Disability Models and Vision

A pair of rectangular frame glasses with black and orange frames on top of a vision test chart.

There are two basic models of understanding disability: medical and social. The medical model conceives of disability as originating within the body, and often as in need of medical interventions.  By contrast, the social model draws distinction between impairments (physical maladies) and disabling barriers to full inclusion. Obviously many disabilities and illnesses fit the medical model well; cancer treatment usually requires medication or surgery more urgently than disability accommodations. Yet cancer prevention measures such as reducing industrial pollutants can’t be addressed in a hospital or doctors’ office.

Today I want to “look” at vision impairment and the two models of disability. Under the medical model, such a disability is recognized as originating in the body, being physical in nature, and eligible for medical interventions such as eye surgery and corrective lenses. The social model goes much further. It pushes for social acceptance of glasses, for childhood vision tests to ensure early diagnosis, and for larger font size options on government forms. Both models have something valuable to contribute.

The medical model “looks” into causes and cures. The social model addresses accommodation and culture, the way we “see” things and the “invisible” ableism and vidism (preference for sighted people) in our everyday speech. The medical model can’t usually go beyond the individual patients. Doctors can prescribe wheelchairs (which Medicare may not cover), but it was disabled activist wheelchair and crutch users who crawled up the steps of the US Capitol building demanding ramps and the passage of the Americans with Disabilities Act.

Eye surgery and corrective lenses have both advanced greatly over the years. For many people they are sufficient to cure or accommodate impairment. But our world in many ways makes life harder than impairment alone explains. Our modern world is incredibly visual. I take in most of the ideas I encounter and conversations I have by reading text on a screen with a smooth surface and no tactile distinction. Children in school without a diagnosis of Blindness are expected to learn primarily through visual reading.

Our most popular cultural forms of entertainment – television and movies – exclude people who can’t see and process visual information quickly. We describe the act of consuming this audiovisual media in visual terms: we watch television, we go see movies. Important plot points are revealed on screen without auditory explanation, and descriptive audio tracks are available on only a handful of DVDs.

The medical model can create screen readers, text-to-speech apps, and other individual accommodations. The social model is the one pushing for built-in audio options everywhere a visual option exists, so that every web page or bus stop sign could provide as much information to a person with vision impairment as someone without by default.

Both models have value. It’s important to follow the lead of individuals in how they want their own disabilities discussed, and that may be fairly nuanced. Someone might want medication for their ADD and accommodation for their Deafness. I want cures for my arthritis and IBS, and acceptance for learning disabilities and developmental delays. Two different people with the same diagnosis may want different things. As always, respectfully asking is the best course of action.  “See” you next time.

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