Correspondence

Case 3-2001: Unilateral Visual Loss

N Engl J Med 2001; 344:1870June 14, 2001

Article

To the Editor:

Dr. Smith's addendum to the Case Record in the January 25 issue1 contains a misleading and erroneous statement. The patient is described as being “legally blind in the right eye” while able to see with an acuity of 20/30 in the left eye. A patient cannot be legally blind in one eye. Legal, or statutory, blindness refers to the condition of both eyes. The criterion for this condition in the Commonwealth of Massachusetts is a visual acuity of 20/200 or less in the better eye or a visual field with a radius of 10 degrees or less in the better eye.

Simmons Lessell, M.D.
Harvard Medical School, Boston, MA 02115

1 References

1. 1

   Case Records of the Massachusetts General Hospital (Case 3-2001). N Engl J Med 2001;344:286-293
   Full Text | Web of Science | Medline

To the Editor:

In Case 3-2001, Dr. Smith perpetuates an all-too-common misuse of the description “legally blind.” Legal blindness is defined as a best corrected acuity of 20/200 or less in the better eye or as a constriction of the visual field in both eyes to within 10 degrees of the point of fixation with the use of a standard stimulus. This means that a person who is completely blind in one eye and has normal vision in the other is not legally blind.

Thus, it is imprecise to describe one eye as “legally blind.” It is better to report the vision in terms of the Snellen acuity or fingers counted at a specified distance or in the conventional terms used to describe very low levels of vision: perception of hand motions, perception of light only, or no light perception. In addition, to qualify as legally blind, a person must be tested with his or her best correction. A statement such as “I am legally blind without my glasses” is incorrect if the person making it can see with them.

John W. Gittinger, Jr., M.D.
Boston Medical Center, Boston, MA 02118

Citing Articles (1)

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