PRELIM Flashcards by MECAELA AGUILLON

Composition of low vision team

Individual with low vision family members
Eye care providers
Human service/allied health personnel
Education/rehabilitation specialists

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An ophthalmologist or optometrist who has additional training and expertise about low vision.

Clinical Low vision specialists

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Purpose of eye care providers

Assess clinical visual functioning
Matches various treatment options
Prescribes various optical and non-optical devices as appropriate
Provides follow up services and examinations

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Evaluates and treats cognition, communication, and typically addresses swallowing.

Speech and language specialist

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Evaluates and treats participation in activities of daily living, sensory-motor integration, and upper extremity functional use.

Occupational therapist

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Evaluates and treats musculoskeletal impairments, posture, positioning, balance and ambulation, and identifies functional physical deficits that may be caused by visual or vestibular impairments

Physical therapist

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Facilitates effective transition between adolescence and adulthood, and who ensures that an individual is adequately prepared for life beyond school.

Transition coordinator

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Special education and development of children with congenital disabilities

Habilation

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Teaching of visual efficiency skills as well as daily living skills

Habilitation

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No prior experience of learning skills

Habilitation

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Acquired impairment in late adolescent/adulthood

Rehabilitation

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Low vision services:

Habilitation
Rehabilitation
Vision rehabilitation services

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A wide range of professional services that can restore functioning after vision loss

Rehabilitation

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Have symptoms or changes in organ

Organic

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Classification by aetiology

Organic
Functional

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Classification by the period of occurence

Congenital
Acquired

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Classification by the progression of disorder

Regressing
Stable
Progressive

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Classification by type of visual disorders

Loss of VA
Changes in VF
Color deficiency
Reduced contrast sensitivity

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Classification by characteristic

Acute
Chronic
Recurrent

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Classification by age

Infants and preschool age
School age
Adults
Elderly

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Classification by social background

Functional
Dysfunctional
Absent

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Classification by the presence of additional disadvantage

Changes in appearance
Multiple disabilities
Discriminating or incapacitating situation of permanent nature

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Vision impairment can be:

Congenital
Acquired

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Adjustment to blindness or low vision depends on:

Etiology
Progression
Stability
Extent of vision loss

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Loss of vision can be:

Rapid Slow

Impact of vision loss to:

• Work • School • Leisure activities • Family life • Friendships

Erroneously believed stereotypic ideas:

Inferior and useless Pitiable To be feared, avoided esp in intimate relationship Emotionally and sexually maladjusted Paying for precious sin, immoral, and evil

Vision loss impacts three (3) major aspects of a person’s life

Functional implications Social implications Psychological implications

Functional implications: Site of disorder determines level of functioning

• Mobility affected if loss is lower half of visual field • Reading affected if loss is right field of vision • Education is a problem if central vision is lost • Physical activities are difficult if peripheral vision is affected • Different visual acuities of 2 eyes may cause depth perception problem

Sociological implications

• Behavior influences attitude of others toward self, but reflects on individual’s self-concept and self-esteem • How visually challenged person feels about self, blindness, and attitudes of others towards self are important in self-esteem

Sociological implications: Immature and egocentric behavior

• Visually challenged children and young adults tend to be more socially immature • Remain more egocentric longer than sighted peers

Sociological implications: Isolation and withdrawal

• Unable to choose companions for conversation • Wait for others to initiate conversation • In a group they are unable to participate when comments directed to them • Unable to observe the nonverbal gestures in social interaction • Sighted people’s uncertainty about approaching a visually challenged person

Sociological implications: Passivity and dependence

• The visually challenged persons tend to be more passive, less assertive • The reasons: • Difficulty to react quickly with appropriate reaction in emergency situations • Decisions being made on behalf of them without consultation • Depriving them of developing and practicing their abilities to make choices • Being unable to observe and perceive social courtesies

Sociological implications: Inadequate social role models

• Visually impaired person finds it difficult to emulate the available role models • Number, range, and variety of observations are more limited • Opportunities for participating in social situations more restricted • Don’t realized some of their behaviors are socially unacceptable

Psychological implications:

Denial Anger Fear Grief Depression Isolation Withdrawal Low self-esteem

Refuse to accept the fact

Denial

Anger with the situation, with a particular person or with God

Anger

Fear of losing residual vision, job, leading life

Fear

Grieving about the loss and the situation

Grief

Depressed about loss, being involved and lose interest in life

Depression

Prefers to be isolated rather than depending to anybody

Isolation

Uninvolved from all social situations

Withdrawal

Being low in mood, unwilling to recognize one’s own calibers

Low self-esteem

Basic losses to psychological security: I am not normal.. I am cripple.. I am not a whole person

Loss of physical integrity

Basic losses to psychological security: I don’t believe what I hear.. I don’t know what it is that I am touching

Loss of confidence in the remaining senses

Basic losses to psychological security: The world is no longer real, the things i knew, the people I knew, and the places I knew, no longer seems to exist

Loss of reality contact with environment

Basic losses to psychological security: I no longer see the scenery around me

Loss of visual background

Basic losses to psychological security: I was always afraid in the dark

Loss of light security

Basic losses in basic skills: I cannot get from place to place

Loss of mobility

Basic losses in communication: I can’t read a book… I can’t read a letter

Loss of ease of written communication

Basic losses in communication: When I am talking with someone, I can’t see his/her gestures

Loss of ease of spoken communication

Basic losses in communication: I am unable to keep with present times

Loss of informational progress

Basic losses of appreciation: I can’t see my children at play, I can’t watch my wife in the kitchen preparing dinner for me..

Loss of visual perception of the pleasurable

Basic losses of appreciation: I can’t beautiful sunset, a painting

Loss of visual perception of the beautiful

Basic losses concerning occupation and financial status: I can’t play cricket. I must give up my stamp collection

Loss of recreation

Basic losses concerning occupation and financial status: I have got to change my work, the job I trained for is now impossible

Loss of career vocational goal job opportunity

Basic losses concerning occupation and financial status: Who is going to pay the rent, who will pay for my family’s food

Loss of financial security

Resulting losses of the whole personality: I am “helpless blind man”, I must always depend on others to do things for me

Loss of personal independence

Resulting losses of the whole personality: Blind people are a minority group.. Sighted people are afraid of me

Loss of social adequacy

Resulting losses of the whole personality: I can’t have a private life.. When I use the white cane I am telling everyone to look at me

Loss of obscurity

Resulting losses of the whole personality: I am not much good anymore.. I am poor example of a capable man/woman

Loss of self-esteem

Resulting losses of the whole personality: Blindness has a common power to upset, undermine and change a life-long balance of personality of the individual

Loss of total personality organization

A number of factors affect individual’s reaction to vision loss:

Degree of loss Speed of onset Medical prognosis Age at which occurs Preconceived ideas the person holds about blindness Other health factors

• May be a time of withdrawal • Period of protective emotional anesthesia in response to severe stress • Cannot predict how long stage will last • Caring friends and family can just be there and no specific action or words are necessary • Encouraging a false hope that vision will be restored is not a good idea.

Shock and disbelief

• Person expresses feelings through a strong negative attitude • Frustrating for caregivers and family members • Medical profession, caregivers, family and friends can become the object of patient’s anger

Anger

• Outright denial of the situation or refusal to accept visual limitations • At this point a person may refuse to contact with an agency for the blind

Denial

• Sudden feelings of being different and a sense of loss control may be the basis for this kind of response • Patient prefers isolation

Depression

• Person starts to emerge from state of depression and begins to recognize inevitable effect of changed vision • More realistic to describe adaptation as accepting the unpleasant reality of the situation by recognizing remaining assets and capabilities

Realization

• Person recognizes that the loss is final and irreversible

Acceptance

Factors that may help people with vision loss towards acceptance:

• Meeting others who have managed • Discovering ways of coping that have worked in past crises • Time to grieve for their lost vision • Support from family and friends • Obtaining practical help with day to day tasks until they feel ready to assume more responsibility • Obtaining information about available community support

Basic losses to psychological security

Loss of physical integrity Loss of confidence in the remaining senses Loss of reality contact with environment Loss of visual background Loss of light security

Basic losses in basic skills

Loss of mobility Loss of techniques of daily living

I can’t comb my hair.. I can’t cook my food..

Loss of techniques of daily living

Basic losses in communication

Loss of ease of written communication Loss of ease of spoken communication Loss of informational progress

Basic losses of appreciation

Loss of visual perception of the pleasurable Loss of visual perception of the beautiful

Basic losses concerning occupation and financial status

Loss of recreation Loss of career vocational job goal opportunity Loss of financial security

Resulting losses of the whole personality

Loss of personal independence Loss of social adequacy Loss of obscurity Loss of personal total organization Low self-esteem