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Visual Impairment across the Life Span
Visual impairment is a broad term used to describe vision loss in individuals who are totally blind, functionally blind, or legally blind, or who have low vision. Like those who are totally blind, individuals with functional blindness will rely on the auditory and tactile senses for learning. Legal blindness is defined as central acuity of 20/200 or less with best correction, or less than 20 degrees of visual field remaining (normal visual field is about 160 degrees). Acuity measures such as 20/200 report the individual's distance vision as compared with the normal visual acuity of 20/20. Therefore, 20/200 means that what a person with normal vision could recognize at 200 feet would need to be viewed at 20 feet by an individual with legal blindness.
The term low vision is used to describe vision that is measured between 20/70 and 20/200. Low vision is used as the minimal criterion for services offered in schools through a teacher of the visually impaired (TVI), while legal blindness is generally the minimal criterion used to gain services through adult rehabilitation agencies, offered by rehabilitation teachers. Individuals who are born with a visual impairment are said to have a congenital vision loss. Those who acquire visual impairment later and have visual memories that enhance learning (usually acquired by the age of 5 years) are said to have an adventitious vision loss. Some visual conditions are stable (unchanging), and others are progressive (worsening).
Prevalence across the Life Span
The prevalence of visual impairment is difficult to determine due to varying definitions and reporting procedures. About 9 million people have a significant visual impairment (Hardman, Drew, & Egan, 2002). The American Printing House for the Blind registered 57,148 legally blind children for fiscal year 2003 (American Printing House for the Blind, 2003). The Twenty-Fourth Annual Report to Congress on the Implementation of the Individuals with Disabilities Act (U.S. Department of Education, 2002) reported 25,927 children with visual impairment. This report cites data on children receiving special education services under 13 different disability categories, resulting in many children with visual impairment being reported under other categories, such as multiple disabilities or deafblind. Common additional disabilities include cognitive and neurological involvement, cerebral palsy, and hearing loss. Vision loss is also an age-related phenomenon, with nearly 50% of senior citizens (65 years and older) having a visual impairment (Hardman et al., 2002).
Symptoms of Visual Impairment
Symptoms of visual impairment include swollen eyelids, protrusion of the eye, crusty rims or discharge, red eyes, twitching eyes, irregular eye movements, tilting of the head to see, eye rubbing, fluctuating blurriness, itchy or burning eyes, dry eyes, light sensitivity, eye discomfort, double vision, flashing lights or spots in the visual field, severe headaches, loss of ability to see shades of color, and double vision (Orr, 1998; Ward & Johnson, 1997). When such symptoms exist, it is appropriate to request a full evaluation by an ophthalmologist or optometrist.
Common Eye Conditions
In Children
The leading causes of blindness in U.S. children ages 0–19 years are congenital cataracts, albinism, retinopathy of prematurity, and optic atrophy. The two leading causes among children without additional disabilities are albinism and optic nerve hypoplasia (Ward, 2000). Refractive errors and cortical visual impairment are also common causes of visual impairment.
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