VISUAL IMPAIRMENTS

Visual impairment is a physical loss of useful vision.

In dealing with visual impairment, it is important to remember that a visually impaired
child should be considered as a child first. Like all the children they are entitles to
opportunities for growth and development. They have the same needs of belonging,
acceptance, achievement, self-actualization, opportunity for learning and encouragement
to grow and gain independence as the normally seeing child.

HIGHLIGHTS :

1. Visual impairments is classified according to age at onset, place of lesion and

degree of visual acuity.
2. The causes of blindness are categorized into 3 divisions, namely prenatal (before
birth), perinatal (during birth ) and postnatal ( after birth)
3. The predominat prenatal causes of blindness are congenital malformation/
malfunctioning of the eye such as : coloboma, retinitis pigmentosa, diabetes,
retinophaty and improper functioning of muscles of the eye , retrolental
fibroplasias for perinatal
4. The causes of blindness often have psychological implications both for the totally
blind and low vision.
5. The social and emotional characteristics of the visually impaired should be given
special attention and care to improve the child’s personality and develop a
positive outlook in life.

CLASSIFICATION OF VISUAL IMPAIRMENT

1. For educational Purposes

1.1 Totally Blind

Those with very little and no vision perception at all. They have the
visual acuity of 20/200 or less in the better eye with corrective glasses, such
that they need Braille in order to read.

Low Vision
Those with better visual perception who primarily read large print or
regular print under special conditions. They have remaining visual acuity
between 20’200 and 20’70 in the better eye with the best possible
correction.

2. Kinds and Types of Blindness

2.1.1 Congenitally Blind
Those who were born blind or the impairment is present at the
time of birth.
2.1.1.1.1 Consequently Blind
Those who acquired blindness before the age of five. They may
 have no experience on visual imagery or may have retained very little
of it including recognition of color.
2.1.2 Adventitiously Blind
Those who lost their vision from six years or above.
2.1 According to Visual Function
2.2.1 Light Perception – discriminate the light in the absence of light .
2.2.2 Light projection – discriminate the light in the absence of light and
additionally visually locate the source of light.
2.2.3 Form Vision - recognize form or the outline of matter / shadow.
2.2.4 Color Vision – recognize differences and similarities in color.
2.2.5 Motion Perception – visual acuity is up to 5/200 would be unable to
count
fingers at a distance of three feet.
2.2.6 5/200 referred as to travel vision amount of vision that is sufficient for
independent travel.
2.2.7 20/200 – legally blind.
2.2.8 10/200 Would be unable to read headlines of a news paper but would be
expected to have some travel vision.
2.2.9. 20/100 – would be able to read print used in children’s book
2.2.10 20/70 - would be able to see at twenty feet in the better eye after
correction one with “normal” vision can see at 70 feet.
(Refractive Part)

2.3.1 Myopia (Nearsightedness) – usually the result of the eyeball being too
long. The lens is too far from the retina, causing the focus for the rays
of light from the distant objects to fall in front of the retina.
2.3.2 Hyperopia (Farsightedness)- the result of the eyeball is being too short.
The les is too close to the retina, causing the focus for rays of light
from distant objects to fall behind the retina.
2.3.3 Cataract – the result of the opacity of the crystalline lens.
2.3.4 Astigmatism - a refractive error resulting from an irregularity of the
cornea or lens of the eye.
2.2.5 Glaucoma – may cause damage to the eye due to increase pressure
from accumulation of aqueos fluid.

(Protective Part)
2.3.6 Trachoma – (serious form of conjunctivitis or pink eye) a major cause of
blindness which affects the eyelids.

(Directive Part)
2.3.7 Strabismus – ( cross-eyes) – the failure of both eyes to direct their gaze
simultaneously at the same object because of faulty muscle coordination.
2.3.8 Nsytagmus – a rapid and voluntary movement of the eyeball that may
occur as a secondary characteristic of a variety of visual disorders and
brain injury.
2.3.9 Amblopia ex Anopsia – dimness of vision due to disuse of the weakeye
 from improper muscle balance.

(Receptive Part)
2.3.10 Retrolental Fibroplasia (RLF) - a condition of the retina caused by
excessive oxygen to premature infants. It is characterized by scan tissue
behind the lens of the eye.
2.3.11 Retinitis Pigmentosa – a hereditary degeneration and atrophy of the
retina by misplace pigment.
2.3.12 Optic Atrophy-degeneration of the nerve fibers which connect the
retina to the brain.

CAUSES OF BLINDNESS

A. Prenatal Causes – cause of impairment before birth.

Viral diseases – syphilis, ghonorhea, toxoplasmonia, German measles
(rubella)
 Toxic conditions – excessive drug intake of pregnant mothers.
 Blood incompatibility – occurs when Rh negative mothers have Rh
positive fetuses.
 Congenital malformation / malfunctioning of the eyes
- colobomo – an incomple formation of the peripheral area of the
retina.
- Retinitis pigmentosa – a degeneration of the retina .
* strabismus (crosseyedness
* nystagmus ( rapid involuntary movement of the eyes)
- congenital cataracts and glaucoma
 exposure to radiation ( x-ray)

A. Perinatal Causes – cause of impairment during birth.

 Traumatic experience during delivery
 pelvic pressure or injury
 use of forceps and intracranial hemorrhage
 Anoxia or loss of oxygen due to prolong labor
 heavy sedation
 retrolental fibroplasias (RLF) – over-exposure of premature babies to
oxygen resulting in the malformation of the blood vessels of the eyes.
B. Postnatal Causes 0 cause of impairment after the child is born.
 Diseases/Ailments
 meningitis – infection of the parts of the brain responsible
for seeing.
 other viral infections – German measles, sore eyes
 glaucoma – due to gradual build-up of pressure inside the
eye which destroys the retina and optic nerve.
 cataract – clouding of the lens of the eye due to old age,
metabolic disturbances or action of certain drugs and
 poison, illness or injury.
• Accident/Injuries
- Eye injury caused by pointed objects, scissors , pencils and
other sharp objects.
- Overexposure to : sunlight , eclipse, reflection of snow,
intense flash of electricity / short circuit.
• Other Causes
- Heredity
- Prematurity
- Malnutrition

CHARACTERISTICS OF VISUALLY IMPAIRED CHILDREN

1. Physical
 Absence of eyeball deformities in the area of the eyes
 Discolored eyes
 Severe cross eyes
 Excessive involuntary movement
 Poor posture and unnatural gait
 Restriction in mobility and spatial orientation
2. Social and Emotional Characteristics
 Tend to be extremely dependent
 Inferior
 Fearful
 Unduly sensitive
 Easily discouraged/frustrated
 Self-conscious
 Easily embarrassed
 Exhibits brief and superficial criticism
 Develops emotional problems not as a result of visual handicap but as
a responds to the attitude of others towards him.
3. Intellectual / Learning Characteristics
 The intellectual development of the visually impaired who are not
mentally handicapped is the same as that of the sighted.
 The lack of normal visual stimulation may retard mental growth and
development, but an affective program of remediation may may make
up for the development of lag.
 Any intellectual deficiency which accompanies visual impairment is
due to
 uncompensated limitation of sensory input and mobility.
 Some visually impaired children begin to talk later than the sighted,
since they need more
 time to learn to imitate movements involved in speech which he
cannot see at all.
  In mathematics, spelling and general information, blind children are
retarded
 educationally as compared to seeing this areas.
 The visually impaired who have talent and interest in music may
show exceptional ability in this area.

Other Distinctive Characteristics:

 Groping
 Wearing dark glasses
 No eye to eye contact
 Slow in moving
 Use of cane
 Sensitive to sound and smell
 Cannot read printed materials
 Peering characteristics

HIGHLIGHTS:

Visual impairment can be easily detected because of common behavior

manifestations. Psychoeducational assessment for these children includes a combination
of formal and informal assessment procedures.
Functional vision
Language and cognitive development
Social and daily living skills
Academic achievement
Career and vocational skills
It is important to test the visual acuity of visually impaired children for choice of
educational format and see if the eye condition is curable :
Services of a psychologist/specialist can be solicited for further psychological and
medical evaluation
VISUAL ACUITY TEST
Distance and near vision test should be given to all people being assessed. Usually a
person is tested with both eyes open.
The first test is to test distance visual acuity. One way to measure distance acuity is
by testing the smallest symbol that can be recognized.
Measure of visual acuity are use to identify the amount of vision, changes in vision
from one time to another and the effects of treatment The measure of visual acuity does
not tell how well vision is used.
A special test using the pinhole mask can identify those people with poor vision who
may need spectacles to improve their vision. The pinhole should be used when a person
has distance visual acuity worse than 6/18. People who have visual acuity improved with
the pinhole should referred for examination and treatment by an eye specialist.
It does not matter if the person cannot read. Vision can be tested using the E cards.
Other tests can be used if you have them. Use the test that is easiest for the person you are
testing.

Acuities : 6/18 – at least 3 out of 4 small ES (size 18) identified form 6 metres.
6/60 – at least 3 out of 4 large Es (size 60) identified from 6 metres, but
size 18 symbols not correctly identified.
3/60 – at least 3 out of 4 large Es identified from 3 metres but not from 6 meters.

The size 60 and 18 are the distances in metresthat the shape can be ready by a person
with normal vision.
A person having visual acuity of 6/18 may be able to see smaller symbols but these
are not used in the distance test. If the near vision card is used at 6 metres and the largest
Es are seen, visual acuity is 6/6.
If at 3 metres the large E cannot be recognized, visual acuity is recordedas less thean
3/60 9often written as <3/60). The person may have useable vision and it is important to
discover the amount and quality of the vision even though it is limited.; test visual acuity
with the large E at 2 or 1 metre.
If vision is being tested for a regional or country survey, The World Health
Organization (WHO) categories should be used. N
normal vision is acuity of 6/18 or better.
Low vision is acuity less than 6/18.
Blindness is acuity less than 3/60.

In some countries, distance for testing is measured in feet. 6 metres is approximately

equal to 20 feet. Visual acuity are recorded as “
20/20 = 6/6
20/60 = 6/18
20/200 = 6/60
10/100 = 3/60