Why do we need to be aware of visual impairment?

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* Visual impairment can affect anyone.

* Many visually impaired people will not be immediately recognisable as such.

* Visual impairment doesn't just affect the eyes - it affects the whole person and their family and friends.

* There are a range of organisations who can support visually impaired people to maintain independence.

The impact of this support is dependent on a greater awareness and understanding of visual impairment in society as a whole.

Facts and figures

According to The Department of Health, there are currently over 300,000 people registered as blind or partially sighted in England alone. However, it is accepted that these figures are a gross underestimation, as registration is voluntary.

There are many misconceptions about blindness. Only 4% of people who are registered blind have no vision at all. For the other 96%, the nature of their residual vision will vary according to different eye conditions.

Major causes of visual impairment include:

- Macular Degeneration. This is the most common cause of visual impairment in the UK and is generally related to old age - it is sometimes referred to as 'wear and tear' on the eye. When degeneration occurs, it is the detailed central vision that suffers; peripheral vision is almost completely unaffected. This means that the person will still see objects, obstacles and steps 'out of the corner of the eye'. The main practical difficulties are likely to be concerned with seeing fine details such as reading, writing, seeing people's features or crossing roads.

- Glaucoma. This is the name for a group of eye conditions in which the optic nerve is usually damaged by raised pressure within the eye. Damage to the optic nerve from glaucoma can result in two different defects: either defects in the overall field of vision, or later, defects to the central vision. Glaucoma cannot actually be cured, but the disease can be controlled. Treatment is usually by eye drops, sometimes by laser and occasionally by an operation to improve the drainage from the eye. Due to a reduced field of vision, steps and low obstacles can be a hazard to glaucoma sufferers. Items such as televisions, shelves and fire hoses can also be a problem if placed on the wall at head height.

- Cataract. A cataract is a cloudiness or mistiness in the lens of the eye. The cataract can appear in old age, after injury or inflammation, or be congenital. It may also be linked with diabetes. In the early stages, the visual problems are hardly noticeable. Later the cataract may be visible through the pupil as a whitish area inside the lens. Untreated, it can lead to overall loss of vision. However, relatively straightforward surgery is very successful in the removal of cataracts. Appropriate lighting is very important for cataract sufferers. If lighting is too bright it will cause glare and reduce vision.

- Diabetic Retinopathy. About one person in fifty in the UK is affected by diabetes mellitus, which means that the sugar levels in the blood are not as they should be. This causes blood vessels in the body to be fragile and liable to rupture. When this occurs in the blood vessels within the eye, a visual impairment may well occur. Generally, the vision is described as looking at a jigsaw with pieces missing. The pattern of these missing pieces will differ from person to person. As such, it is most important for people with this condition to be asked individually about their needs.

Living with a Visual Impairment

Although 'blindness' is a common term, few people are totally blind and unable even to tell the difference between light and dark. Much more common is 'visual impairment', in which sight is blurred, dimmed, restricted, or impaired in some other way. Because most people rely on sight for so many daily activities, people with a visual impairment can be at a disadvantage unless specific provisions, equipment and facilities are made available. Some are explained below:

* Braille
The Braille system of touch reading was invented in 1829 by a Frenchman called Louis Braille, blinded by an injury when four years old. Today there is a standard system for English speaking people. Patterns of up to six raised dots represent the alphabet, numbers, music and symbols.

* Talking Books
Only four percent of all visually impaired people can read Braille. For many people who cannot see enough to read, 'talking books' are particularly important. The tapes / CDs may be recordings of lessons, for schoolwork, or of speakers reading books which the listener can enjoy. Some national newspapers are also available in audio format.

* Mobility
The main piece of equipment used by visually impaired people to assist with mobility is the cane. A visually impaired person with a stick is a familiar sight to most people, but the distinction between white sticks and white canes is not generally appreciated. A stick may be painted white, but its essential function is to support the user. White canes are designed as a mobility aid and are not meant to take any weight at all.

* Registration
In addition to the physical provisions available to people who are visually impaired, simply being registered can also be beneficial. Registration is voluntary and can allow access to services / benefits provided by national and local government departments and to enlist the help of some voluntary agencies. However, some agencies do not insist on people being registered in order for them to benefit from their services.

* Sighted Guiding
There are times when visually impaired people need help from sighted people in getting around. Even people who are very good at travelling alone or with a guide dog welcome help sometimes. The following important points should always be borne in mind when helping to guide someone:
a) People with white canes are not necessarily totally blind. Many have useful vision, but even partially sighted people may need help, for example, at night or in an unfamiliar place.
b) People with a white cane with red bands on have both visual and hearing impairments, as do people whose guide dog has red bands on the harness.
c) Visually impaired people should always be asked if they actually want help. Some may not need help, or prefer their independence. Never grab someone and take charge - no-one likes to be handled in this way.
d) Don't be put off if help is refused - the next person may be glad of it.
e) Do give precise instructions to help visually impaired people find their way. It is no use saying 'it's over there' and pointing.
f) A guide dog in harness is working and should not be distracted.
g) Always announce yourself by name when talking to a visually impaired person.
h) Always say when you're leaving; otherwise the person could find himself or herself talking to an empty space.

Computers open up many new opportunities for communication through the use of accessible hardware and software. A special keyboard with touch-patterned keys allows information to be typed accurately. New programmes also allow people to speak into the computer, and have their speech converted into written text. Instead of a normal printer, visually impaired people may use a Braille-embossing printer, or a speech synthesiser may 'speak' the results out loud. More complex systems turn normal printed matter into Braille automatically.

* Low Vision Aids
When conventional spectacles can no longer help and surgery or medical treatment is not appropriate, low vision aids need to be considered. These range from simple hand-held magnifiers to electronic devices and different ones are needed for different visual tasks. For some visually impaired people, these aids permit maximum use of residual vision, enabling them to read again.

* Optical Aids
Different types of optical aids include:
- Hand magnifiers
- Stand magnifiers
- Spectacle mounted magnifiers
- Spectacle mounted telescopes
- Hand-held telescopes
- Electronic aids.

Electronic aids such as closed circuit television (CCTV) provide excellent contrast and high magnification. With this type of equipment, the user sits comfortably in front of the set and the material to be read is displayed on a screen in large print. This is achieved by a camera mounted vertically above a moveable platform on which the reading matter is placed. The user moves the platform so that the camera scans the print. A more reasonably priced version is also available which can be used in conjunction with a television set.

* Daily Living Equipment
There are a number of types of equipment that can assist people with a visual impairment in their day to day lives. These include:
- Special kitchen utensils
- Writing aids
- Talking clocks / watches
- Medicine dispensers
- Talking thermometers
- Rain alerts
- Iron guards
- Signature guides
- Tactile tape / CD player controls

Most people take tasks such as pouring a cup of tea for granted. But if you cannot see when the water has reached the top of the cup, it becomes much more difficult. A liquid level indicator has been designed to enable visually impaired people to tell when the sufficient amount of liquid has been poured into a cup or glass.

These are just some of the many ways in which visually impaired people can overcome the challenges of their visual impairment in their day to day lives, and continue to live as independent a life as possible. Visual impairment is neither a test of strength nor a competition - no visually impaired person can be expected to conform with another's attitudes or progress. However, given time and the right support, each person will move forward in his or her own way.

Link: The Henshaws Society

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Untrained Melodies: Twelve short stories written by the author - Chris High.

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As a UK charity, the Henshaws society is always grateful for much needed donations. The Untrained Melodies CD-Rom has not only been design to be user friendly for the visually impaired, but sales of this amazing interactive medium will raise money and awareness for the wonderful work done on a daily basis by the Henshaws society.

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Quote from Chris High in 2003 “Writing gets me away for a while' from this world and into one where I, alone, can make or break the rules as I see fit.”


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