Living with visual impairment and the resulting fatigue
It’s a Friday night and I’ve been invited to a bar at the last minute. I don’t know the venue, its layout, or what the lighting will be like. I only know two of the people in the group. Most people would turn up, grab a drink, and socialise. But when you add in not being able to see clearly, both physically and the psychological weight that comes with that, the situation changes. I’m lucky to have mates who look out for me and never make me feel like helping is a burden. Even so, the stress is there in the back of my mind. That constant alertness, the need to stay focused, is draining. It’s not just tiredness in the usual sense; it’s a kind of mental overwhelm that builds from navigating the world with limited vision.
I’m 26, living in Glasgow, and I have Retinitis Pigmentosa, a genetic condition that causes progressive loss of peripheral vision and severe night blindness. In practical terms, it feels like sometimes looking through a narrowing tunnel, where the edges are missing, and as soon as the light dims, even the central vision I rely on becomes unreliable. This means crowded or dimly lit spaces, like bars, cinemas, atmospheric restaurants, museums or just the easy walk home, can be physically challenging to navigate and mentally exhausting to manage.
When you have a visual impairment, the brain must work harder to understand fragmented or unreliable input. There’s a stereotype that other senses become “heightened.” I wish I could say I had some kind of Spidey-sense, but the truth is you just rely more on hearing, touch, and memory while still forcing your eyes to work overtime. That constant effort creates a background level of tension. For me, this often means being on edge when moving around alone. Most people are surprised at how well I get by, and I value that independence, but the real strain comes from the mental load of anticipating obstacles that might suddenly appear. White and Grant’s (2009) research in Glasgow showed that people with visual impairments aren’t limited by confidence or ability, but by the psychological stress caused by poorly designed environments: uneven paving, unexpected bollards, or crossings with no audible or tactile cues. It’s that combination of hyper-focus and constant low-level anxiety that drains energy, leading to fatigue long before the day is over.
There’s also a social dimension to fatigue: when you can’t read facial expressions, every conversation takes extra effort. It’s tempting to compare this to what someone on the autism spectrum might experience, struggling to interpret social cues, but it’s not the same. For people with visual impairments, the barrier is sensory, not neurological, and it’s more about missing visual data, not processing differences. That momentary mental scramble of wondering if you’ve misread a tone, or if you missed a cue, drains energy. And if you trip over a curb or bump into something, you might feel embarrassed. With close friends, these moments can be a source of laughter (which I expect) and reassurance; with strangers or acquaintances who don’t understand, it can chip away at your confidence. Seasonal changes make this worse. In the UK, long summer evenings give way to short, dim winter days, sometimes offering just six hours of usable light. That means pushing harder mentally to navigate public spaces daily, every outing can become mentally exhausting.
This psychological toll is supported by research: a UK review found that people with sight loss often report lower emotional well‑being, including symptoms of depression, anxiety, reduced social confidence, and diminished overall quality of life (Nyman, Gosney & Victor 2010). Fatigue compounds these challenges in a way that is more than simply feeling tired. Multiple studies have shown that adults with visual impairment experience significantly higher levels of fatigue compared to those with normal vision. Schakel et al. (2019) found that fatigue is not explained solely by the degree of sight loss, but is strongly associated with depressive symptoms, poor perceived health, and the mental effort required to carry out daily tasks. In other words, it is the constant psychological strain of navigating an environment designed for the fully sighted that drains energy over time. Demmin and Silverstein (2020) reinforce this by showing that people with visual impairment report higher rates of depression and anxiety than the general population, with fatigue acting as both a symptom and a driver of these conditions. This means that fatigue is best understood as multidimensional: it is physical, because of the increased energy needed to move safely; emotional, because of the stress and vigilance required; and cognitive, because the brain is continuously working to fill in missing visual information. Together, these layers make fatigue one of the most persistent and disabling aspects of living with sight loss.
Over the years, I’ve developed my own coping strategies. A decade ago I tried to keep my sight loss hidden and avoided talking about it; now I’ve learned that being open is far easier in the long run. While this may not be in everyone’s nature, planning makes a big difference. That doesn’t mean saying no to spontaneous plans, but it does mean thinking ahead about routes, who will be there, and how you’ll get home. For organised events, I’ve also found it helps to contact the venue in advance or as you arrive. On a recent night out, I told the bouncer at the door about my eyesight. Later, after I completely blanked the bar staff because I couldn’t see them, the bouncers explained it for me. That small exchange meant I felt comfortable going back to that club. At a comedy gig during the Edinburgh Fringe, I emailed ahead, and staff let me in early to get to my seat and adjust to the lighting before the crowds came in. Those little moments of speaking up transformed what could have been stressful into genuinely enjoyable experiences.
Equally important is being upfront with friends. The people I’m closest to instinctively look out for me, and that support makes any outing more relaxed. It doesn’t take away my independence, but it means I don’t carry the whole burden of navigating new spaces on my own. Research has shown that social support acts as a protective factor for people with sight loss, reducing the risk of anxiety and depression and helping individuals cope with fatigue more effectively (Nyman, Gosney & Victor 2010). In my experience, the presence of friends who understand what I need removes a huge layer of background stress. They can help with something as simple as warning me about steps, reading a menu, or guiding me through a dark corridor. This doesn’t mean giving up control or losing your independence; it means sharing the load. Every interaction, every movement in a crowd, comes with the extra task of processing what you can’t see. When friends step in with small acts of awareness, it preserves energy for the parts of the outing that really matter, including connecting with people, enjoying the atmosphere, and feeling included. In that way, support from friends is more than practical help: it directly reduces the psychological strain of constant vigilance, helping me balance independence with well-being.
At the start I mentioned being invited to a bar at the last minute. A few years ago that would have felt overwhelming, but now I’ve learned ways to make it easier. The truth is, I’m still going to fall over sometimes, miss a step, or blank someone in conversation without meaning to. My friends usually find it hilarious, but I know they have my back. That mix of humour and support makes all the difference, and knowing they are aware of it and I am not trying to hide it takes the pressure off.
Fatigue will always be part of living with sight loss, but having people around who get it means I don’t carry the whole load on my own. It turns what could be stressful into something I can laugh about, too, and that’s often the best way to keep going. Over the last year or so, I’ve also found that with practice and by pushing myself to keep showing up, my confidence has grown. The falls and slip-ups still happen, but each time I deal with them, I realise I can handle more than I thought.
There’s also support available beyond friends and family. Depending on where you live, your local council or the government can offer help, so it’s worth asking your eye specialist or support worker what you might be entitled to. This could mean things like a Blue Badge for parking, free or discounted bus travel, Access to Work, or even companion tickets so someone can come with you to an event at no extra cost. These schemes don’t solve the challenges of fatigue, but they do make day-to-day life a little easier to manage.
Written by Guest Blogger Dafydd
Nyman, S.R., Gosney, M.A. & Victor, C.R. (2010) ‘Emotional well-being in people with sight loss: Lessons from the grey literature’, British Journal of Visual Impairment, 28(3), pp. 175–203.
Schakel, W., Bode, C., Elsman, E., van der Aa, H.P.A., Hulshof, C.T.J., van Rens, G.H.M.B. & Bosmans, J.E. (2019) ‘Understanding fatigue in adults with visual impairment: A path analysis study of possible risk factors’, PLOS One, 14(11), e0224340.
Demmin, D.L. & Silverstein, S.M. (2020) ‘Visual impairment and mental health: Unmet needs and treatment options’, Clinical Ophthalmology, 14, pp. 4229–4251.
White, R. & Grant, M. (2009) Designing a Visible City for Visually Impaired Users. 13th International Conference on Computers Helping People with Special Needs (ICCHP). Paris: Association for the Advancement of Assistive Technology in Europe.