VISUAL

IMPAIRMENT
Melody L. Mejia

Visual impairment is the consequence of a

functional loss of vision.
Unimpaired vision has four components:
1. The object to be viewed
2. The light that reflects from object to the eye
3. The normally functioning eye to receive the
reflections
4. The occipital lobes of the brain to interpret the
signals transmitted from the eye.

A visually handicapped child is one where visual

impairment interferes with his/her optimal
learning and achievement unless adaptations
are made in the methods of presenting learning
experiences the nature of the materials used
and/or in the learning environment. (Barrga,
1983)

Legal Definition
Legally, the basis for classifying a child as
visually impaired (whether blind or with low
vision) depends on measurements of visual
acuity, the ability to clearly distinguish forms
or discriminate details at a specified distance.
20/20 vision- contrary to popular belief, 20/20
visual acuity i not synonymous to "perfect
vision".
What it does indicate is that at a distance of 20
feet, the eye can see what a normally seeing
eye should be able to see at that distance.

Indicators of Visual Impairment for

children

-Rubs eyes excessively

Behavior -Shuts or covers one eye, tilts head or thrusts head
forward.
-Has difficulty in reading
-Blink more often than usual
-Stumbles over small objects
-Holds books close to eyes
-Unable to see distant things clearly
-Squints eyelids together or frowns
-Crossed eyes
Appearan -Red-rimmed, encrusted or swollen eyelids
ce
-Inflamed watery eyes
-Recurring sties
-Eye-itch, burn or scratchy
Complaint -Can't see well
s
-Dizziness
-Headaches following close eye work
-Nausea
-Blurred or double vision

Nine (9) Warning Signs

Does the child exhibit:
Clumsiness and trouble walking in unfamiliar
settings?
Holding the head in an awkward position or holding
material close for the eyes to see it?
Lack of attention to written information on
blackboards or other visual presentations?
A constant need for explanation of what is
happening at events?
Extreme sensitivity to glare or loss of vision in
different types of light?
Extreme squinting?
Excessive eye rubbing?
Poking the eyes with fingers or knuckles?
Physical anomalies such as swollen eyes or
strabismus?

Characteristics of Visually
Impaired Children
Academ a. Does not usually seriously affect
ic Skills intellectual functioning
b. Intelligence is notably affected by
cumulative experience.
a. Usually do not interfere with everyday
language or communication abilities
Languag
b. Slower than sighted children in forming
e
hypothesis about word meaning
c. Restricted experiences lead to lack of
linguistic experiences that are only
related to their lack of interaction with
the environment.
d. May indulge in verbalism

a. Restricted mobility and consequent

Personal
and Social
Adjustmen
t

limited experiences.
b. Some may become socially
immature, self-conscious, isolated,
passive, withdrawn and dependent.
c. Appropriate smiling and facial
expression and postural messages are
difficult.
d. Difficult to hold sighted playmates'
interest, their conversations become
brief and self-centered rather than
focused on shared activities.
e. Presence of stereotypical behaviors
(ex. body rocking, eye rubbing and
inappropriate hand and finger

Causes of Visual
Impairments

-Hereditary conditions
-Infectious diseases (AIDS, gonorrhea,
Rubella)

-Eye injury
-Neoplasms (tumors)
-Malnutrition
-Substance abuse
-Systemic diseases (diabetes)
-Poisoning (excess oxygen).
Retinopathy of prematurity (formerly
called retrolental fibroplasia).

Famous Blind People

Helen Keller-American Author and
Philanthropist (born June 27, 1880 in
Tuscumbia, Alabama) who became blind as
the result of an undisclosed illness when
she was 19 months old.
Louis Braille-Inventor of Braille (born in
1809 in Coupvray near Paris) became blind
as the result of an accident when he was 4
years old.
Dr. William Moon-Inventor of the Moon
System of Reading which became part of
the National Institute for the Blind (born in
Kent in 1818) lost his eyesight at age 21
after being partially sighted throughout his
childhood.

Conditions of the eye

Refractive Disorders
a. Hyperopia- farsightedness; results from the failure
of the cornea and the lens of the eye to focus light
appropriately and allows the individual to focus on
objects at a distance but not when they are close.
b. Myopia- nearsightedness; focus on objects that
are close but not as a distance.
c. Astigmatism- results in blurred vision caused by
an uneven curve of the cornea or the lens of the
eye almost always correctable with surgery as
corrective glasses.
d. Cataracts- occur when the lens becomes clouded
and vision is masked.
e. Aniridia (ocular albinism) - lack of color in the iris
of the eyes; leads to extreme sensitivity to light to
a reduced visual acuity

Eye Muscle Problems

a. Strabismus- is the result of improper muscle
functioning that causes either or both eyes to
be directed inward, two separate images may
be sent to the visual cortex of the brain.
b. Nystagmus- characterized by the rapid,
involuntary movements of the eyes, usually
laterally, movements make it difficult to focus
upon objects and cause dizziness and nausea.

Retinal and Optic Nerve problems

a. Retinal degeneration- can be the result of
an infection or it may be inherited,
underlying cause of the deterioration is
unknown.
b. Retinal detachment- retina becomes
separated from the outer layers of the eye
tissue; causes interruption in the
transmission of visual signals for the brain to
interpret.
c. Macular degeneration- macula, a small
area near the center of the retina gradually
deteriorates as a result, peripheral vision is
retained while central vision is lost.
d. Retinitis pigmentosa- causes degeneration
of the retina results in the narrowing of the
field of vision.

e. Coloboma- retina is malformed, results in

both visual field and visual acuity problems.
f. Glaucoma- occurs when the flow of fluids in
the eye is restricted, causes pressure to
build and retain the blood supply to the
optic nerve damaging the retina causing
blindness.
g. Optic nerve atrophy- causes the optic
nerve to function less efficiently and results
in reduced efficiency of many types.
h. Color vision problems- diminished ability to
differentiate colors have little or no effect to
vision.
i. Diabetic retinopathy
j. Optic tumor

Classifications of Visual
Impairments

Moderate- the impairment can be

almost entirely corrected with the help
of visual children can either learn in a
regular classroom or a resource room.
Severe- Necessary use of visual aids
Profound- The child can no longer use
vision as educational tool, touch is a
predominant channel of learning.
Blindness- loss of vision

Assessment Process
a. Parental concern about vision
b. Visual acuity screening test failure
c. Ophthalmologist determination of disorder
d. Optometrist and low vision expert determination of
whether impairment can be corrected
e. Functional evaluation of low vision
f. Evaluation by an orientation and mobility specialist
g. Intelligence testing by a school psychologist
h. Comprehensive determination of the potential
effects by an orientation and mobility specialist, a
speech pathologist and a regular education teacher.
i. Estimate of social and daily living skills needed by a
teacher of the visually impaired orientation and
mobility specialist, daily living professional and
parents.

Visual Acuity Screenings: Snellen Chart

Functional Vision Assessment- to measure residual
vision for utilization
a. Visual capacity-amount of usable visual field and how
the child responds to information presented visually.
b. Visual attention
Visual alertness-how sensitive child is to environmental visual
stimulus
Visual selection- ability to select information from different
sources
Degree of attention- ability to change attention from one
stimulus to another
Processing capability- ability to make sense of visual input

c. Visual efficiency- depends on how well the individual

can use --- modifications or alternate methods that
depend on auditory or tactile stimuli. Enhances by
changing seat placement, adapting materials using
specialized equipment and modifying classroom teaching
techniques.

Educational
Approaches
a. Concreteness- children must work
with objects that can feel and
manipulate
b. Experiences
c. Learning by doing- to learn about
the environment, the children
must be motivated to explore the
environment.

Essential unique needs of students

with visual impairments
-minimum use of vision
-development of concepts
-determination of learning mode
Concept
development -academic support
and academic -listening skills
skills
-organization and study skills
-reading charts, maps, graphs
-use of reference materials
-handwriting
-development of legal signature
-use of Braille writer
Communicatio
-use of slate and stylus
n skills
-use of word processors
-use of adaptive equipment
-note-taking skills

-knowledge of self
-knowledge of human sexuality
-knowledge of visual impairment
Social/Emotiona
-knowledge of others
l skills
-development of interaction skills
-lifelong recreation and leisure skills
-self-advocacy
-development of gross motor skills
-development of fine motor skills
-development of strength, stamina
Sensory/motor
and endurance in legs, arms, hands
skills
-identification of textures factually
-identification of kinesthetic sources
-identification of olfactory sources

-development of body image

-development of concrete environmental concepts
Orientatio -development of spatial concepts
n and
-understanding traffic and traffic control
mobility -trailing techniques
skills
-use of vision for travel and orientation
-development of orientation skills
-use of long cane
-independent travel in a variety of environments
-personal hygiene (dressing; clothing care)
-eating
-food preparation
-housekeeping
-basic home repair
Daily
-money identification and management
living
-use of telephone and information
skills
-use of desk tools
-time and calendar activities
-shopping skills, restaurant skills, community skills
-knowledge and use of community services

Career and
vocational
skills

-knowledge of relationship between work

and play
-understanding of value of work
-knowledge of characteristics of valued
workers
-awareness of the variety of jobs people
hold
-awareness of jobs people with visual
impairments often hold
-awareness of jobs teenagers hold
-job acquisition skills (want ads, resume,
applications, and interviews)
-typical job adaptations made by workers
with visual impairments
-in-depth knowledge of a variety of jobs of
interest
-work experience
-laws related to employment

AIDS TO TEACHING AND LEARNING

-Braille reading and writing, Braille typewriters,
computers, slate and stylus, portabe recorder
-Listening comprehension program
-Audio aids
-Calculation aids- talking calculator, abacus,
mental math
-Talking/audio books
-Optical aids

PREVENTIVE MEASURES
1. Increase vitamin A-rich food intake
2. Early diagnosis and treatment
3. Surgery and medication
4. Primary eye care- protective goggles, use
of car seatbelts
5. Provision of low vision care- eyeglasses,
eye drops, check-ups

Sources:
Exceptional Children, W.L. Heward (1996)
Children With Disabilities: Awareness, Attitude And
Competencies Of Teachers, G. L. Reddy, Discovery
Publishing House, 2010
Language Disorders And Intervention Strategies: A Practical
Guide To The Teachers, G. L. Reddy, Discovery Publishing
House, 2004
Educating Exceptional Children (12th edition) by Kirk,
Gallagher, Coleman & Anastasiow (2009 Wadsworth,
Cengage Learning)
National Information Center for Children and Youth with
Disabilities, The Source for Learning, Inc. NEC, 2001-2011
http://www.teachersandfamilies.com/sped/prof/deaf/defn.htm
l
http://www.kidsource.com/NICHCY/deafness.all.dis.3.html
www.rnib.org