Low Vision and Blindness

These slides are for the training to Health post Incharge of Nepal Government

1. Low Vision and Blindness 1 Rabindra Adhikary [email protected]

2. External structures 2

3. basic Anatomy 3

4. Basic Anatomy 4

5. Basic Anatomy 5

6. General Anatomy 6

7. How eye focuses??? 7

8. How eye focuses??? 8

9. How eye focuses??? 9

10. How eye focuses??? 10

11. Difference between low vision and blindness???? 11

12. General Concept of Low vision and blindness Low vision ( Go"g b[li6 ) Best corrected visual acuity in the better eye less than 6/18 and/or visual field less than 20 degree from the point of fixation . Blindness ( b[li6ljxLg ) Best corrected visual acuity in the better eye less than 3/60 and/or visual field less than 10 from the point of fixation. A person with low vision is not blind 12

13. 6 Meters Assessing visual acuity 6 meters

14. WHO classification SN Visual Acuity (Snellen Notation) Classification Grading 1 ≥6/18 Normal/ Near Normal Normal 2 <6/18-6/60 Moderately VI Low Vision 3 <6/60-3/60 Severely VI 4 <3/60-PL Legally Blind Blindness 5 NPL Totally Blind 14

15. WHO Definition A person with low vision is one who has impairment of visual functioning even after treatment and/or standard refractive correction, and has a visual acuity of less than 6/18 to light perception, or a visual field less than 10 degrees from the point of fixation, but who uses, or is potentially able to use, vision for the planning and/or execution of a task.” Modern Concept???? 15

16. Visual impairment Medical Definition: A functional limitation of the eye(s) or visual system manifesting as reduced visual acuity or contrast sensitivity, visual field loss, photophobia, diplopia, visual distortion, visual perceptual difficulties, or any combination of the above. Social Definition: Vision inadequate for an individual’s needs. It can result in a visual disability or a visual handicap . It limits the abilities of the individual and limits the individual’s personal and socioeconomic independence. 16

17. Aspects of vision loss Disease / Disorder Anatomic changes- inflammation,atrophy , scar Impairment Functional changes- visual acuity, VF, contrast sensitivity Disability Skills and abilities affected- reading, writing, DLAs Mobility Handicap Socioeconomic consequences- extra effort, loss of independence Disease impairment disability handicap

18. Conclusion Blindnes s is the condition of lacking visual perception but low vision clients have significantly reduced vision, visual performance is affected but there is still residual vision that can be used and they are not labeled blind . Low vision people have some usable vision and if there is usable vision, training to use that vision might be possible . A complete blind people can’t perform their activities but a low vision people can use, or is potentially able to use, vision for the planning and/or execution of a task themselves. 18

19. Todays perception Major difference between low vision and blindness is the person's attitude toward his or her visual impairment . People who confidently identify themselves as blind have accepted blindness as a personal trait. People who identify themselves as having low vision tend to struggle with trying to function as if they were normally sighted. 19

20. FACTS About 285 million people are visually impaired. 39 million are blind. 246 million have low vision (severe or moderate visual impairment. Up to 80% of the world's blindness is avoidable . About 90% of the world's visually impaired people live in developing countries. 20

21. Causes of Low Vision Top causes of visual impairment: 1.refractive errors (43%) 2.cataracts 3.glaucoma Top causes of blindness: 1.cataracts , 2.glaucoma and 3.age-related macular degeneration 21

22. afn cGwf ] kgf M g] kfnsf ] cj:yf cg'dflgt #) xhf / @ ;o afnaflnsf b[li6ljxLg s/La ! nfv afnaflnsf Go"g b[li6 ePsf # nfv #) xhf / afnaflnsf ulDe / b[li6 bf]if ePsf ! Nffv @% xhf / afnaflnsf clN5 cf+vf ePsf k|To ]s lbg & hgf afnaflnsf cGwf x'G5g \ k|To ]s jif { s/La #% nfv afnaflnsfsf ] cf+vf k/LIf0f cfjZos x'G5 eg ] s/La % nfvn ] dfq ;f] ; ' ljwf kfO /x] sf 5g

23. sdhf ]/ cf+vf - b[li6 bf]if_ le6fldg P sf ] sld cf+vfdf nfUg ] rf ]6k6s Dff ] ltljGb ' Major causes of Childhood Visual impairment

24. hGdhft hnljGb ' cf+vf kfSg ] /f]u cf+vfsf] SofG;/ Minor causes

25. Impact of visual impairment 25

26. Impact of visual impairment contd.. 26

27. Social problem economical problem

28. Role of Government Government should make strategy about how best to help those losing sight. It’s the duty of government and the concerned people to establish rehabilitation centers and provide low vision clients with easily accessible and available low vision services to them. 28

29. Access technology such as screen readers, screen magnifiers and refreshable braille displays enable the blind to use mainstream computer applications and mobile phones. 29

30. VISION 2020 - working together to eliminate avoidable blindness . VISION 2020 is the global initiative for the elimination of avoidable blindness , a joint program of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with an international membership of NGOs, professional associations, eye care institutions and corporations. 30

31. Target disease areas for VISION 2020 Cataract Refractive Error Trachoma Childhood Blindness Low Vision Onchocerciasis /River Blindness Glaucoma Diabetic Retinopathy Age Related macular degeneration 31

32. BLINDNESS IS THE BEND IN THE ROAD NOT AN END OF THE ROAD….. 32