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Healthcare has the past decades shifted from a narrow medical perspective to a more holistic, biopsychosocial perspective. Disability understood as a contextual condition constituted by the relation of the individual to their social and physical context. The disability model of the International Classification of Functions (ICF) contextualizes activity, participation, body functions and structure by including environmental and personal factors. However, illustrated by the consideration of the environmental factors as a neutral dimension, the dynamic interrelation of the individual parts of the system is rather unchartered. In 2017–2019, a lighting assessment was developed and tested on 60 participants in low vision rehabilitation. An action research project accompanied the pilot study from 2018. Ethnographic participatory observations of the low vision consultants in 15 consultations, semi-structured interviews, and a document analysis of the project material of the pilot project has been analyzed using the theoretical framework of science and technology studies. Mapping the physical environment showed a range of factors from spatial organization to luminaires and light bulbs. Moreover, in relation to specific activities, relevant factors were identified and assessed, and in the intervention adjusted to relevant personal and social factors. Identifying overlapping personal, environmental, and professional spheres illustrates the complexity of practicing rehabilitation in people's everyday lives. Acknowledging and coordinating different versions of lighting enabled low vision consultants to work across these spheres relationally. ICF was embedded in the practice of low vision consultants as a frame of reference, however, implementing this framework occurred through an assemblage of tools from different fields. The focus on lighting as an active element in low vision rehabilitation demonstrated a way to work across the personal and environmental to reduce the gap that caused disability. In everyday life, the physical environment was pivotal in the person–environment relationship and in enabling or disabling the individual. However, the physical environment was also key to the rehabilitation process, facilitating the individual's learning and change processes and reconfiguring their understanding and use of the environment. Consequently, the physical environment was not a neutral background to the other factors but rather enabling the rehabilitation and recovery processes.

Objective – The objective of this paper is to open up the ‘black box’ of low vision rehabilitation related to domestic lighting and to explore a current progress in practice. Background - Alterations and adjustments of the home or working environment for people with low vision have been based on scientific diagnostics and the level of vision and translated into a level of required lighting. This narrow and technical approach have recently been challenged by rehabilitative initiatives from professional and political stance. The rehabilitation approach embraces the everyday self-reliance of the citizen, where the social and physical contexts play an important role. Since 2015, the Danish municipalities have been required to offer citizens with impaired functioning rehabilitative initiatives that are ‘organised and performed in a holistic and interdisciplinary manner’. The methods and theories for handling this in a holistic and interdisciplinary manner have been missing. Consequently, some of the low vision services have developed their own methods to gain a better understanding of the social and physical context of low vision rehabilitation and the citizens’ quality of life. In addition, the current practice is adapted along the way. Methods – Two low vision consultants and their implementation of a recovery-based lighting assessment have been explored by participative observations in home visits and in the light lab, followed by a semi structured interview with the consultants. Drawing on the field of science, technology, and society studies the paper discusses different kinds of knowledge and their role in rehabilitation practices. Results – By focusing on issues of domestic lighting in relation to everyday activities, the scientific diagnostics were translated to highly contextualised conditions. Different types of knowledge were addressed in the consultations, including tacit knowledge, embodied in the participants and embedded in guidelines, technologies and surroundings. The narratives of the citizen, accompanied with photos and lux measures were used to recreate the settings when moving to the light lab. Based on the specific activity, the consultant demonstrated different lamps and arrangements and was guided by the immediate feedback from the participant when different lamps were compared. The approach by large resemble the person-environment-occupation model, enabling different types of knowledge and the aspect of development over time. Conclusion – By framing the visual impairment in terms of light and occupation, the consultants enabled a space for discussing challenges and testing possibilities regarding the citizens’ physical and social context, and to co-create the most relevant knowledge.

The objective of this paper is to open up the ‘black box’ of low vision rehabilitation related to domestic lighting and to explore a current progress in practice. Alterations and adjustments of the home or working environment for people with low vision have been based on scientific diagnostics and the level of vision and translated into a level of required lighting. This narrow and technical approach have recently been challenged by rehabilitative initiatives from professional and political stance. The rehabilitation approach embraces the everyday self-reliance of the citizen, where the social and physical contexts play an important role. Since 2015, the Danish municipalities have been required to offer citizens with impaired functioning rehabilitative initiatives that are ‘organised and performed in a holistic and interdisciplinary manner’. The methods and theories for handling this in a holistic and interdisciplinary manner have been missing. Consequently, some of the low vision services have developed their own methods to gain a better understanding of the social and physical context of low vision rehabilitation and the citizens’ quality of life. In addition, the current practice is adapted along the way. Two low vision consultants and their implementation of a recovery based lighting assessment have been explored by participative observations in home visits and in the light lab, followed by a semi structured interview with the consultants. Drawing on the field of science, technology, and society studies the paper discusses different kinds of knowledge and their role in rehabilitation practices. By focusing on issues of domestic lighting in relation to everyday activities, the scientific diagnostics were translated to highly contextualised conditions. Different types of knowledge were addressed in the consultations, including tacit knowledge, embodied in the participants and embedded in guidelines, technologies and surroundings. The narratives of the citizen, accompanied with photos and lux measures were used to recreate the settings when moving to the light lab. Based on the specific activity, the consultant demonstrated different lamps and arrangements and was guided by the immediate feedback from the participant when different lamps were compared. The approach by large resemble the person-environment-occupation model, enabling different types of knowledge and the aspect of development over time. By framing the visual impairment in terms of light and occupation, the consultants enabled a space for discussing challenges and testing possibilities regarding the citizens’ physical and social context, and to co-create the most relevant knowledge.