assistive Technology for Daily Life

Assistive technology for low vision falls into several categories. An OT or low-vision AT specialist should recommend specific items based on your functional vision, your goals, and your existing devices.

Magnification

  • Optical magnifiers: Handheld or stand magnifiers for spot reading (price labels, medication labels). Available from low-cost to specialised. Most are low-cost AT items under the NDIS threshold.
  • Electronic video magnifiers: Devices with a camera and screen that magnify and enhance contrast. Portable or desktop versions. Particularly useful for reading printed text and mail. Typically over $500 and require AT assessor recommendation and NDIA approval for NDIS funding.
  • Smartphone magnification: Built-in camera magnifier apps on modern smartphones are surprisingly capable for many low-vision tasks and can be set up during a vision rehabilitation session at no additional cost.

Screen Access Technology

  • Screen reader software: VoiceOver (Apple devices), TalkBack (Android), NVDA or JAWS (Windows computers) convert on-screen text to synthesised speech. Free or low-cost. Training from a vision rehabilitation therapist is often more valuable than the software itself.
  • Voice-controlled assistants: Devices like smart speakers allow hands-free control of reminders, timers, shopping lists, weather, and phone calls without relying on visual interface.

Talking Devices

Talking household devices reduce reliance on visual reading for everyday tasks:

  • Talking clocks and watches
  • Talking weight scales
  • Talking thermometers
  • Talking blood glucose monitors (important for people with diabetic retinopathy)
  • Talking microwave timers

Most talking devices cost under $100 individually and qualify as low-cost AT under the NDIS.

Mobility Aids

  • White cane: The primary mobility aid for significant vision loss. O&M specialists prescribe and teach technique. Funded under NDIS and My Aged Care.
  • Guide dogs: For people with more severe vision loss, guide dogs are provided through Guide Dogs Australia. There is typically a waitlist. Ongoing costs (food, vet) may be funded through NDIS.

For more detail on NDIS-funded vision impairment supports beyond mobility aids, see our guide on NDIS supports for vision impairment.

Medication Safety with Vision Loss

Medication errors are a significant and underappreciated risk for people with vision loss living at home. Inability to read labels, identify tablets by sight, or confirm dose instructions creates real harm potential.

Practical strategies:

  • Use a dosette box or medication organiser with a consistent weekly layout, set up by a carer or support worker at the start of each week
  • Talking pill reminders and smart medication dispensers provide audible alerts at dose times
  • Ask your pharmacist to apply large-print labels on all medication bottles
  • Request blister packs from your pharmacist: these are easier to manage tactilely and reduce the risk of double-dosing
  • An OT or vision rehabilitation therapist can assess your current medication management and recommend a system suited to your functional vision

When to Escalate: Clinical Red Flags

Not all vision-related safety concerns are within the scope of allied health providers to manage. The following situations require medical escalation rather than provider or equipment solutions:

  • Sudden or rapid vision change in one or both eyes: refer immediately to an ophthalmologist or emergency department
  • New onset of flashes or floaters: could indicate retinal detachment; requires urgent ophthalmology review
  • Fall resulting in injury: requires GP or emergency assessment regardless of injury severity; medication review and vestibular assessment often follow
  • Unexplained weight loss or change in appetite: may indicate the person is not managing food preparation safely
  • Evidence of medication errors (excess tablets remaining, wrong doses): requires GP review and medication safety assessment

The support team’s role is to identify these situations and prompt appropriate action, not to manage them alone.

Questions to Ask Before Engaging Providers

For an occupational therapist

  • Do you have specific experience in low-vision rehabilitation, or is your practice primarily physical disability?
  • Can you complete both the functional capacity assessment and the home modification report, or do I need separate providers?
  • Do you work with both NDIS and My Aged Care clients?
  • How long does the assessment and report process take from initial booking?

For an orientation and mobility specialist

  • Are you accredited through the Orientation and Mobility Association of Australasia?
  • Have you worked with clients with macular degeneration or glaucoma specifically?
  • Do you train clients in indoor and outdoor environments, or indoors only?
  • How many sessions does an initial O&M program typically involve?

For a home modification builder

  • Are you registered as an NDIS provider for home modifications?
  • Have you completed lighting upgrades and contrast modifications for vision-impaired clients before?
  • Do you work from OT specifications, or do you conduct your own assessment?
  • What is your current lead time from quote to work commencement?

Frequently Asked Questions

It depends on age and functional impact. If you are under 65 and have a confirmed diagnosis with corrected visual acuity of 6/60 or worse in both eyes, or visual field constriction to within 10 degrees, you may meet the NDIS access criteria. If you are 65 or older and not already receiving NDIS, you access supports through My Aged Care instead. A report from an ophthalmologist, not an optometrist, is required to establish eligibility.

What does a low-vision occupational therapist do?

A low-vision OT assesses how your vision loss affects daily activities at home, including cooking, medication management, personal care, and navigation. They recommend assistive equipment, home modifications, and compensatory strategies. They produce reports that support NDIS or My Aged Care funding applications and can liaise with other providers including orientation and mobility specialists and vision rehabilitation therapists.

What is orientation and mobility training?

Orientation and mobility (O&M) training teaches safe navigation with reduced vision. An accredited O&M specialist works with you to use a white cane, learn specific indoor and outdoor routes, and develop strategies for unfamiliar environments. O&M is funded under NDIS for eligible participants and is one of the most practically useful supports for people with significant vision loss.

What home modifications reduce falls risk for people with low vision?

Key modifications include upgrading lighting to high-lumen LED throughout the home, installing sensor-activated lights on stairways and hallways, removing area rugs and trip hazards, adding high-contrast colour markings on stair edges and door frames, fitting handrails on all stair runs, and ensuring clear defined pathways between frequently used rooms. An OT can assess your specific home and produce a modification report for funding.

Can Vision Australia help me access NDIS funding?

Yes. Vision Australia is a registered NDIS provider and can provide low-vision assessments, assistive technology training, orientation and mobility services, and support with NDIS access applications. They work with both NDIS participants and My Aged Care clients. Contacting Vision Australia early is a practical first step for anyone newly diagnosed with significant vision loss.

What assistive technology is funded under NDIS for low vision?

Funded AT includes electronic video magnifiers, screen reader software and training, talking devices (clocks, scales, thermometers, measuring cups), white canes, and in some cases electronic wearable vision aids. Items under $1,500 can be purchased through your Capital Supports budget without prior NDIA approval once an AT assessor has recommended them. Higher-cost items require quotes and NDIA approval.

Is there a difference between low vision and blindness supports?

Yes. Low vision means residual functional vision remains, so supports focus on maximising use of remaining sight through magnification, lighting, and contrast. Blindness supports focus more on non-visual techniques: braille, orientation by touch and sound, guide dogs, and screen readers used with zero visual reference. Many providers cover both, but the rehabilitation approach differs significantly. Confirm whether a prospective provider has specific experience in low-vision rehabilitation as distinct from blindness services.

What happens to my NDIS supports when I turn 65?

If you are already receiving NDIS funding when you turn 65, you continue receiving your supports through the NDIS. Your plan continues and is reviewed on the usual cycle. You do not move to My Aged Care unless you choose to. If you are not yet receiving NDIS when you turn 65, you must access disability-related supports through My Aged Care for age-related conditions.

Key Resources

Carevo connects people with age-related vision loss to vetted OTs, home modification specialists, and vision rehabilitation providers across Australia. Find providers through Carevo to start building your support team.