Visual Impairment Awareness

Visual Impairment Awareness
A Collaboration between University Hospital,
The Low Vision Services Committee and
Community Services
Sensory Impairment Team
& Coventry Society for the Blind
Session aims
To understand What a visual impairment is?
What causes visual impairments?
How visual impairments affect people?
What can we do to help those who have a
visual impairment?
What is a visual impairment?
Bob Wright
(The Low Vision Services
A Snap Shot!
“People with Impaired Vision”
Why “People with impaired vision”,
rather than “Visually impaired
Because they are people first who
happen to have a disability attached
to them.
How Many?
1 in 60 people in the UK has impaired
vision which equates to 1.4 million people.
The incidence of impaired vision is
Between 1982 and 2000 the incidence of
those registered as blind rose by 41% and
the incidence of those registered as
partially sighted rose by 50%.
What the RNIB says…
Currently there are 1,500 people
registered severely sight impaired/blind or
sight impaired/partially sighted in Coventry
- recent research suggests that these
figures could be 20% higher
the number of people eligible to register in
Coventry therefore could be as high as
the majority (85%) of people with sight
problems are older people, aged over 65
Largely because:
impaired vision is age related
the demographers tell us that the
proportion of older people will continue to
increase until at least 2050
It is expected that the number of people
with visual impairments will reach 3 million
by 2030
Department of Health
Estimates that as many as 4 million older
people do not have regular eye
examinations that could detect some
conditions that are treatable
Key message
You will often meet people with a
significant visual impairment in your work
there are many people with a significant
visual impairment now and there will be
many more in the future
What is it like to live with a
visual impairment?
Bob Wright
(Low Vision Services
Common Causes of Vision
Annette Ryman
Clinic 9 – Coventry & Warwickshire
NHS Trust
(Clinical Nurse Specialist for Retinal
Commonest forms of vision loss
Commonest conditions associated
with loss of vision
Cataracts (Temporary vision loss)
Age Related Macular Degeneration
Diabetic Retinopathy
Quick anatomy lesson!
What is a cataract?
It is an opacity or clouding of the lens
Causes of Cataract Development
Certain medications: long term oral steroids, Tamoxifen,
long term aspirin usage, Amiodarone, Allopurinal
Medical disorders such as Diabetes, Glaucoma, other
metabolic disorders
Long term over indulgence of alcohol
Poor diet
Long term exposure to ultraviolet light/radiation
Reduced depth perception
Diminished colour perception
Glare in sunlight/ sensitivity to bright
Poor night vision
Headaches/ eye fatigue (eye strain)
How do we treat cataracts?
Usually surgical removal – cataract
extraction with a lens implant
Cataract Surgery
What is Age Related Macular
It is the most common cause of
blindness in the United Kingdom for
individuals over 60 years of age.
There are two types wet and dry:
The wet type (10%) is treatable and
the dry (90%) is not.
Normal eye
What happens?
With age, tissues break down and
fluids begin to seep between the
layers of the retina, causing them to
separate. As they do, the result is
macular degeneration.
ARMD degeneration process
Age Related Macular Degeneration
Distorted vision
Inability to read print
Central part of the vision is missing
Wavy lines
Age Related Macular Degeneration
There is no known cure for macular
degeneration, but there are treatments which
may help to slow it down
Thermal Laser treatment
Photodynamic Therapy
Intravitreal Steroid injection
Intravitreal drugs – Macugen/Lucentis/Avastin
Patients do not go totally blind but all of
these patients will require Low Vision and/or
Social Services support at some point.
Charles Bonnet
Sometimes as a result of severe vision loss people can see
hallucinations, not necessarily exclusive to people with AMD
This is the result of the brain creating images and filling in the
missing pieces of vision
Often people describe little people, gargoyles, distorted faces,
Can make navigation difficult
No cure but it may disappear in a year to 18 months
The key to helping these people is to reassure them, and their
family, that they are not going mad
Not everyone will recover but as long as they realise that what
they see is not real they can cope reasonably well
What is Glaucoma?
Pressure created by the fluid in one or
both eyes builds up to an abnormally high
When this pressure remains elevated over
a period of time, damage occurs to the
delicate visual structures. Left untreated,
blindness often results.
Can be chronic or acute
The Drainage
System of the
Cupping of the Optic Disc
Incidence/Prevalence of Glaucoma
By the age of 40 it is estimated that 1 in
100 people develop some form of
By the age of 70 this increases to 1 in 10
High risk groups include people of African
descent ,people who are short-sighted,
have diabetes and have a family history.
(BBC News 24 – January 2004)
What are the symptoms?
There are no warning symptoms
until late in the disease.
Peripheral vision is lost
It often goes unnoticed until it's
too late – sometimes referred to
as the “thief of sight”
No cure, but, it can be controlled.
The most common treatment for glaucoma
is eye drops to lower the pressure.
If the pressure does not decrease
treatment may involve laser treatment or
laser surgery which opens the drainage
system in the eye so fluid will flow freely.
Early detection and treatment are the only
ways to prevent permanent vision loss.
What is Diabetic Retinopathy?
It is a complication of diabetes caused by
the deterioration of blood vessels
nourishing the retina. Glucose is thought
to damage retinal and renal capillaries
This condition can cause blindness at any
Incidence is affected by how long a person
has had diabetes and how stable their
diabetes has been.
Diabetic Retinopathy
Gradual blurring of vision may occur.
Changes may go undetected without a
retinal examination.
Deterioration of vision potentially leading
to severe visual impairment.
Diabetic Retinopathy
In many cases, treatment may not be required
BUT in others, laser treatments may be
recommended to halt further progress of the
Where swelling is present, steroids or intravitreal
treatments may be considered.
Early diagnosis and treatment are vital to
preventing visual loss from diabetic retinopathy.

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