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Vision impairment and blindness

Vision impairment and blindness content

There are an estimated 246,773 people in Ireland who are blind or visually impaired, this figure is expected to increase to 271,996 people by the year 2020. Many people who have a vision impairment are able to see something.

This can vary from being able to distinguish between light and dark, to seeing large objects and shapes, to seeing everything but as a blur, or seeing a patchwork of blanks and defined areas. Vision impairment is a term used to describe all levels of sight loss. It covers moderate sight loss, severe sight loss and blindness.

In this section:

 

Registration of vision impairment

To be registered as legally blind in Ireland a person must be registered with the National Council of the Blind (NCBI). Qualifying for registration requires that your best corrected visual acuity is equal to or less than 6/60 in the better eye or your field of vision is limited, the widest diameter of vision subtending an angle of not greater than 20 degrees.

A measurement of 6/60 equates to being able to read the top line of the Snellen eye chart. This means you can see at six metres what a normally sighted person can see at 60 metres.

Registration with the NCBI is necessary to apply for government entitlements in relation to vision impairment and blindness. A letter from your ophthalmologist is required to confirm your level of vision for registration. For more information you can contact NCBI on 01 830 7033 or info@ncbi.ie.

 

The spectrum of sight loss

People are not either sighted or blind, there are different degrees of sight loss and different ways in which sight loss can affect a person’s vision. For example, some conditions, like retinitis pigmentosa (RP), affect the peripheral vision or cause difficulty seeing in dim light.

Other conditions, such as age-related macular degeneration (AMD), affect the central vision causing difficulty with reading, driving or recognising faces. Other conditions can cause gaps in vision, colour blindness, sensitivity to glare or many other symptoms.

Sight loss can affect people of all ages and can have an impact on all aspects of a person’s life: social, school and work, and everyday tasks. A vision impairment can be present at birth, occur at any time from disease or accident, or be part of a medical condition or syndrome.

The actual effect of a vision impairment on an individual varies widely, depending on many different factors, including the condition, its progress and the individual themselves. It is important never to assume that someone living with sight loss needs your help, always ask the person if they would like some assistance and respect their response.

Here are some helpful pointers when meeting a person who is living with sight loss:

  • Greet a person by saying your name in case the person does not recognise your voice.
  • Talk directly to the person rather than through a third party and there’s no need to shout.
  • Don’t be afraid to use terms like ‘see you later’, ‘good to see you’, or ‘do you see what I mean?’ People with sight loss use them as well.
  • Give clear verbal directions, don’t point.
  • Don’t assume that because a person can see one thing that they can see everything, people may have pockets of vision or see better in different light levels.
  • Many partially-sighted people use a white cane or guide dog so don’t assume the person is totally blind.
  • Always let a person know when you are entering or leaving a room, so they are not left talking to themselves.
  • Don’t leave a person with sight loss standing in space – let them have contact with some object such as a chair, desk or a wall.
  • Never distract a guide dog when working (i.e. in harness).
  • Someone using a white cane with a red stripe has a hearing impairment as well as a vision impairment.

 

Guiding someone with a vision impairment

Bear in mind that many people affected by severe vision loss may not use a guide dog or cane but may require some assistance. Also, many people who do use a guide dog or cane may have residual sight, may be quite independent or may be very familiar with their surroundings, and may not require assistance.

Always ask someone if they would like some assistance, don’t assume that a person will need your help. The following are some guidelines for guiding a person safely, however people may have their own preferences about how they like to be guided so always ask the person what they are comfortable with.

Suggested initial approach

Begin by asking the person if they would like some help. If they accept, ask if they would like to take your elbow. The person may indicate whether they would prefer to take your left or right elbow.

Grip

The person may hold on to your elbow or simply touch it.

Your position

Walk half a pace ahead of the person you are guiding.

Single file

You may need to walk single file when moving through crowds or narrow spaces. Put your guiding arm behind your back. The visually impaired person will straighten out their arm and walk right behind you, taking shorter steps so they don’t walk on your heels.

Going through doors

Approach the door with the person you are guiding on the hinge side. Open the door and the visually impaired person can use their free hand to take the door handle from you. If the person you are guiding is not on the hinge side, ask them to change sides. They will side-step behind you, taking your other elbow with their other hand. Bend your elbow and point it out behind your back to make it easier for them to find it.

Steps and kerbs

When you reach a kerb or step, approach it straight-on, stop, and say ‘step down’ or ‘step up’. Warn them if the step is higher or lower than usual.

Stairs

Approach stairs so the person’s free hand is near the handrail and tell them where it is. Say ‘stairs up’ or ‘stairs down’. Always say when the top or bottom of the stairs has been reached.

Sitting on a chair

If the visually impaired person is holding your left elbow, use your left hand to grip the back of the chair so they can feel where it is. They can then release your arm, and sit down by themselves. Never push anyone backwards into a chair.

Getting into a car

Say which way the car is facing and place the visually impaired person’s hand on the door handle. The person should then be able to manage by themselves.

 

Membership survey 2017

The Fighting Blindness National Survey was conducted in early 2017 with the subsequent report launched at the Retina conference later that year. There were 349 responses to the survey, which collected information about specific conditions, healthcare, quality of life, research, and interaction with Fighting Blindness. Thank you to everyone who took the time to complete the survey and share your thoughts and experiences with us. Some of the key findings of the survey are outlined below.

The majority of respondents (80%) were adults living with vision loss, 11% were the parent/guardian of a minor affected by vision loss, and 5% were a family member or friend of someone living with vision loss.

Types of sight loss

Sixty-one per cent of respondents had a rare sight loss condition and 34% had a common sight loss condition. The rare conditions included achromatopsia, Charles Bonnet syndrome, choroideremia, cone-rod dystrophies, Leber congenital amaurosis (LCA), Leber hereditary optic neuropathy (LHON), retinitis pigmentosa (RP), Stargardt disease, and Usher syndrome. The common condition category includes wet age-related macular degeneration (wet AMD), dry age-related Macular Degeneration (dry AMD), cataracts, diabetes related sight loss, glaucoma, and retinal tear or detachment.

The majority of people (79%) were affected by one sight loss condition but 21% were affected by more than one condition. For example, 38% of people who had age-related macular

degeneration also had another condition: 14% had cataracts, 9% had glaucoma, 6% had a retinal tear or detachment, 6% had retinitis pigmentosa (RP) and 3% had diabetes related sight loss.

Fifty-nine per cent of people were registered as legally blind. People with a rare condition only were more likely to be registered as legally blind (71%) than those with a common condition only (24%).

Healthcare

The majority of respondents (55%) receive care in the public health system; 38% receive care in the private sector and 30% through a research project, such as Target 5000. Some people receive care in more than one sector.

Forty-three per cent said they had visited one in the previous six months, 20% in the previous year, 9% in the previous 18 months, 8% in the previous two years, 9% more than two years ago, and 11% more than five years ago.

Diagnosis

Seven out of 10 people were not diagnosed when they first began experiencing problems with their vision. Thirty-one per cent said they were diagnosed within a year, 23% waited between one and five years for a diagnosis, 9% waited between six and ten years, 3% waited between 11 and 15 years, 16 and 20 years, and more than 21 years respectively. Four per cent of people were diagnosed

before they began experiencing vision problems and 23% could not recall when they were first diagnosed.

Genetic testing

The vast majority of respondents (80%) who have availed of genetic testing have done so through a research project such as Target 5000. Ten percent had a genetic test carried out by an ophthalmologist at the time of diagnosis and 9% received testing through the National Centre for Medical Genetics. Two percent of respondents travelled abroad for genetic testing.

Wellbeing and quality of life

Eighty percent of people with vision loss reported feelings of uncertainty as a result of vision loss at some point since their diagnosis, 71% reported feelings of anxiety, 70% reported feelings of stress, 62% feelings of fear, and 36% reported feelings of depression.

Only 44% of respondents were referred to a support service following their diagnosis.

Vision loss affected people in all areas of their lives: 44% of respondents stated that their vision had had an impact on their career or job, 43% on leisure time and hobbies, 38% mobility and getting around, 33% day to day routine, 14% on social withdrawal, 22% on falls or accidents, 21% om relationships, 19% on isolation, 19% on education, and 13% on how they communicate.

If you would like any further information about the results of the survey please contact the advocacy department on 01 6789 004 or advocacy@fightingblindness.ie.