Estimates suggest that between 1,000 and 2,500 people have lost their sight or suffered visual impairments since the beginning of the full-scale invasion. The ambiguity around the exact number is due to the information coming from state medical services and not the usual ministries, said Olesia Perepechenko, acting president of the Modern Vision (Suchasnyi Pohliad) NGO and a qualified teacher for children with visual impairments. Perepechenko is currently working to rehabilitate Ukrainian soldiers.

As a child, Perepechenko almost completely lost her sight after complications from an illness. The majority of people with visual impairments now are soldiers who have sustained blast injuries or polytrauma. Vladyslav Yeshchenko, head of the Let’s See The Victory (Pobachymo Peremohu) charitable foundation, is one of them. Yeshchenko, whose alias is Samurai, served as an explosives technician; now he also has a hearing impairment and has had several facial plastic surgeries. Despite his personal struggles, he has founded a charitable foundation and is now helping other soldiers who have completely or partially lost their sight.

Illustration: Anna Shakun

   

 

Vladyslav Yeshchenko

head of the Let’s See The Victory (Pobachymo Peremohu) charitable foundation

Olesia Perepechenko

acting president of the Modern Vision (Suchasnyi Pohliad) NGO

 

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Starting is the hardest

Physical, psychological, social, and occupational rehabilitation can’t begin until medical rehabilitation is complete, says Modern Vision’s Olesia Perepechenko, who has been organizing rehabilitation camps for soldiers since 2019. “When someone is discharged from the hospital, it’s crucial that they don’t feel like they’re in a shell or in complete darkness, so that they can still learn things and gradually return to the independent living they had known before their injury,” Perepechenko says.

There are two stages of rehabilitation: primary and secondary. Primary rehabilitation focuses more on one-on-one, personalized treatments, while secondary rehabilitation prioritizes group therapy and teamwork. Perepechenko says that during group classes people might meet others who could inspire them or help them find a new career.

 

 

 

 

The process of rehabilitation usually begins before the veteran attends a rehabilitation camp, with a call or visit from a rehabilitation expert to the veteran him- or herself, or their partner. “If we know that there is a soldier who has lost their sight in a hospital, we don’t just give them a cane and tell them what to do. If they’re not ready, the more you talk about rehabilitation, the more frustrated they get,” Perepechenko says. “First we talk about other things, in fact we mostly let them speak. At some point they feel they’re ready. It took me half a year to convince one soldier to go through a rehabilitation process. Later, he thanked me for not trying to push him and giving him time to adapt to his new circumstances,” she adds.

 

 

If they’re not ready, the more you talk about rehabilitation, the more frustrated they get

 

Vladyslav Yeshchenko, war veteran and the founder of the Let’s See The Victory foundation, says that he was in critical condition when he was hospitalized. Later he found out doctors thought he had a 20% chance of survival. He spent 10 days in a coma. His medical rehabilitation took nearly four months: two were spent in a hospital in Kyiv, then in an otolaryngology institute, then at an ophthalmology clinic and at Kyiv City Hospital №1.

Yeshchenko says that after his long recovery he failed to give enough time to social rehabilitation and adjusting to daily living in his new circumstances. He decided to dive head first into work. He set up a charitable foundation to help soldiers with visual impairments and their families together with his friend, Artem Pakhomov. Through this work, Yeshchenko met Perepechenko, who invited him to attend a rehabilitation camp in Rivne Oblast.

“We were in contact with a dozen of organizations and I was completely taken aback by the thought that I need to undergo rehabilitation – until I spoke to Olesia [Perepechenko],” Yeshchenko says. “So my rehabilitation process didn’t really start until a year after I sustained my injury. I learned ways to orient myself in space, to use a phone and a computer, and I completely rethought my attitude to the white cane: I had to accept that I’d be using it and that the cane is there to help me. After two weeks at the rehabilitation camp, I felt as if I was a different person. I realized I didn’t need to reinvent the bicycle, but to scale up this line of work. That’s how we partnered up with the Modern Vision NGO.”

 

Gym, ergonomic kitchen, and first grocery shopping alone

Modern Vision doesn’t have premises where it can host rehabilitation procedures and classes, so it organizes up to six rehabilitation camps every year, each with 6-10 participants (soldiers), the relatives or assistants accompanying them, and rehabilitation experts. Primary rehabilitation can last 2-4 weeks, depending on the group.

During the first day, participants undergo a diagnostic screening of their physical state as well as capacity to handle a series of routine tasks. Experts assess how fast and flexible participants are and how their muscles work. Usually people become less active and move less after losing sight, which can affect their health, Perepechenko explains.

Camp participants are also asked what they are and aren’t able to do in their daily life, including questions about personal hygiene (brushing their teeth, shaving, showering). Their spouses and relatives are also asked these questions, as the answers sometimes diverge. During the first day, participants also undergo a mental health check.

A team of 12-14 rehabilitation experts then draws up a personalized plan and program for each participant, taking into account the participants’ own wishes and goals. Perepechenko says that lots of people say their first wish is to go to the gym. Rehabilitation gyms have to be specially equipped to ensure that people with vision impairments don’t get injured by accidentally walking into equipment underfoot or at head level. Personal assistants can be useful here.

Later on, camp participants usually realize that relearning other aspects of daily routines, how to navigate social situations, and to orient in space is no less important. “Two of the guys wanted to be able to make cabbage rolls!” Perepechenko says.

First, camp participants learn to navigate a room without their cane. Perepechenko says that people with visual impairments learn about their environment – whether a room is square or rectangular, how it’s oriented, how many windows it has, what furniture it contains and how it is situated – from tactile cues. If a visual impairment is acquired and not inborn, people are used to thinking about the world using images, visual thinking; they might remember what a particular room looks like from before their injury. (People who were born blind require a different approach.)

 

If a visual impairment is acquired and not inborn, people are used to thinking about the world using images, visual thinking; they might remember what a particular room looks like from before their injury

   

Photo: ГС "Сучасний погляд"

Perepechenko says exercises aimed at developing and improving other sensory systems help with orientation in space. After losing sight, many people have to learn to walk straight again. It’s important to also work on tactile awareness: the ability to perceive warmth or cold, wind or drafts. It’s possible to develop sensory processing such that some people are able to perceive certain objects from a distance of 1-1.5 meters. Being able to orient in space is very important, because when someone who has lost their sight is outside, they have to be able to tell how far they are from traffic, which direction the traffic is moving, and where the sidewalk ends and the road begins, Perepechenko says.

After the soldiers learn to navigate a small enclosed space, they’re taken outside for walks with their canes. They start going to grocery stores or using public transport – first with their assistants, then on their own. When paying at a grocery store, people with visual impairments can ask the cashier how much change they are giving or use the Cashreader app, which recognizes banknotes from different countries. “They can feel ashamed that they’re holding up people in the queue with their questions; that’s a social interaction issue, which sometimes we can resolve in therapy,” Perepechenko says.

At the camp’s ergonomic kitchen, the soldiers with visual impairments learn to use sound and weight to pour liquids and to use tactile cues in their daily lives. Special sensors can be used to gauge how much water you’ve poured from a kettle into a cup; those sensors are only one of several assistive technologies available. Camp attendees are taught how to use these assistive technologies, but also to navigate their daily lives in their absence. “Not everyone has access to these technologies, or a device might run out of charge,” Perepechenko explains. She stresses that it’s not like they have to teach camp participants everything anew but rather to help them regain skills and abilities they already have: “If someone used a spoon to eat their entire life, we’re not going to tell them they have to use a fork.”

The rehabilitation program is intensive, but leaves people room to choose among different options. For example, you can choose to go to the gym if you don’t want to go to a computer class, or to opt in for dance and movement therapy instead of Scandinavian walking.

Around 20:00 each day, all camp participants meet in a conference room to talk about their day and play board games. There are special chess and chequers for people with visual impairments: different-coloured chequers have different textures (smooth, concave or convex) and the board is relieved accordingly too. “You can feel the position of different pieces when you touch the board with your hand. We’re always saying that our fingers and hands are our eyes,” Perepechenko says.

   

They can feel ashamed that they’re holding up people in the queue with their questions; that’s a social interaction issue, which sometimes we can resolve in therapy

   

“Over the first couple of days we get to know everyone’s level of ability. Some people learn quickly, others are slower. It’s not like in other types of group work, where the whole group advances even if someone hasn’t quite grasped something. We spend the entire day, from 08:00 to 23:00, together in different classes and sessions. They have to master a number of things, even if they don’t think they need to,” Perepechenko adds.

Camp organizers are learning to work with soldiers who have suffered from polytrauma, for example those who have lost a limb or are also suffering from a hearing impairment. “We teach them how they can use their teeth, or how they can use their prostheses,” Perepechenko says, adding that there are unfortunately still very few experts who can help people with polytrauma.

Veterans who are missing their arms, or parts of their arms or hands, or who have suffered damage to blood vessels in their fingers can’t use the Braille code. Perepechenko believes that having to learn Braille is a myth. It’s not necessary, for example, to prescribe medications, because there are now apps that can say out loud things that are written down. Of course, those who want to can still learn Braille, though likely not in an effort to truly master it, but rather to help establish the finger-brain connection, Perepechenko explains.

 

 

The importance of working with families of people who have a visual impairment

People who lose sight tend to at first see it as a disability: “No one cares about me,” “I’m disabled, I can’t do it.” They tend to deprecate themselves while also, in some cases, manipulating those around them: “Why should I learn to make myself tea if Natalka can always bring me some?” Perepechenko says, then continues: “So we have to work with Natalka as well. She should be able to say: ‘You put your clothes in the closet, so go and get them. You should be able to do it yourself.’”

 

   

 

 they’re asked to carry out some tasks while blindfolded: not so much so they can understand what it feels like to lose sight, but to be able to offer the right kind of help

 

   

 

The wives and other family members of soldiers who have lost sight are taught how to gradually stop over-caring and communicate in a way that won’t undermine the dignity of a person with a visual impairment. Soldiers’ relatives have their own physical therapy and social rehabilitation classes. 

For example, they’re asked to carry out some tasks while blindfolded: not so much so they can understand what it feels like to lose sight, but to be able to offer the right kind of help: not just to hand an object to the person who can’t see, but to talk them through it: “Why aren’t you taking it? I’m handing it to you.” Or, for example, to gently touch them to indicate that they should pick something up.

 

 

Mutual help among people with sight loss

When soldiers in rehabilitation camps realize that their trainers are also people who have suffered partial or complete sight loss, they trust them more, Perepechenko says: “Soldiers get really frustrated when counselors or social workers just tell them that everything will be okay. I don’t usually mention that I also have a visual impairment when I first meet camp participants. They usually just stay silent, or ask me what I want from them, or start to grumble. Then I ‘accidentally’ drop my cane, and someone always asks me: ‘What’s that?’ And I tell them it’s my cane. Their attitude immediately changes. They look at us doing things and they think: ‘What about me? I should also be able to do that’,” Perepechenko says.

“I don’t need to tell someone with a visual impairment how much I struggle, we don’t even talk about it. They just know what to do,” Yeshchenko agrees.

 

 

 It’s amazing to see a grown man once again be able to dial his mom’s number and say ‘Mom, I’m calling you all on my own!’

 

That’s why 75% of Modern Vision’s 30-strong team – from massage therapists to experts in the fields of daily life and social interactions, movement therapy, and navigation – are people with partial or complete sight loss. Where necessary, these experts work with fully sighted assistants. The team needs to be big because each participant requires 6-8 hours of one-on-one work a day – a physically and emotionally demanding job, Perepechenko explains.

She doesn’t agree that the blind can’t teach the blind. People teaching soldiers to use smartphones or computers often also have partial or complete sight loss. Perepechenko says that people with no visual impairments can’t fully convey information to those who have them, because the latter have to operate in a completely different way – for example, they use special screen access software and screen readers. In order to be able to use a smartphone, they first need to correctly place their fingers and to set up the voice synthesizer (to choose the pace and male or female voice, etc.).

“It’s amazing to see a grown man once again be able to dial his mom’s number and say ‘Mom, I’m calling you all on my own!’ And to hear her respond: ‘Dear son, I missed you so much!’ They are so happy when they can dial the number themselves. Meanwhile parents and others on the receiving end of those calls don’t always understand the happiness and euphoria they experience in that moment,” Perepechenko says.

 

 

Apps for people with visual impairments

“Anything AI-related generally makes our lives easier,” says Perepechenko. “I’ve been obsessed with AI for the past few days,” Yeshchenko echoes her. “If I take a picture, AI can describe what’s in it. If you have two identical soda cans, software like Voiceover (Apple) or Talkback (Android) can help you figure out which one is Coke and which one is Pepsi.”

Sullivan, another app, can detect the text on a photo and read it out loud. “A veteran told me that when it’s raining outside and he goes for a cigarette, he launches this app and reads the announcements by his building’s entryway, so as not to be bored,” Perepechenko says.

Be My Eyes is also an app for people with visual impairments. It connects you with a volunteer who knows the language of the country you’re in and who can help you orient yourself in a new location if you show them around using your phone’s camera. “I know a partially sighted man who uses this app to get around his village on his bike. He sets his phone on the handlebar, and the volunteer tells him when to turn. I’m not a big fan of this though,” Perepechenko says, “Lots of things can happen – a dog can run out into the road, for example, or the internet connection might break up.”

 

People with sight loss and guide dogs

During some stages of rehabilitation, a white cane is enough, Perepechenko thinks. She adds that there isn’t really a culture around using guide dogs in Ukraine, in part because of legislative obstacles: dogs are not always allowed on public transport or in places like pharmacies. Guide dogs are also trained to be less aggressive, which means they’re not prepared to defend themselves from strays – and there are a lot of stray dogs in Ukraine, especially in villages.

Even if it’s possible to train guide dogs in Ukraine, they can’t be certified there; this has to be done abroad. The dogs have to undergo training every three years. And it costs a lot: you could pay up to 150,000 hryvnias (nearly US$4,000) for guide dog training.

The Let’s See The Victory foundation is currently working with the Anteus guide dog training center and hoping to work more in this area. Yeshchenko says the center is currently facing legal trouble because it is located in Mezhyhiria [former president Viktor Yanukovych’s estate, now a museum showcasing his lavish and corrupt lifestyle] and might be shuttered soon.

 

 

Making places accessible for people with visual impairments

“If I’m walking on a sidewalk with my cane, I choose something to orient by on my right and just walk. I try to walk straight, right by the buildings, but sometimes the surface is interrupted by below-ground-level windows or steps that go into shops. My cane helps me sense changes in surface: on the tarmac it makes one sound – off it, a different sound,” Perepechenko says about navigating the city. “Sometimes [municipal workers] just put tape around big holes. That tape does absolutely nothing for me. We need fences that reach at least to a person’s waist to stop people from falling into those holes. This happened in I think Kryvyi Rih once: construction workers dug a hole, then went somewhere, leaving it unguarded, and a man fell into the boiling-hot water inside. It took a while to rescue him.”

Cars parked on sidewalks, billboards and other advertising infrastructure, and all sorts of posts also make the urban environment less accessible for people with visual impairments, Perepechenko says.

However, she says that more and more people are aware of how to act around people with visual impairments. The worst thing for a blind person is when they’re pushed to the side or when someone yells at them to move right or left – often they can’t understand they’re the ones being addressed. “Who are you yelling at? A dog? A driver who’s trying to park their car? Another person?” Perepechenko asks. The best thing you can do is offer help, but without imposing it. If the person refuses, you can just describe the potentially hazardous obstacles ahead of them, if you see them, like a truck that’s being unloaded.

 

 

 The worst thing for a blind person is when they’re pushed to the side or when someone yells at them to move right or left – often they can’t understand they’re the ones being addressed

 

 

In addition to sight loss, Yeshchenko has a hearing impairment and uses a hearing aid. He says he often feels disoriented in urban environments, in part because he finds it difficult to know whether traffic has stopped, or to identify which direction a voice is coming from. Yeshchenko often asks someone to accompany him while he’s crossing the street: you can count the traffic lights that have sound signals on the fingers of one hand, he says.

He believes that the best strategy would be to teach school kids about people with visual impairments so that kids can pass this knowledge and tolerance on to future generations. A pilot with this goal has been launched in Kyiv, with Yeshchenko as the principal instructor. Accompanied by his wife and father, he has visited three Kyiv schools, telling students about the correct ways to offer help to people with visual impairments and playing games designed to help the kids better understand such people – for example, the kids might be asked to grab an object out of a bag while blindfolded.

 

 

 

 

The most ethical way to describe someone who is partially sighted is to say a “person with a visual impairment”. Perepechenko says it’s also okay to say “blind” or a “blind person”, but not in a conversation with someone who has a visual impairment.

 

Corneal transplantation and prosthetic eyes: Is it possible to restore sight?

For over a year, the Let’s See The Victory foundation has been helping soldiers with visual impairments and their families. They started by sharing information about prosthetic eye technologies available abroad, signing an agreement with the Miguel Hernández University in Spain and the Bogomolets National Medical University in Kyiv. Yeshchenko was supposed to take part in an experimental research project in Spain, but decided not to – he didn’t want to spend six months in Spain. Instead, he chose to focus on helping Ukrainian soldiers who have lost sight.

One of the foundation’s primary goals is to help those who might yet be able to recover their sight. Sometimes, corneal transplants can help a person regain their vision: “We had one case where the person could barely see for a year and a half, but can now read following a corneal transplant,” Yeshchenko says. His foundation works alongside Clinical Hospital №1 to purchase the biomaterial for the procedure within Ukraine. One cornea costs around 45,000 hryvnias (around US$1,160). Yeshchenko explains that the hospital does all the paperwork and arranges the purchase, while the foundation pays for it.

Ocular prostheses are a bit trickier, Yeshchenko says. They’re essentially dummies, which have more of an aesthetic effect, while also supporting the orbit and the eyelids. Ocular prosthetics are manufactured to order, and have to match each person’s anatomy. Yeshchenko says that for the most part these prosthetics are made in Ukraine by foreign experts that bring their own raw materials with them. An eye prosthesis can cost around 20,000 hryvnias (US$515). Yeshchenko got his own prostheses in Vinnytsia; he was able to choose from among the ones that were already available.

“I was lucky there were prostheses that matched the shape of my eyes. I was warned that they could fall out, or the opposite, and that I might have to have them replaced, but that didn’t happen. I’ve had these for about a year now. I have to take my hearing aid off when I sleep, but I can sleep with my ocular prostheses; they even help to support the eye orbit. I take them off when I need to disinfect them, but that’s not very often at all,” Yeshchenko says.

Experimental bionic eye technologies are mostly based on using electric signals to restore vision. “Our brain works by firing tiny electrical impulses. It’s possible to detect the frequency and power of these impulses and, in theory, copy them in order to affect a particular part of the brain cortex – without having the eye of the optic nerve involved. They use special AI-powered cameras. This technology can potentially create a 2D black-and-white vision with a low data transmission speed,” explains Yeshchenko.

   

One of the foundation’s primary goals is to help those who might yet be able to recover their sight

   

He adds that around 10 countries, including Germany and Israel, are currently testing this technology. Elon Musk’s Neuralink has promised it will be able to achieve something similar, but Yeshchenko is skeptical: “Musk said that even fully sighted people will be envious of the quality of vision with his technology. That’s a good marketing ploy, let’s see whether it really works.”

The first eye transplant was successfully completed in New York in the summer of 2023. The patient’s blood vessels and retina appeared to function well, but they didn’t regain their vision. Surgeons inserted stem cells from the donor’s bone marrow into the patient’s optic nerve, but it didn’t have the desired effect. Other technologies designed to help the brain connect to the new eye using electrodes are being tested now.

When asked how to tell true assistive technologies from scams, Yeshchenko says that the Veselovskyi family is a great source of information and expertise for his foundation [many of the family members are professors and members of Ukraine’s Academy of Sciences; Zoia Veselovska, for example, was a practicing doctor who has carried out many complex ophthalmological surgeries].

“They research every innovation that becomes available. For example, the Veselovskyis think that the technology being developed in Spain is particularly promising. I also see its promise, because science is advancing very quickly. In the past, it would take decades to develop a technology like this – now we need years, sometimes even months or weeks,” Yeshchenko says confidently.

Yeshchenko’s foundation sometimes shares information about new technologies that aim to restore vision with soldiers and their families. There’s even a special Telegram chat, where soldiers with visual impairments can send each other voice messages.

The Let’s See The Victory also pays for soldiers’ rehabilitation and helps them find new careers and retrain. “It’s very difficult to find funding at the moment. Most people want to help those who are fighting right now, but forget about those who have paid their dues to their Motherland and now need help and rehabilitation,” Yeshchenko says.

He is currently working with the Oleksandr Tereshchenko Foundation (Tereshchenko is the former Deputy Minister of Veterans’ Affairs and has served in the Armed Forces of Ukraine), the After Service Veteran Foundation, the First Medical Union in Lviv, the National Assembly of Persons with Disabilities of Ukraine, and the Modern Vision NGO.

Modern Vision’s Perepechenko says that the Oleksandr Tereshchenko Foundation helps fund the rehabilitation of soldiers who have lost sight. Her NGO also has access to other sources of funding: for example, the Ukrainian Center of Physical Culture and Sports for Persons with Disabilities is a government institution, so it can’t cover rehabilitation trainers’ salaries, but it can pay for veterans’ meals during Modern Vision’s rehabilitation camps.

   

 Yeshchenko’s foundation sometimes shares information about new technologies that aim to restore vision with soldiers and their families

   

 

Benefits available to soldiers with visual impairments and their families

“My life goal was to help others. I made a lot of sacrifices. It was morally and emotionally challenging to find myself in a situation where I myself needed help,” Yeshchenko says. “With time, however, I realized that I have resources to help others, like information and access to experts. So I decided to help a few people. I wanted to create an organization that would offer help. One evening I called Artem Pakhomov. Neither of us had experience doing anything like this, but we decided that we’ll learn from our mistakes, and figure it out.”

Yeshchenko adds that after they set up the foundation, they got messages not only from people who needed help, but also from doctors. “I’m trying to get to the point where all hospitals and ophthalmologists can refer their patients to further social and daily life rehabilitation. In the absence of this, there’s a risk that people with visual impairments won’t be able to go back to normal life and could even develop elements of sociopathy or suicidal thoughts,” he says.

 

   

 

 I wanted to create an organization that would offer help

 

   

 

He also mentions that he tries to speak with each soldier appealing to the foundation: “My example shows them that they shouldn’t give up, and that they can achieve a lot despite sight loss.” Let’s See the Victory is currently working with 80 soldiers – too few and too many at the same time, says Yeshchenko. “Since the beginning of the full-scale invasion, at least 300 people have lost sight completely, 800 partially. Over 1,000 people total. We want to spread information as widely as possible.”