Because of my vision problems I often transfer designs to parchment paper I buy at the dollar store ($1 = 12"x25' roll). Not directly vision related but I can't draw worth a darn either so I will often buy a panto roll and copy that out to sew through it as well. I'm finding my hard won long arm quilting skills are not transferring as well as I'd like to my sit down domestic, big difference in moving the fabric instead of moving the machine.
The parchment paper is in a convenient width and length and I like the price. It holds up better than tissue paper but it tears through relatively easily. If your stitches are good, tearing it out will not give you any issues. I like the consistency I get for all over designs. I can do basic meanders and stipples including shapes like stars or hearts or flowers without paper. Best thing is of course is that no one can ever see your lines and whether you were exactly precise or not.
Finishing up a top right now, thought I should take some pictures during the process but I didn't and I'm basically done. Still have to do another round or two of removing the little "chads" of paper that are left along with some of the border. I do a final wash before I'm done with a project, typically that takes care of anything that lingers.
Downside: It is boring drawing out the lines. The graphite from pencil can transfer into white thread and be difficult to get out. The little bits of paper fluff and static and spread out no matter how neat you try to be. I've also had instances of ink getting stuck in the threads too, I'd suggest a hard narrow mechanical pencil lead. So there is the time front loading the project and then the paper removal, but it gives me the desired results that I don't otherwise get. You are definitely using up your needle when sewing through paper but as I say needles are relatively cheap and I expect to use one per top.
In the case of this photo, I copied the design from a Deb Geissler panto I bought years ago, it had both the border design and an all over pawprint meander. It was easier on the long arm than on my domestic but doable.
You can also make patterns by drawing a design on paper (parchment or other) and sewing through a stack at a time with no thread, the needle punch makes a design you can follow and helps tear out the paper. We had a thread where I posted other pictures of that... will see if I can find it.
Found it in time! Here's that thread:
Custom Quilting on Domestic Machine