VISUAL IMPAIRMENT

Key facts

• 285 million people are estimated to be visually impaired

worldwide: 39 million are blind and 246 have low vision.
• About 90% of the world's visually impaired live in low-income
settings.
• 82% of people living with blindness are aged 50 and above.
• Globally, uncorrected refractive errors are the main cause of
moderate and severe visual impairment; cataracts remain the
leading cause of blindness in middle- and low-income countries.
• The number of people visually impaired from infectious diseases
has reduced in the last 20 years according to global estimates
work.
• 80% of all visual impairment can be prevented or cured.
• It may be said that visual impairment is the functional
limitation of the eye or eyes or the vision system. This leads
to
– Loss of visual acuity and inability of the person to see objects as clearly
as a healthy person
– Loss of visual field meaning inability of an individual to see as wide an
area as the average person without moving the eyes or turning the
head.
– Photophobia – inability to look at light
– Diplopia – double vision
– Visual distortion or distortion of images
– Visual perceptual difficulties or difficulties of perception
– Or any combination of the above features
• There are 4 levels of visual function, according to the
International Classification of Diseases -10 (Update and
Revision 2006):

– normal vision
– moderate visual impairment
– severe visual impairment
– blindness.

Moderate visual impairment combined with severe visual

impairment are grouped under the term “low vision”: low vision
taken together with blindness represents all visual impairment.
• Low visual acuity
The CDC and the World Health Organization suggest that
low visual acuity means vision between 20/70 and 20/400
with the best possible correction, or a visual field of 20
degrees or less.

• Blindness
Blindness is defined as a visual acuity worse than 20/400
with the best possible correction, or a visual field of 10
degrees or less.
Snellen’s
Chart
Causes of vision impairment

• Vision may be impaired due to multiple reasons. These could

be due to eye damage, failure of the brain to receive and read
the visual cues sent by the eyes etc.

• Underlying diseases may also cause visual impairment. The

commonest cause is diabetic retinopathy, 
age-related macular degeneration, formation of cataracts and
raised pressure within the eyes leading to glaucoma.
• Diabetic retinopathy - affects blood vessels in the light-
sensitive tissue called the retina that lines the back of the
eye. It is the most common cause of vision loss among
people with diabetes and the leading cause of vision
impairment and blindness among working-age adults.
• Symptoms
– Blurred vision
– Sudden loss of vision in one eye
– Seeing rings around lights
– Dark spots or flashing lights

The symptoms described above may not necessarily mean that

you have diabetic retinopathy. However, if you experience one or
more of these symptoms, contact your ophthalmologist for a
complete exam. It is also important to note that pregnancy and high
blood pressure may aggravate diabetic retinopathy.
• A cataract is a clouding of the normally clear lens of
your eye. For people who have cataracts, seeing through
cloudy lenses is a bit like looking through a frosty or fogged-
up window.
Signs and symptoms of cataracts include:
• Clouded, blurred or dim vision
• Increasing difficulty with vision at night
• Sensitivity to light and glare
• Seeing "halos" around lights
• Frequent changes in eyeglass or contact lens prescription
• Fading or yellowing of colors
• Double vision in a single eye
At first, the cloudiness in your vision caused by a cataract may
affect only a small part of the eye's lens and you may be unaware
of any vision loss. As the cataract grows larger, it clouds more of
your lens and distorts the light passing through the lens. This may
lead to signs and symptoms you're more likely to notice.
• Glaucoma is a group of eye conditions that
damage the optic nerve, which is vital to good vision.
This damage is often caused by an abnormally high
pressure in your eye.
What are the Warning Signs?
Unfortunately, most cases of glaucoma do not occur with
readily noticeable symptoms that warn of the irreversible optic
nerve damage being done. However, the presence of the
following warning signs, indicates that you need a thorough
examination by an eye doctor:
• Unusual trouble adjusting to dark rooms
• Difficulty focusing on near or distant objects
• Squinting or blinking due to unusual sensitivity to light or glare
• Change in color of iris
• Red-rimmed, encrusted or swollen lids
• Recurrent pain in or around eyes
• Double vision
• Dark spot at the center of viewing
• Lines and edges appear distorted or wavy
• Excess tearing or "watery eyes"
• Dry eyes with itching or burning; and
• Seeing spots, ghost-like images
Who does visual
impairment affect?
• Although impairment of vision can occur at any point in life, it
is more common among the elderly.

• Sometimes visual impairment may be inherited. It manifests

at birth or in childhood in such cases.

• Common conditions are retinitis pigmentosa, genetic or

developmental abnormalities etc.
• These children with partial or complete impairment
are often developmentally delayed especially in gross
and fine motor skills. Visually impaired adults
struggle with gainful employment and day to day
activities. 
How to make visual
materials?
• Font size and amount of text on each slide

– have up to six lines of text with only about five

or six words per line.
– use left justification.
– text must be large enough to be read by most
low vision people in the front of the audience
and by people with ‘normal’ vision at the back
– a recommended text size is no less than 32 point
– use mixed upper and lower case letters rather
than all capitals
• Color and Brightness Contrast
– Background and foreground colors should offer a good color
contrast for people with low vision.
– There are two types of contrast—brightness and color.
– The highest brightness contrast is between black and white.
The highest color contrast is when the colors are
complementary.
– A high color contrast without brightness contrast cannot be
read by color blind people. In particular, they have difficulty
with red-green perception.
– Use dark background colors and bright colors for the text to
avoid glare
– A white font on a deep blue background is a very good
combination
• Font type
– Use sans serif font types such as Helvetica,
Arial and Verdana
– Avoid the use of italic font style
– Try not to use more than one font type per slide
• Figures and graphs
– Keep figures and graphs as simple as possible
– Use brightness and contrasting colors in the same
way as with text
– Use sans serif font types for the text in the figures

• Animation
– Keep animation to a minimum
• Oral support during slide viewing
– When you introduce yourself, explain the format of the
session and when you will take questions
– Read aloud all text presented on slides
– Explain figures and graphs
– Explicitly mention the region of interest in the slide, do not
just point to it
– Explain each slide in an expressive manner so that the
audience understands which area of the slide you are
referring to
– If you need to use a lot of text on a slide, read it slowly and
clearly
• Handouts
– Distribute copies of your slides before you
presentation
– Be aware that color is lost in grey tone prints
– Have enough full page copies of your slides for
people with reading difficulties
• Help for those who are blind

– Have your material available on a memory stick (USB) so that

blind members can to download it on to their laptops. Ideally,
also have your material in other accessible formats such as
Braille or on CD
– Presentations can also be provided on the web – either as
HTML or as downloadable Word or PowerPoint.
– If you display it, say it! Imagine that you were hearing your
own presentation on the radio, would it make sense and
would you fully understand all the information that was being
put across?