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Vision impairment

blind; blindness; Braille; Deafblind; vision; sensory; impairment; eyesight; sight; cataracts; albinism; optic; nerve; macular; degeneration; retinitis; nystagmus; retinopathy; ROP; Usher's; pigmentosa; eye; strabismus; squint; glasses; shortsighted; impairment; poor; long; monocular; myopic; hypermetropic; disability; contact; lens; blurry; headache; better; start; initiative;

When a child's vision problem is permanent and cannot be corrected to give normal vision, this is called a 'vision impairment'. There are different degrees of vision impairment from mild loss to total blindness (no reaction to light).

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Children can have many different problems with their eyes or vision (sight). Some problems are temporary and can be treated. Other problems are permanent (they do not get better).

Some permanent vision problems can be helped ('corrected') by eye exercises or by wearing glasses or contact lenses. However, not all vision problems can be corrected. When a child's vision problem is permanent and cannot be corrected to give normal vision, this is called a 'vision impairment'. There are different degrees of vision impairment from mild loss to total blindness (no reaction to light).

Alert!

See your doctor if your child complains of blurry vision, sensitivity to light or sore eyes or when there is a white or coloured discharge from the eyes.

A child who suffers from persistent headaches and is unable to concentrate may also have vision problems.

For information about resources in South Australia have a look at Vision impairment - resources.

What is vision Impairment?

Vision impairment is a condition that prevents normal vision in one or both eyes. There are many problems with vision such as being near or short sighted (myopic), long sighted (hypermetropic), having normal vision in one eye only (monocular) or a turned eye (strabismus). Sometimes strabismus will be called a squint.

Many people have poor eye sight which can be corrected by wearing glasses or contact lenses. However, there are a number of serious vision problems that cannot be corrected by glasses or contact lenses.

Some of these are:

  • cataracts (where the lens inside the eye becomes cloudy). People with cataracts lose clear vision and become sensitive to light.
  • albinism (an inherited condition that affects clear vision and causes sensitivity to bright light, glare and direct sunlight)
  • optic nerve damage (damage to the nerves involved in vision). Optic nerve damage will affect a person's field of vision (see 'Vision field' below). Glaucoma is one type of eye condition that can cause optic nerve damage.
  • macular degeneration (where damage happens to a small section of the retina inside of the eye that allows us to see colour and fine detail)
  • retinitis pigmentosa (a degenerative condition that reduces the field of vision - degenerative means that it gets worse)
  • nystagmus (an involuntary repetitive movement [flicking] of the eyes)
  • retinopathy of prematurity - ROP (damage to the retina that occurs in some premature babies who are treated with oxygen at birth)
  • Usher's syndrome (a genetic disorder that includes hearing loss and retinitis pigmentosa).

A person's level of vision (or sight) may remain the same over time or it may change. Eye sight will get worse as part of some conditions, such as retinitis pigmentosa and untreated cataracts.

The amount of vision loss will affect the type of support your child will need at home, at school and in the community. Generally, people talk about how much vision has been lost. The terms 'low vision' or 'blindness' may be used.

Low vision

Low vision exists when a person's sight cannot be corrected to normal vision by wearing eye glasses or contact lenses but the person has some vision. People who have low vision are sometimes called 'legally blind'. Legally blind is a term used to help determine who will be eligible for government benefits and services. When people are unable to see clearly (even using glasses or contact lenses) something six metres away that can be seen from 60 metres by people without sight problems, they are called legally blind. (Source: Vision Australia Foundation)

There are two main types of vision problems which can cause low vision. These involve a person's 'visual acuity' and 'vision field'.

Visual acuity (clarity of sight)

People who have low vision may have problems seeing objects clearly (visual acuity). They will often have trouble seeing printed words and may need to have very large print or highly magnified glasses to read.

Vision field (range of sight)

How much a person is able to see when looking straight ahead is called the 'visual field'. Normally, this is a field of 180 degrees (when looking straight ahead, a person can see objects that are on either side to a line which is parallel to their shoulders). Vision problems related to 'visual field' can mean that the height or width of what a person sees is reduced. This can be like looking through a telescope. Only things which are straight ahead can be seen. Things that are to the side or above or below are no longer seen. Sometimes, there will be blank spots in part of what a person is seeing. The person will have an incomplete picture in the same way that a camera with a dirty lens will record only part of a scene.

Blindness

Being blind means that a child has no vision in one or both eyes. This may be due to damage to the eye, nerves or brain, or because the child does not have an eye.

Causes of vision impairment

There are many causes of vision loss that can affect different parts of the eye.

  • Vision impairment can be present from birth (congenital).
  • Vision impairment may also develop later in life due to an accident, illness or disease.
  • Some people inherit genetic conditions, such as Usher's syndrome, retinitis pigmentosa or albinism, that cause vision impairment to develop over time.
  • Other disabilities, such as epilepsy, intellectual disability and Down syndrome may be associated with vision impairment.
  • If left untreated, some types of conjunctivitis can cause permanent damage to vision (eg trachoma).

Treatment

  • Some vision problems can be treated. For example, when a person has cataracts, surgeons can replace the cloudy lens with an artificial lens.
  • Blindness and degenerative conditions (conditions that get worse over time), such as retinitis pigmentosa, are not curable.
  • Eye specialists will be able to give you more information on treatments that may be effective for your child's vision problems.

Sometimes, people who have vision impairment can be helped by:

  • large print
  • technology, including optical scanners and digital magnification through closed circuit television.

What is braille?

Braille is a system of reading by touch used by people who are blind. Braille is also used by people who can see light but not shape or who have trouble seeing words, even in large print.

The letters or symbols used when writing in Braille are formed by different dot patterns. The dots are moulded on the page so that the reader can feel the patterns of each letter or word.

Dual sensory loss or deafblindness

  • The combination of hearing and vision loss is often referred to as 'dual sensory loss'.
  • Most children will have some hearing or sight. Very few are both profoundly deaf and totally blind.
  • The term 'Deafblind' is used for children who are totally blind and profoundly deaf. Some people also use this term when speaking about children who have both a significant hearing loss and a significant vision loss but may have some degree of hearing or vision.
  • Individuals will have different needs depending upon how the hearing and vision impairments affect them.

What you can do

In the home

  • For serious vision impairment, attention to the placement of furniture is important.
  • Ensure that big or bulky furniture or furniture with sharp edges is not placed near regular walkways.
  • Families can develop helpful habits, for example, making sure that doors and drawers are not left open and that kitchen or dining chairs are pushed under tables.
  • For children who have low vision, you can make the home safer by checking that lighting is appropriate in every area.

Getting help

Vision impairment may affect your child's general development. You may wish to be involved in or supported by an early intervention program that can help children and their families to encourage development in the following areas:

Motor skills

 Poor vision may decrease your baby's ability to explore in the important first twelve months of development. This may mean that it takes longer for a child to crawl or walk. Early intervention, occupational therapy or physiotherapy may be helpful.

Sensory development

This refers to the development of the senses of touch, hearing, sight, smell and taste.
Sometimes, a person who has vision impairment may be frightened by new experiences involving different textures or sounds. A person who has vision impairment may find it difficult to develop body awareness. Early intervention along with occupational therapy or physiotherapy can help this.

Communication and social skills

 Many conversations begin when people make eye contact (look each other in the eye) or use some type of signal, such as a welcoming smile or a wave. People who have vision impairment may not always recognise our efforts to communicate with them because they may not be aware when we are looking, smiling or waving at them. People may need to work out ways of getting their attention by sound or touch.

Children who have vision impairment may also need help to learn the social skills that are expected during conversations. They may need to learn to "look" towards a speaker and when it is appropriate to enter a conversation. They may also need to be taught about the facial expressions or body postures that other people expect from them during a conversation.

Parents, teachers and friends can assist by using words in place of gestures. For example, it is important to say 'goodbye' rather than to wave, or to answer 'yes' rather than respond with a nod. Speech pathologists and specialist teachers can provide help with this.

Self-help skills

Children who have a vision impairment will not notice and copy what others are doing. Therefore, self-help skills may be slower to develop and may require specific teaching. Fine motor skills to manage buttons, laces and zips may need more practise. Early intervention, teachers, occupational therapists or physiotherapists can help with this.

Getting help

Specialist agencies for vision impairment, community health centres or hospitals may offer early intervention services, speech pathology, occupational therapy and physiotherapy services. Many specialist disability agencies and education departments will have early intervention or special education programs.

Preschool and school

At preschool or school, teachers will think about changes that need to be made to the environment and about programs to help your child. Changes may involve the types of books, games and equipment used. Teachers may also consider changes to the preschool or classroom furniture and where it is placed. Once at school, teachers will discuss any special needs for large print, special reading aids, orientation and mobility training, additional technology (such as braillers) and keyboard skills.

Depending on the needs of your child, teachers may get extra help in the preschool or classroom. They may also receive advice from visiting specialist teachers. Parents can help teachers by giving them all necessary and up-to-date information about their child's vision. This will aid teachers in choosing appropriate teaching methods.

Resources

South Australia

South Australian School for Vision Impaired
1B Duncan Ave, Parkholme 5034, tel 8277 5255
http://www.sasvi.sa.edu.au/ 

Can Do 4 Kids - provides a range of services, programs and activities to children and young adults up to 25 years of age who are blind/vision impaired, Deaf/hearing impaired, or deaf blind, and who may have additional disabilities.
http://www.cando4kids.com.au/

Blind Welfare Association of SA
Address: 1/247 Milne Rd, Modbury North SA 5092
Postal Address: PO Box 163, Greenacres, 5086
Tel: 8334 8000
Fax 8334 8001
http://www.blindwelfare.org.au/

Disability Connect 
diSAbility connect is for parents and carers of children and young people with disability living in South Australia. It provides a gateway to help you to find information about your child’s disability and to existing information on programs, services, benefits and payments that may help you to care for your child. 
http://www.dss.gov.au/disability-connect

For a more comprehensive list of resources in South Australia, and books about vision impairment, see the topic Vision impairment -Resources

Australia

Better Start initiative

Better Start for Children with Disability (Better Start) initiative. This initiative aims to assist eligible children with developmental disabilities to access funding for early intervention services. Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA)

Prepared in collaboration with
Department of Education, Training and Employment
Ministerial Advisory Committee on Students with Disabilities

References and further reading

  • Arter, C, Mason, HL, McCall, S, McLinden, M & Stone, J, 'Children with visual impairment in mainstream settings', David Fulton, London, 1999.
  • Kelley, P & Gale, G, 'Towards excellence: Effective education for students with vision impairments', Royal Institute for Deaf and Blind Children, Sydney, 1998.
  • Mason, HL & McCall, S, 'Visual Impairment: Access to education for children and young people', David Fulton, London, 1997.
  • Mills, AM, 'Language acquisition in the blind child: Normal and deficient', Croom Helm, London, 1983.
  • Sacks, SZ, Kekelis, LS & Gaylord-Ross, RJ, 'The development of social skills by blind and visually impaired students', American Foundation for the Blind, New York, 1992.
  • Warren, DH, 'Blindness and children: An individual differences approach', Cambridge University Press, Cambridge, 1994.

Journals

  • British Journal of Visual Impairment
  • Exceptional Children
  • Focus on Exceptional Children
  • Journal of Visual Impairment and Blindness
  • RE:view (published by the Association for Education and Rehabilitation of the Blind and Visually Impaired, Alexandria, Virginia, USA).

A useful source of information on current research is available from the Arlene R Gordon Research Institute of Lighthouse International at http://www.lighthouse.org/research/.

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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