Topic 2: Difficulties in Seeing

• To have a disability means that one has fundamental difficulty accomplishing things that others take for granted. Disabilities can be
physical in nature (an inability to walk due to amputation, or muscular or neurological dysfunction, for example), sensory (as in blindness,
or deafness), cognitive (as in brain damage or mental retardation), behavioral (as in an inability to work), or even emotional.

• Disabilities can take a severe psychological toll. To be disabled means to have lost a range of functioning or to never have acquired that
functioning in the first place. It can also easily mean being more isolated from others than one would like to be. And because people are
sometimes cruel and/or clueless, disabled persons are often made to feel ‘different' by others. Grief and loss, a sense of being ‘broken' or
‘useless', and self-pity can easily cascade into a diagnosable depression or related mental disorder. For this reason, it is important that
persons with disabilities remember to take care of their mental health needs as well as their physical ones.

What is Visual Impairment?

• Visual impairment is a term experts use to describe any kind of vision loss, whether it's someone who cannot see at all or someone who
has partial vision loss. The American Foundation for the Blind estimates that 10 million people in the United States are visually impaired.

An educational description of visual impairment may include the following:

• Totally blind which means the individual receives no useful information through the sense of vision and must use tactile and auditory
senses for learning (severe impairment)

• Functionally blind which means learners learn mostly through other senses but may be able to use vision to supplement information
receive from the other senses. They would need to use Braille to learn to read. Functional vision cannot be measured using visual field and
visual activity tests.

• Low vision learners primarily use vision as a means of learning and with magnifying devices. They may learn to use print (Mild to
moderate impairment)

• Visual efficiency refers to how well a person uses whatever vision present. This includes the ability to control eye movements to
discriminate objects from their background, and to pay attention to impairment details (Beatrice and Janet 2003, Yao and Prosper 2011).

Types of Vision Problems

Refractive Errors

• Refractive errors are the most frequent eye problems that most individuals face recently.

• Refractive errors include myopia (near-sightedness), hyperopia (farsightedness), astigmatism (distorted vision at all distances), and
presbyopia that occurs between age 40–50 years (loss of the ability to focus up close, inability to read letters of the phone book, need to
hold newspaper farther away to see clearly) can be corrected by eyeglasses, contact lenses, or in some cases surgery.

Classification of Refractive Errors

 Myopia (near sightedness or short sightedness)- means a person can see nearby objects clearly but distant objects appear
blurred.
 Hypermetropia (far sightedness)- is a condition of the eye in which light is focused behind, instead of on, the retina. This results
in objects appearing blurry, while far objects may appear normal.
- is a vision condition in which distant objects can be seen clearly, but close ones do not come into proper focus.
 Astigmatism- is a common vision condition that causes blurred vision. It occurs when the cornea (the clear front cover of the
eye) is irregularly shaped or sometimes because of the curvature of the lens inside the eye.
 Presbyopia- is when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging. In fact, the
term “presbyopia” comes from a Greek word which means “old eye.” You may start to notice presbyopia shortly after age 40.

Age-Related Macular Degeneration (AMD)

• A central area of woolly or cottony opacity obscures the central part of the vision.

There are two forms of AMD:

 Wet AMD- is when abnormal blood vessel behind the retina start to grow under the macula, ultimately leading to blood and fluid leakage.
 Dry AMD- is when the macula thins overtime as part of aging process, gradually blurring central vision.
Glaucoma

• Glaucoma is called the “sneak thief of sight” because people don’t usually notice a problem until some vision is lost.

• Glaucoma occurs when a build-up of fluid in the eye creates pressure, damaging the optic nerve.

• A comprehensive eye exam is important so glaucoma can be found early.

Cataract

• A cataract is a clouding of the lens of the eye. It often leads to poor vision at night, especially while driving, due to glare from bright lights.

Diabetic Retinopathy (DR)

• Diabetic retinopathy is damage to the blood vessels of the retina caused by diabetes. It causes blurred or dark spots in the field of vision
and can eventually lead to blindness.

• All people with diabetes, both type 1 and type 2, are at risk for DR. It is caused by damage to blood vessels in the back of the eye
(retina). The longer someone has diabetes, the more likely he or she will get DR.

• There are four stages of DR. During the first three stages of DR, treatment is usually not needed. To prevent progression of diabetic
retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. For the fourth stage of
DR, called proliferative retinopathy, there are treatments that reduce vision loss, but are not a cure for DR.

• Warning signs of diabetic retinopathy includes blurred vision, gradual vision loss, floaters, shadows or missing areas of vision, and difficulty
seeing at nighttime.

• People with diabetes are at greater risk for cataract and glaucoma as well.

Crossed Eyes (strabismus)

• Strabismus occurs when the eyes do not line up or they are crossed. One eye, however, usually remains straight at any given time.

• If left untreated strabismus can cause amblyopia.

Common forms of strabismus include:

 Esotropia – one or both eyes turn inward toward the nose

 Exotropia – one or both eyes turn out; also called wall-eyed
 Hypertropia – one or both eyes turn up
 Hypotropia – one or both eyes turn down
.

Lazy Eye (amblyopia)

• Amblyopia — often called lazy eye — is a problem that is common in children.

• Amblyopia is a result of the brain and the eyes not working together. The brain ignores visual information from one eye, which causes
problems with vision development.

Color Blindness

 Color blindness occurs when you are unable to see colors in a normal way. It is also known as color deficiency. Color blindness often
happens when someone cannot distinguish between certain colors.

Bulging Eyes

• Bulging eyes, or proptosis, occurs when one or both eyes protrude from the eye sockets due to space taking lesions such as swelling of
the muscles, fat, and tissue behind the eye.
TEACHING LEARNERS WITH VISUAL IMPAIRMENT IN AN INCLUSIVE EDUCATION SETTING

CHARACTERISTICS OF PERSONS WITH VISUAL IMPAIRMENT:

• Intellectual abilities are similar to those of sighted peers

• They are unable to use sight to assist them in the development of concepts

• Their concepts development depends on their tactile experience

• They are unable to use visual imagery

• They may display repetitive, stereotyped movement for example, rocking or rubbing of eyes.

• They are withdrawn, dependent and are unable to use non-verbal cues

• They have difficulty using spatial information and visual imagery and imagery problems with functional implications

• They have unusual facial behaviors such as a squinting, blinking or frowning while reading or doing close work.

• They are unable to locate or pick up small objects

• Physical indicators may include red eyes, swollen eyelids watery eyes or discharge eyes that do not appear straight, uneven seized eyes,
eyes with drooping eyelids and crusts on lids between the eye lashes.

• They may have poor eye-hand coordination

• Usually have problems in distinguishing similar shaped letters, numbers or words for example b and d

• They have difficulty in writing or are not able to write within the lines

• They have difficulty in reading books within the normal range thus bringing the book/object closer to the eyes. · Some students may be
sensitive to bright light and may shut their eyes or squint.

• They may have difficulty to seeing in dim light or have inability to see in the dark (UNESCO, 2001, Yao and Prosper, 2011 ).

CURRICULUM CONSIDERATION FOR INDIVIDUALS WITH VISUAL IMPAIRMENT

• The class teacher needs to adjust, to teach social norms that are valuable and necessary within the classroom setting. An appropriate
inclusive school environment for children with visual impairment should provide infrastructure that are disability friendly, teaching
facilities(materials and equipment’s), human resources and other related services needed for the well being of the students within school
milieu (Jatau, Uzo & lere, 2002 )

STRATEGIES FOR TEACHING INDIVIDUALS WITH VISUAL IMPAIRMENT

• Using large writing on the chalk board or visual aids. The use of colored chalks is recommended. Let the children come close to the board
or teaching aids so that they can see more easily.

• Read aloud what is written on the chalkboard

• Prepare teaching aids that learners can read more easily such as large print materials. Other learners in the class could help prepare these
or they can be produced by enlarging font sizes on computer printout. This can also help learners who have difficulties in reading.

• Learners may have difficulties seeing the lines on writing papers. They can be given papers with thicker lines drawn on it.

• Some learners will benefit from using magnifying aids. Two types are available. Ones that enlarge the whole page or line magnifiers, which
are a useful aid to reading

• Encourage the learners to use a pointer or their finger when reading. Cover the rest of the page with paper except for the paragraph they
are reading. Use a bookstand to avoid reflection.

• Children with poor vision need to learn through touch as well as through hearing. They should be given a chance to handle objects.

• Pair the pupil or student with a seeing classmate who can assist him/her to organize their work. The partner can help find the correct page,
repeat your instructions and so on.

• Use verbal praise or touch to give the children encouragement · Use the name of the pupil’s or students during class discussions so that
the individual knows who is talking.
 • Computers offer particular support to learners with visual impairment. They can print out a large print copy, read text on the screen using
the text on a voice synthesizer or convert it in to Braille. · When teaching math’s, the teacher should make use of abacus, tactile
geometrical shapes, talking calculator and Braille ruler.

• Lessons can be taped using a cassette recorder for later playback at home or as revision. Learners who experience difficulties in writing
can also provide International Journal of Education and Research Vol. 6 No. 2 February 2018 115 information on audiotape. Taped
versions of books are sometimes available in libraries and resource rooms.

EDUCATIONAL PROVISION FOR INDIVIDUALS WITH VISUAL IMPAIRMENTS IN THE INCLUSIVE CLASSROOM

 Portable note taker

 Larger format books
 Slate and stylus
 Magnifying glasses
 Electronic Braille writer
 Perkins Braille
 Specialized computer software (Jaws, Zoomtext etc)
 Orientation and mobility (Cane skill)

Conclusion

It can be concluded that maximum learning outcome expected of the children with visual impairment in an inclusive educational setting can be
achieve if the classroom teacher should observe the following:

• · Master the use of assistive technology devices necessary for classroom teaching/learning processes

• · Ensure adequate classroom organisation to ensure easily movement and classroom interaction

• · Adopt effective use of chalkboard by ensuring that essential information are written bully on the chalkboard for the partially sighted to see
and

• · The teacher should use appropriate tactile diagrams or models (instructional materials) while teaching in order to concretise concepts
being taught.