Coping with Loss as a Result of Diabetes and Blindness/ Low Vision

By Margaret E. Cleary, M.S., R.N., CVRT

Thomas J. Carroll’s book, Blindness, describes twenty different losses and restorations that a person may experience when low vision or blindness occurs. He said he wrote this book as a practical guide for the “adventitious, noncongenital, or newly blinded” and those who work with them. Blindness advocates, skeptics, and professionals considered Carroll a pioneer, a teacher, and an upstart, depending upon their biases. Reader’s Digest published a story about his revolutionary concepts around when the book came out.

A Catholic priest, Thomas Carroll worked as a chaplain with wounded war veterans during World War II. He established St. Paul’s Rehabilitation Center for the Blind in Newton, MA in 1954. He hired me, a rehabilitation nurse, as his field representative in 1961. My assignments were to promote Blindness and spread his message of the essential content and value of St. Paul’s residential rehabilitation for adventitiously blind adults. In the first four years, I traveled to 26 states.

I believe that much has changed in rehabilitation practices since 1961, and some of Carroll’s ideas and expressions are obsolete. Nevertheless, many of his observations are still worthy of exploration.

I have long thought about the impact of these losses and restorations on people with diabetes mellitus, self-managing facts barely mentioned in Blindness. In 1961, almost three-quarters of the students at what is now called the Carroll Center for the Blind had diabetes, most being totally blind. Being interested in diabetes, I became a certified diabetes educator (CDE). My work had taken me to 47 states and four continents when I retired in 2009 as Director of Admissions and Diabetes Educator.

You will find Thomas J. Carroll’s descriptions and my conceptualization of the twenty losses and restorations when an individual has both blindness/ low vision and diabetes. It’s very important to note that all individuals are not similarly challenged by the losses or the restorations.

Wouldn’t Father Carroll be pleased that Reader’s Digest (through VisionAware) has honored him by bringing these issues to the forefront once more?


  • Information in this article excerpted from Diabetes and Visual Impairment: A New View for Vision Professionals Online, CarrollTech, Carroll Center for the Blind, August 2011.
  • Carroll Center for the Blind: Provides distance education online courses, webinars, seminars, white papers, and residential and commuting rehabilitation programs, as well as Diabetes and Visual Impairment: A New View for Patients and Families, a free online course offered for vision professionals, health professionals, rehabilitation professionals, patients, and families.

Coping Resources

  • Carroll Center for the Blind: Provides distance education online courses, webinars, seminars, white papers, and residential and commuting rehabilitation programs.
  • Hadley Institute for the Blind and Visually Impaired: Offers distance education courses, webinars, and seminars for consumers and professionals, materials available in large print, braille, audiotape, and online, and the online course Diabetes: Toward Self-Management.
  • Learning Ally: a national nonprofit volunteer organization with the largest digital textbook library of accessible educational materials (formerly Recording for the Blind & Dyslexic).
  • National Federation of the BlindBridging the Gap: Living with Blindness and Diabetes is a compilation of pertinent articles from Voice of the Diabetic. This discontinued newsletter included both general diabetes information and information for people who are blind or low vision.

Losses and Restorations to Psychological Security

Loss of Physical Integrity Carroll’s Concept: Physical integrity involves being whole as a person, belonging to the in-group and feeling okay with one’s body image. Life is under one’s control and privacy is possible. People with visual impairment experience being different, now feel no longer part of the in-group, develop unconscious fears and symptoms, and […]

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Losses and Restorations in Basic Skills and Information

Loss of Mobility Carroll’s Concept: To lose mobility means to be unable to get about with grace, ease, and safety. One of the first marks of infant development is the power to walk. Adults cheer and praise, independence begins. With loss of mobility comes the return to the creeping dependency of childhood or the forced […]

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Losses and Restorations in Appreciation

Loss of the Visual Perception of the Pleasurable Carroll’s Concept: There is a loss of the visual perception of a personally pleasing or lovable object. It might be a work of art, a smile on a loved one’s face, a new car, a running horse, one’s face in the mirror, or a beautiful person. People […]

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Losses and Restorations Concerning Recreation, Occupation, and Financial Security

Loss of Recreation Carroll’s Concept: Recreation is refreshment, reanimation, the giving of fresh life, especially after wearying toil, work, or anxiety. In one form or another, it is important to everybody and most of all to those under stress. Recreation varies a great deal with individual needs, temperaments, and habits. People with visual impairment may […]

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Losses and Restorations to the Whole Personality

Loss of Personal Independence Carroll’s Concept: Individuals react differently to forced dependence. From birth to our dependent old age, two forces are at work: the desire for independence with its freedom and the desire for dependence and its protection. The true measure of independence is the degree to which we can accept forced dependence. The […]

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