Interpreter's Role in
the Assessment of Vision

Interpreting in a medical setting is often interesting but time-consuming because the offices cannot keep the doctors' schedules well organized. Aside from interpreting in a mental health setting, interpreting in the office of an ophthalmologist is among the most demanding interpretation assignments because so much of the diagnostic work is based on subtle nuances in the patient's answers and because deafblind persons value their vision so much.

Ophthalmological interpretation is often a linguistic challenge; it requires fluency in both English and sign language in and outside medical interpretation. Especially in rehabilitation, all kinds of technical terms related to different workplaces, tools, techniques, magnifying devices, mobility and orientation, social, educational, and economic issues are needed daily. That means demanding working conditions which at the same time are seldom boring.

Before anyone makes the decision to become a deafblind interpreter, it is advisable to learn to know the deafblind community, the ways of communication, one's own reactions created by the unfilled expectations in visual communication and reactions to tactile communication. The involvement is much deeper, much more humane and holistic than in almost any other communication, especially when functioning as the eyes and ears of a totally blind, totally deaf person who has to rely on the interpreter-guide quite differently from a deaf person. The complexity and sophistication of interpretation is on an unusually high level when not only the discussions but everything in the environment should be captured, when you have the challenge of being the deafblind person's "mass media" for a few hours.

The deep involvement in the lives of deafblind persons is often rewarding and supportive in the way that we get a new perspective into our own problems when looking at the world through the blind eyes of a deafblind individual; deafblind interpretation is not, however, to be recommended as a remedy for personal problems.

At the beginning you may be struck by the extremely limited amount of communication that many deafblind persons have. There are only a few real deafblind communities and outside them deafblind persons are isolated both in their work environment and in many families. The situation is slowly changing for the better. The quality of communication sometimes makes up for the limited quantity. As one of my deafblind friends pointed out, hearing people often communicate in ways that the deafblind person wants to avoid. We say unpleasant things to each other but are less likely to fingerspell the same kind of unfriendly messages on the palm of a deafblind person. There is also less of the very superficial "junk food" conversation that fills many hearing persons' days.

Anyone considering deafblind interpretation usually has years of experience of deaf culture and medical interpretation. Visual impairment may make the life of deafblind persons different from other deaf persons' lives. The effect of visual impairment on all major areas of daily functions, communication, activities of daily life (ADL), mobility and orientation, and near work like reading, varies greatly depending on which part of the visual field is affected, by the nature of the disorder and how profound is the loss of vision.

Demonstration glasses give some idea of how visual impairment decreases the amount of critical visual information in almost all tasks, but they do not convey the disturbances of the image quality. They are caused by changes in the long chain of neural cells transferring visual information from the sensory cells to the brain. It must be constantly annoying to try to figure out whether one can rely on the image that one sees or whether the information should be confirmed by tactile information, if possible. The numerous misunderstandings and more or less dangerous adventures that are common to both hearing and deaf visually impaired persons will always be a part of the life of the deafblind community.

After the experiences in the deafblind community it is advisable to learn to know the ophthalmological services, especially the few doctors who see deafblind patients. When a deafblind person is going to have an appointment with the ophthalmologist, you may be able to function as a guide and observe how the other interpreter takes care of the communication and how well the doctor and the interpreter can work together.

The video materials give you some ideas about visual signing to a patient with tunnel vision. Tactile signing is very different. It is something that everyone learns literally "hands on". The best places to learn it are the deafblind communities where tactile communication is a widely-used and well-accepted mode of communication.

In order to use correct classifiers you have to have more than the usual college education in the structure and functions of the eye and visual pathways and in eye diseases and visual rehabilitation. You may start by reading "Eyes and Vision" written for deaf people and then glance through a nurse's handbook in ophthalmology because it describes the numerous instruments and procedures that you will hear mentioned in the eye clinics.

In the work with the ophthalmologist you will have the need of working with an equal, which may sound strange thinking on today's ranking order. However, the diagnostic work will be so much more rewarding if you can discuss your observations and opinions with the ophthalmologists freely, that you may want to look around for a while, and observe the communication and behaviour of different doctors several times before you make up your mind.

If after all these preliminary investigations you feel hooked you might be the right person to get involved with deafblind interpretation. Once you start, you will find that the work is even more interesting and challenging than you thought.