01 - LOW VISION - Introduction to Blindness and Low Vision.pptx

Introduction to Blindness and Low Vision
Dr. Jasmine S. Dean
Low Vision Optometrist

Please follow our training room agreement:
- Camera on when possible.
- Go on mute when you’re not talking.
- If you need to intervene, raise your hand.
- Keep your phone and any other distraction away during meeting hours.
- Submit all requested activities on time.
- Enjoy learning! I am always open to your suggestions to improve our
discussion.

Learning Objectives
After the course, students will be able to:
- Understand what blindness and low vision is.
- Determine the impact of visual impairment to the quality of life.
- Develop empathy to patients with visual impairment.

“Every time we make a decision which road to
take in our career path as doctors/health
workers, we must always recognize the
privileges (no matter how little) that allow us to
make that choice. It’s never about us, and
always about the people we serve.”
-Dr. Ronnie E. Baticulon (@ronibats, Twitter)

Outline
● Global Perspective of Low Vision and Blindness
● Definition of Terms
● Epidemiology
● Vision 20/20 The Right to Sight
● Impact of Blindness and Low Vision
● Needs of People with Low Vision

KEY FACTS
Globally, at least 2.2 billion
people have a near or distance
vision impairment. In at least 1
billion of these cases, vision
impairment could have been
prevented or has yet to be
addressed
The leading causes of vision
impairment and blindness are
uncorrected refractive errors
and cataracts.
The majority of people with
vision impairment and
blindness are over the age of
50 years; however, vision loss
can affect people of all ages.
Vision impairment poses an
enormous global financial burden
with the annual global costs of
productivity losses associated with
vision impairment from uncorrected
myopia and presbyopia alone is
estimated to be USD 244 billion and
USD 25.4 billion
“
https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment

Definition
The International Classification of Diseases 11 (2018) classifies vision impairment into two groups,
distance and near presenting vision impairment.
Distance Vision Impairment
Vision Impairment Visual Acuity in meters Visual Acuity in feet
Mild Vision Impairment worse than 6/12 to 6/18 worse than 20/40 to 20/60
Moderate Vision Impairment worse than 6/18 to 6/60 worse than 20/60 to 20/200
Severe Vision Impairment worse than 6/60 to 3/60 worse than 20/200 to 20/400
Blindness worse than 3/60 worse than 20/400

Definition
The International Classification of Diseases 11 (2018) classifies vision impairment into two groups,
distance and near presenting vision impairment.
Near Vision Impairment
Visual acuity worse than N6 or .08 at 40 cm.

Vision
Impairment
A person’s experience of vision
impairment varies depending upon many
different factors.
For example:
- the availability of prevention and
treatment interventions
- access to vision rehabilitation (including
assistive products such as glasses, or
white canes)
- whether the person experiences
problems with inaccessible buildings,
transport and information.

Disability
- the umbrella term for impairments, activity limitations and participation
restriction
- results from the interaction between individuals with a health condition, such
as cerebral palsy, Down syndrome and depression, with personal and
environmental factors including negative attitudes, inaccessible
transportation and public buildings, and limited social support.
- a human rights issue, with people with disability being subject to multiple
violations of their rights, including acts of violence, abuse, prejudice and
disrespect because of their disability, which intersects with other forms of
discrimination based on age and gender, among other factors.

Disability
- the umbrella term for impairments, activity limitations and participation
restriction
- results from the interaction between individuals with a health condition, such
as cerebral palsy, Down syndrome and depression, with personal and
environmental factors including negative attitudes, inaccessible
transportation and public buildings, and limited social support.
- a human rights issue, with people with disability being subject to multiple
violations of their rights, including acts of violence, abuse, prejudice and
disrespect because of their disability, which intersects with other forms of
discrimination based on age and gender, among other factors.
https://www.who.int/health-topics/disability#tab=tab_1

Consequence of Disease (Disease Process)
Low Vision
Visual
Impairment
Visual Disorder/
Disease
May be corrected by lenses, contact lenses,
or treated with surgery, medications
Blindness
VA worse
than 6/18
VF less
than 20°

Consequence of Disease (Disease Process)
Visual Disease/
Disorder
The impact of the
disease or injury on the
anatomical structure of
visual function within the
organ.
Cataract, macular
degeneration, retinitis
pigmentosa
Visual
Impairment
The consequence, in
terms of measurable
loss or departure from
functional capacity, to
the bodily organs,
affected by disorder or
disease.
Blindness
Low Vision
Activity
Limitations
A dimension of health/
disability capturing long-
standing limitations in
performing usual
activities due to health
problems.
Difficulty seeing, hearing,
walking, or problem
solving
Participation
Restriction
It refers to health
problems that can hinder
people’s involvement in
different life events.
Restrictions in working,
engaging in social or
recreational activities,
obtaining health care

Persons with Disability (PWD)
- under RA 10524, it refers to individuals who suffer long-term physical,
mental, intellectual, or sensory impairments, which upon interaction with
various barriers, may hinder their full and effective participation in society on
an equal basis with others.
https://www.ncda.gov.ph/disability-laws/republic-acts/republic-act-no-10524-an-act-expanding-the-positions-reserved-
for-persons-with-disability-amending-for-the-purpose-republic-act-no-7277-as-amended-otherwise-known-as-the-magna-
carta-for-persons/

Low Vision
It refers to the reduced ability to perform important life activities, such as:
1. Enjoying and seeing visual images
2. Obtaining education
3. Being employed
4. Traveling and living independently
…due to irreversible visual impairment which cannot be treated to a good level of
vision even after medical treatment, spectacles or contact lenses.

Low Vision
- Visual acuity: 20/70 up to light perception
- Visual field: less than 20 degrees (or 10 degrees from point of fixation)

Blindness
- A lack of vision (cannot see anything, even light)
- It may also refer to a loss of vision that cannot be corrected with spectacles,
contact lenses, or surgery

Prevalence
“ Globally, at least 2.2 billion people have a
near or distance vision impairment. In at least 1
billion - or almost half - of these cases, vision
impairment could have been prevented or has
yet to be addressed.
This 1 billion people includes those with
moderate or severe distance vision
impairment or blindness due to:
1. Unaddressed refractive error (88.4
million)
2. Cataract (94 million)
3. Glaucoma (7.7 million)
4. Corneal opacities (4.2 million)
5. Diabetic retinopathy (3.9 million)
6. Trachoma (2 million)
7. Near vision impairment caused by
unaddressed presbyopia (826 million)

Prevalence
- With regards to near vision, rates of
unaddressed near vision impairment are
estimated to be greater than 80% in
Western, Eastern, and Central Sub-
Saharan Africa
- Comparative rates in high-income regions
of North America, Australasia, Western
Europe, and of Asia-Pacific are reported to
be lower than 10%.
In terms of regional differences, the prevalence of distance vision impairment in
low- and middle-income regions is estimated to be four times higher than in high-
income regions.
Population growth and aging are expected to increase the risk that more people
acquire vision impairment.

In the Philippines…
…Over two million people nationwide are
blind or suffering from poor vision, as
reported by the Department of Health.
- an estimated 332,150 people in
the country are bilaterally blind
- 33% cataract
- 25% EOR
- 14% glaucoma
- 2,179,733 have bilateral low
vision
- 43% EOR
- 34% cataract
- glaucoma and other eye
diseases

Vision 20/20:
The Right to Sight

Vision 20/20: The Right to Sight
- aims to eliminate avoidable blindness in the world by 2020 and targets the world’s leading
causes of avoidable visual impairment: cataract, trachoma, onchocerciasis, childhood blindness
(including vitamin A deficiency), and refractive error
- Vision Loss Expert Group (VLEG) has conducted a major update of the Global Vision Database in
collaboration with researchers from the Global Burden of Diseases, Injuries, and Risk Factors Study
(GBD study). Updated estimates are of particular interest because of recent rapid socio-economic
development, for example in China and South Asia. Additionally, progressive emergence of
causes of vision impairment such as myopic macular degeneration (particularly in China)
and diabetic retinopathy as significant contributors to the vision impairment burden warrants a
global update. With ageing populations, it was anticipated that two other conditions, glaucoma and
age-related macular degeneration, would continue to be major causes of vision impairment.
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/416262#:~:text=VISION2020%20aims%20to
%20eliminate%20avoidable,low%20vision%20(Figure%201)
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30489-7/fulltext )

Personal Impact
In children:
- Young children with early onset
severe vision impairment can
experience delayed motor,
language, emotional, social, and
cognitive development, with
lifelong consequences.
- School-age children with vision
impairment can also experience
lower levels of educational
achievement.
In adults:
- Young Adults:
- Vision impairment severely impacts
quality of life (QOL) among adult
populations.
- Lower rates of workforce participation
and productivity
- Higher rates of depression and anxiety
- Older Adults:
- may contribute to social isolation,
difficulty walking, a higher risk of falls
and fractures.
- greater likelihood of early entry into
nursing or care homes.

Economic Impact
Vision impairment poses an enormous global financial burden.
For example, the annual global costs of productivity losses associated with
vision impairment from uncorrected myopia and presbyopia alone were
estimated to be USD 244 billion and USD 25.4 billion, respectively.

Needs of Person with Low Vision

NEEDS OF PEOPLE WITH LOW VISION
AUXILIARY SOCIAL SERVICES
04
● restore the person's social
functioning and participation in
community affairs.
HEALTH
03
● protect and promote the right to health of disabled persons
and shall adopt an integrated and comprehensive
approach to their health development which shall make
essential health services available to them at affordable
cost.
EMPLOYMENT
02
● equal opportunity for employment; a qualified disabled
employee shall be subject to the same terms and
conditions of employment and the same compensation,
privileges, benefits, fringe benefits, incentives, or
allowances as a qualified able-bodied person.
EDUCATION
01
● adequate access to quality education
and ample opportunities to develop
their skills.
Reference: RA 7277

NEEDS OF PEOPLE WITH LOW VISION
POLITICAL & CIVIL RIGHTS
07
● System of voting
● Right to assemble
● Right to organize
ACCESSIBILITY
06
● Barrier-free movement
● Mobility
● Access to public transportation
TELECOMMUNICATIONS
05
● Broadcast media
● telephone services
● postal charges
Reference: RA 7277

THANK YOU VERY
MUCH!
E-mail:
jacqbsamonte@gmail.com

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