Impact of visual impairment Flashcards
(38 cards)
what is a system that can be used to define health and health related states
ICIDH (International Classification of Impairment, Disability and Handicap) (1980)
what is an impairment
A loss or abnormality of physiological or anatomical structure or function
e.g. loss of leg or eye
what is a disability
Any restriction or lack (resulting from impairment) of the ability to perform an activity in the manner or within the range considered normal for a human being
e.g. by losing your leg (the impairment) you have a disability as your unable to walk.
but you might have an impairment where you’ve lost an eye, but that doesn’t lead to a disability because you can still watch t.v. with one eye
what is a handicap
A disadvantage for a given individual, resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal for that individual (in relation to age, sex, social and cultural factors)
give an example of the impairment, disability and handicap of a person who has AMD
impairment:
at the level of the photoreceptors, so theres something wrong with the macula which results in a loss of VA and VF
disability:
difficult to recognise faces or read
handicap:
patient goes outside and is unable to recognise their neighbour, they feel this has put them in a disadvantage
or if you cannot read and you want to vote but you cannot see the voting form, this puts you in a social disadvantage
what replaced the ICIDH (International Classification of Impairment, Disability and Handicap) (1980) which is the system that can be used to define health and health related states
and why was it replaced
The ICF (2001) replaced the ICIDH (International Classification of Impairment, Disability and Handicap) (1980)
Because:
- ICIDH can only describe ‘consequence of disease’
Whereas:
- ICF can describe conditions of both health and disease i.e. it can be used to describe any individual in the society, healthy or diseased.
WHO wanted a definition that looked at global health and was able to describe an individual regardless of whether they had a disease or whether they were normal
explain how the ICF describes an individual and how this is categorised, give examples of this with a px who has AMD
The ICF describes the individual in terms of the:
- Body part thats affected
- The whole person
- The functioning at the level of the person
- The functioning in the society
e. g. with AMD
- The impairment is photoreceptor loss, which results in a loss of va and central vf loss
- What you can do for AMD depending on the type would be e.g. lucentis treatment
- If you then look at the whole person and look at the activity limitations i.e. what affects AMD will have on an individual e.g. px will be unable to read, so for that individual you will give a stronger pair of glasses or magnifier to help them read
- Next thing to look at is the individual interacting with society, an AMD px may not be able to participate in society as they cannot see well e.g. to vote
- So design the voting form to be accessible to everyone
So ICF tries to look at:
The body part, the individual on their own and the individual in society and different interventions at different stages which can help the individual
what does the interaction between components of the ICF describe
How different components of the ICF interact with each other
Describes:
the limit in activities and participations depends on environmental and personal factors
e.g. px might live in a society with iPads, iPhones etc so not to read conventional print is not a big problem as they can enlarge the print or read out the text
this depends on the individual and their environment and also on personal factors e.g. what people accept as being normal differs between individuals
list the: impairment disability handcap of a person with AMD
- Impairment
Loss of central vision and visual acuity - Disability (difficulties)
Reading
Recognising faces - Handicap
Loss of independence
as cannot read themselves, cannot recognise faces = have to depend on others
list the: impairment disability handcap of a person with cataract
- Impairment
Loss of contrast
Glare
Poor acuity - Disability
Detail
Low contrast targets
Bright environments
Handicap
- Night time driving
You don’t see patients with just a cataract in the LV clinic, they may also have it with e.g. AMD, DM, glaucoma etc.
you can get a patient with a dense cataract and surgery for some reason may not be an option for them
list the: impairment disability handcap of a person with glaucoma
- Impairment Contracted field (due to loss of nerve fibre layer)
- Disability
Mobility (from loss of visual field, bump into things)
- Handicap Getting about (if have constricted vf)
list 6 effects of the impact of vision loss on the individual
- Employment
- Independence
- Impact on QoL/leisure activities
- Psychological Impact
- Wellbeing
- Social Impact
explain how the impact of vision loss can affect the individual’s employment
34% of individuals who have SI or SSI are in employment in comparison to 75% overall (Douglas et al. ,2008)
People with a visual impairment are less likely to be in work than those with other kinds of disability (McNeil, 2001) but are more likely than those with other disabilities to graduate from secondary school (Kaye, 1992)
So most VI people are educated, but can’t find a job because of their VI
explain how the impact of vision loss can affect the individual’s independence
- Loss of independence (Mitchell et al., 2005)
- No longer able to drive, mobility problems, problems while cooking and managing money (Sloan et al., 2005)
- Correlation between distance visual acuity and independent living for individuals between the ages of 70 and 95 years of age (Bergman & Sjöstrand, 2002)
As distance VA declines, more likely to end up in care home, as px has not much independence
explain how the impact of vision loss can have an impact on QoL/leisure activities
- Rovner and Casten (2002) found that over half VIP had lost valued activities: most common being reading and driving
- Rees et al. (2007) found that 79% of VIP had problems with reading, 46% had difficulties with household tasks and 31% had problems with personal care
explain how the impact of vision loss can have a psychological impact
- VIP are prone to depressive symptoms (e.g. Burmedis et al., 2003) so need to ask about depressive symptoms to pick them up
- Rate of depressive disorder is twice that among the elderly VIP than among the overall elderly population (Brody et al., 2001)
- Visual impairment in the elderly has been shown to lead to an increased risk of committing suicide (Waern et al., 2002)
- Poor sleep quality has also been frequently reported among VIP (Asplund, 2000)
explain how the impact of vision loss can affect the individual’s wellbeing
- Visual impairment can increase the number of injuries resulting from falls (Vu et al., 2005) compared to non VIP
- VIPs more likely to visit GPs( Branch et al., 1989)
- Visual impairment can increase the risk of death from injuries (Lee et al., 2002)
explain how the impact of vision loss can have a social impact
- Reduced participation in social activities because the individual has mobility problems and is worried about having problems recognising faces (Dickinson 1998)
- VIP are more likely to be single/have never married than those in the general population (Clements & Douglas, 2009)
Loss of vision is one of the most feared results of aging
explain how large the economic impact is on vision loss
Future Sight Loss UK (2009)
- Cost of visual impairment in 2008 was approximately £6.5 billion.
- £2.2 billion were direct costs, such as hospital and social care
- £4.3 billion was indirect costs, such as costs associated with lower employment, informal carers, LVAs and home modifications etc.
Costs associated with loss of healthy life and loss of life due to premature death associated with visual impairment is estimated at a further £15.51 billion
list 3 impacts that vision loss can have on the VIP’s carer and family
- Depressive symptoms
- Economic impact (if cannot work and support family)
- Psychological impact
list the 5 stages of response to a visual loss that a VIP may have (seen in clinic)
- Denial
- Anger
- Bargaining (e.g. religious person may bargain with god)
- Depression
- Acceptance
list 7 factors affecting the adjustment to visual impairment (i.e. how well someone will adjust to visual impairment)
- Type of loss
- Cultural and Family reaction
- Life stage
- Significant life event
- Patient expectations
- Self concept
- Personality
what 5 types of visual loss are there, that can affect the adjustment to visual impairment
- Congenital: VI for long time = better adjusted as may have not known what good sight is
- Adventitious and long standing
- Adventitious and recent onset
- Blind
- Low Vision
how can a congenital type of visual loss affect an individual’s adjustment to visual impairment
better adjusted as may have not known what good sight is
