Sight Loss

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What is Visual Impairment?
Common Causes of Sight Loss
Helping People with Sight Loss
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What is Visual Impairment?

Sight loss takes many, many forms. Visual impairment is a deeply personal experience and no two cases are the same. Some people don't see in the dark - others are badly affected by bright sunlight. Some have a restricted field of vision, whether peripherally, centrally or randomly. Two people with the same eye condition will cope in different ways with a similar impairment. Sight varies, some days we see far better than on others.

How is visual impairment measured?

Partial sight can be hard to judge, there being so many variables. However, put simply, if you cannot read normal newsprint whilst wearing glasses or contact lenses, then you could be considered to be partially sighted. However, blindness and partial sight are formally defined terms, which relate to the quality of vision. Furthermore, blindness does not mean the absence of sight.

What does Registration mean?

If you have eye problems that can't be resolved by your optician, you will be advised to consult your GP. Should your GP think it necessary, you will be referred to the eye clinic at your local hospital.

After an examination by an ophthalmic consultant, appropriate treatment will be offered (for example, surgery to restore vision obscured by cataract). If conventional glasses cannot improve your sight, you will be offered an appointment to attend the hospital low vision service. If your eyesight is substantially impaired, you may be told you are eligible to be certified either as partially sighted or blind.

If you do become certified as partially sighted or blind, it is extremely unlikely that you will lose all of your eyesight. If your consultant signs a certificate of partial sight, copies are sent to you, your GP and to the local social services office. The local rehabilitation worker will contact you to offer a visit, during which he or she can assess and advise you on specialist services, support and training that may be available. If you agree, your rehabilitation worker can also place your name on a register, which can give you access to some financial benefits and services and which will help the local authority to plan its services.

Why should I have my details put on the visually impaired register?

For a number of reasons recently diagnosed people are sometimes cautious of being put on the visually impaired persons' register. Diagnosis can be a shock and quite enough to cope with on its own. This phase passes more quickly for some than for others. For most people it will pass, eventually. Some fear that registration somehow means that they are more likely to go blind. Registration has no bearing on the outcome of your medical condition. Sometimes people perceive a lack of confidentiality or fear that Big Brother might be watching them. In fact, if you are registered as a visually impaired person, your records will not be released to anyone without your personal permission.

Advantages of Registration

Registration may be taken into account if you claim benefit.

There are increased personal income tax allowances for people who are registered blind - if you don't work, allowances can be transferred to a working partner

Parking concessions (e.g. A blue badge and discs permitting parking in restricted areas), are available for use by people who are registered as blind.

Anyone who is registered blind can claim a 50% reduction in the cost of his or her television licence.

By registering your visual impairment, you help yourself and your family and also other people who are or who will be registered in Uttlesford. Because so many people are not registered, Social Services have an incomplete picture of the number of visually impaired people in our area. For example they know of 2,000 VI people on their register, when there are at least 4,000 people eligible for registration as visually impaired. If the authorities lack the information to assess and support present needs and allocate funds for services today, they will certainly be under-resourced in the future.

Common Causes of Sight Loss

Macular degeneration

This group of eye conditions causes damage and potential loss of central vision. Sight may appear distorted or there may be blank areas in the central field of vision. The macular, the part of the retina at the back of the eye which "sees" detail and colour, becomes damaged either by an accumulation of waste products or by leakage of blood, sometimes referred to as "dry" or "wet" degeneration. The most common type of macular degeneration (MD) occurs in people over 50 years of age and it accounts for over one third of all cases of visual impairment in this country.

Unfortunately, even with recent advances age-related MD is still largely untreatable, but in a few types of MD direct laser treatment can sometimes halt the progression of vision loss. There are new treatments such as photo-dynamic therapy and surgical procedures that are developing which may prove helpful. It is important to remember that for any treatment to be effective, the sight must be regularly checked in case of further problems.

MD is a very serious condition, but even if it is very advanced, the person affected will not go totally blind -peripheral vision is unaffected, and a good degree of independence can be maintained with training and use of specialist equipment, issued by social services or available at Support 4 Sight.

Cataract

Cataract, commonly associated with ageing, is a condition where the lens inside the eye becomes opaque. Cataracts can be caused by trauma to the eye or by other eye conditions. Surgery can remove the opaque lens, which is usually replaced by a small plastic lens fitted inside the eye, known as an intra ocular lens. This can be a fixed focus lens (for either, close up work, such as reading, or for seeing distance) or a multi-focal lens for distance and close up vision. This treatment is usually very effective. However spectacles may still be needed to give fine focus. If an implant is not appropriate, vision is corrected with glasses or contact lenses.

Diabetic Retinopathy

This eye condition is more likely to affect people the longer they have been diagnosed with diabetes. It involves haemorrhaging of the vessels at the back of either or both eyes. The symptoms may include loss of field, poor focus/detail perception, double vision and these can become more pronounced as the condition progresses. Laser treatment has a very good record for halting the loss of vision and preventing further damage. However, it is very important that the people with this condition remain under regular review and seek medical advice on any further visual symptoms, which may present themselves. Your optician can check for this.

Glaucoma

The risk of glaucoma increases, as we get older. It is a condition usually associated with raised fluid pressure in the eye. The most common type of glaucoma has no symptoms and has been called "the silent thief of sight". If untreated, it may cause blindness. However, in the majority of cases there are several treatments available including drugs, eye drops, conventional and/or laser surgery, which can be used to arrest the progression of sight loss.

Some words of advice

Since three of the four conditions leading to visual impairment are treatable, they ought not to be amongst the major causes of partial sight and blindness. Early detection of most eye conditions leading to visual impairment increases the possibility of effective treatment, although, in most cases, it is only possible to prevent progression of further sight loss rather than to restore vision to its former level.

Eye examinations at two yearly intervals are therefore advisable for every one. More frequent examinations may be required where pathology is present or where there is an increased risk of an eye condition indicated by family history.

For information on other eye conditions, or help with dealing sight loss, contact Support 4 Sight on telephone no 01799 523700 or call into the Resource Centre, 2-4 George Street, Saffron Walden, Essex.

Helping People with Sight Loss

Please treat him/her as you would anyone else and speak in a normal tone of voice. Blindness doesn't mean loss of hearing or intellect.

Identify yourself when entering a room and mention when you're leaving. Address the person by name when you are speaking to them. Also, don't worry about using phrases like, "I see", "look" or "watching TV".

If they look like they need help, ask and they will tell you. If the situation looks potentially hazardous, tell them calmly, but clearly.

Pulling or steering can be awkward or confusing. Don't grab their arm or touch their dog's collar. Please never distract a guide dog.

Ask, "Would you like me to guide you?" Offering your elbow is an effective and dignified way to lead a VIP. Mention that you are an inexperienced sighted guide and ask for tips.

If you leave a visually impaired person alone in an unfamiliar place, make sure it's near something tangible, like a wall, rail or table, for example. Being left alone in an empty space is very uncomfortable.

Be considerate. If you notice a stain on their clothing, approach them privately, as you would like to be told.

Try to give useful directions. Exact directions, such as "turn right at the next corner" is more useful than a vague description like "over there".

Give clear directions regarding available seating in restaurants or bars. Offer to read the menu aloud, but allow VIPs to order for themselves. Once the food order has arrived, offer to describe the location of the food on their plate, as well as the location of other items on the table. For example, "The salt is at 11 o'clock".

Don't leave doors or cupboards half open; either fully open or completely closed. Don't reorganise furniture or possessions belonging to a VIP, without letting them know.

Be sensitive about asking a VIP regarding their sight loss. It's personal and boundaries must be respected.