1. Introduction to Blindness and Low Vision
BJ LeJeune, M.Ed., CVRT, CRC
RRTC on Blindness and Low Vision
Mississippi State University

2. Blindness and Low Vision
A low incidence disability
A social-economic as well as a physical reality
Age related – older persons more likely to be visually impaired so there are often accompanying age-related losses.

3. Stereotypes of Blindness
Negative
Positive
Unable to work or care for themselves
Incapable
To be pitied
Dependent & Needy
Punishment for sin
Worst than death
Additional insights and wisdom
Super-human
“Aren’t they just amazing?”

4. Barriers to Social Acceptance
Low self-esteem
Learned Helplessness
Poor Social Skills
Transportation Issues
Overcoming Stereotypes and Negative Attitudes
Unemployment/ preceived low productivity

5. Unemployment Data www. afb. org/Section. asp
Unemployment Data
New Bureau of Labor Statistics data 9/2010
Persons years of age who reported serious difficulty seeing even when wearing glasses, 56% of them did not consider themselves as part of the labor force.
Of the 43% who either did have a job or were actively looking for a job, slightly over 13 % were unemployed. The bottom line is that approximately 38% were employed.
(Percentages slightly off due to rounding)

6. Braille & Employment (http://nfb.org/legacy/bm/bm98/bm980204.htm)
Study by Ruby Ryles (1998)
Among blind and severely visually impaired individuals who learned braille as an initial reading medium there was a 44% unemployment rate, as compared to those who learned to read using print where there was a 77% unemployment rate.
Interesting data related to type of employment – unskilled (u), skilled (s) and professional (p). Braille readers u=16%, s=23%, p=16%; Print readers u=0, s=10%, p=13%

7. Barriers to Employment and Independence (Adele Crudden)
Transportation
Attitudes
Employers
Self (adjustment issues)
Rehabilitation Counselor 36%
Overcoming Print Barriers
Lack of Employment Preparation and Blindness Skill
Braille
Assistive Technology
Independent Living
Work Skills

8. Blindness Defined
1) Definition of Legal Blindness: 20/200 or less in the better eye with best correction, or widest diameter of visual field subtending an angle of no greater than 20 degrees.
2) Severe Visual Impairment: Between 20/70 and 20/200. At this point one is usually unable to obtain a driver’s license.

9. Vision Loss Defined
Visual Abilities: Measurable organic functions including visual acuity, occipital lobe functions, color and light sensitivity, and visual fields (Corn, 1983).
Low Vision: A level of vision that is not improved by the use of standard correction and which hinders an individual in the visual planning and execution of tasks, but which can be enhanced by the use of optical and non-optical aids, environmental adaptations and/or techniques (Corn, 1989).

10. Charting Vision
Snellen
Feinbloom

11. Terminology for Vision Loss
OD (right eye), OS (left eye), OU (both eyes)
1) 20/400
2) 20/600
3) Count Fingers distance)
4) Hand Motion Only (HMO)
5) Light Perception Only (LPO)
6) No Light Perception (NLP)
7) Tunnel Vision

12. Functional Vision/Blindness
Defined in reference to the overall use of residual vision.
The level of vision or lack of vision that is utilized by the individual after incorporating in the use of low vision aids, environmental adaptations, vision enhancement techniques and visual abilities.
Two individuals with the same etiology, visual acuity and field measurements may function differently in trying to accomplish the same task.

13. Factors of Functional Vision: Visual Abilities
Acuity
Visual Fields
Motility
Brain Function and Processing
(Neurological Considerations)
Light and Color Reception

14. Factors of Visual Functioning: Environmental Factors
Color
Contrast
Time
Space
Illumination (Glare and lighting type)

15. Factors for Functional Vision: Individual Factors
Cognition
Sensory Development Integration
Perception
Psychological Make-up
Physical Make Up
Fatigue
Experience

16. Other Issues in Functional Vision
Night Blindness
Depth Perception
Double Vision
Variability in Functioning
Cortical Vision Impairment
“Blurring Out”

17. Major Confounding Factors
Lighting
Color/Contrast
Glare
Fatigue
Size and Magnitude

18. Quote of the Day by Christian Roman
“Contrast is our friend, glare is our enemy.”

19. Blindness Facts
Blindness is considered to be a low incidence disability.
Approximately 2.25 per 1000 people in the U.S. are legally blind.
More people are blinded by definition than any other cause.
Blindness is a unique disability requiring specialized services and trained professionals to help individuals reach their maximum potential

20. Professional Eye Care Specialists
Ophthalmologist – MD Diagnoses, treats, does surgery, refraction and manages eye disease
Optometrist – OD diagnoses, non-surgical treatment interventions and refraction.
Optician – make lenses
Orthopist –work with ocular imbalances
Low Vision Clinician – Physican who does LV
Low Vision Therapist – vision professional who assists a Low Vision Clinician

21. Severe Vision Loss and Age
Rates for children = .02% of school age children, or 2 in 1,000.
Rates for Seniors = 2.5% or 250 per 1,000 in people over 65 years of age.

22. Aging and Vision Loss
Approximately 68% of those who are legally blind are over the age of 55.
Approximately 80% of those over 75 have some functional vision loss.
As many as 40% of these individuals also have hearing loss. The combination can cause additional functional limitations.

23. How many are there?
Current estimates vary, but it is estimated that there are approximately 3.5 million legally blind people in the United States.
Some more questionable studies estimate as high as 18 million.

24. Why the numbers disparity?
Survey Questions vary
N-Hanes (National Health and Nutrition Examination Survey)
NHIS (National Health Interview Survey)
Census
Questions to define vision loss are vague (example: Do you have difficulty reading even with glasses on?)
Self report is unreliable
No national registry

25. International Blindness Facts
The World Health Organization (WHO) estimates that there are between 27 and 35 million blind people in the world today.
Approximately 42 million if you consider those with a visual acuity of 20/200. However, statistics are very unreliable from many developing countries and the numbers may be higher.

26. International Facts
World Health Organization {WHO} estimates that 80% of the world’s blindness is preventable and/or treatable.
The major cause of blindness in the world is cataracts.
Ninety percent of the world’s blind population live in developing countries.
Asia has approximately 20 million.
Africa has approximately 6 million

27. World Causes of Blindness
Cataracts (at least 50% of world’s blindness)
Trachoma (bilateral kerato-conjunctivitis)
Hansen’s Disease (Leprosy)
Onochocerciasis (River Blindness)
Xerophthalmia (Vitamin A deficiency)

28. Quote of the Day
“Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”
Helen Keller