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Visual Impairment Health Article

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Nutrition

Vitamin A deficiency is a widespread cause of corneal degeneration in children in developing nations. As many as five million children develop xerophthalmia from this deficiency each year. Five percent end up blind.

Diagnosis

A low vision exam is slightly different from a general exam. While a case history, visual status, and eye health evaluation are common to both exams, some things do differ. Eye charts other than a Snellen eye chart will be used. Testing distance will vary. A trial frame worn by the patient is usually used instead of the instrument containing the lenses the patient sits behind (phoropter). Because the low vision exam is slightly more goal oriented than a general exam, for example, what specifically is the patient having trouble with (reading, seeing street signs, etc.) different optical and nonoptical aids will generally be tried. Eye health is the last thing to be checked so that the lights necessary to examine the eyes won't interfere with the rest of the testing.

Treatment

There are many options for patients with visual impairment. There are optical and nonoptical aids. Optical aids include:

Telescopes. May be used to read street signs.
Hand magnifiers. May be used to read labels on things at the store.
Stand magnifiers. May be used to read.
Prisms. May be used to move the image onto a healthy part of the retina in some eye diseases.
Closed circuit television (CCTV). For large magnification (e.g., for reading).

Nonoptical aids can include large print books and magazines, check-writing guides, large print dials on the telephone, and more.

For those who are blind, there are enormous resources available to improve the quality of life. For the legally blind, financial assistance for help may be possible. Braille and audio books are increasingly available. Guide dogs provide well-trained eyes and independence. Orientation and mobility training is available. There are special schools for blind children and access to disability support through Social Security and private institutions.

Prognosis

The prognosis generally relates to the severity of the impairment and the ability of the aids to correct it. A good low vision exam is important to be aware of the latest low vision aids.

Prevention

Regular eye exams are important to detect silent eye problems (e.g., glaucoma). Left untreated, glaucoma can result in blindness.

Corneal infections can be treated with effective antibiotics. When a cornea has become opaque beyond recovery it must be transplanted. Good hygiene (e.g., washing hands frequently) to prevent infection, proper use of contact lenses, and not sharing makeup are just some ways to guard against corneal infections.

Cataracts should be removed when they interfere with a person's quality of life.

Primary prevention addresses the causes before they ever begin. Fly control can be accomplished by simple sanitation methods. Public health measures can reduce the incidence of many infectious diseases. Vitamin A supplementation (when appropriate) will eliminate xerophthalmia completely. It is possible that protecting the eyes against ultraviolet (UV) light will reduce the incidence of cataracts, macular degeneration, and some other eye diseases. UV coatings can be placed on regular glasses, sunglasses, and ski goggles. Patients should ask their eye care professional about UV coatings. Protective goggles should also be worn in certain situations (e.g., certain jobs, sports, even mowing the lawn).

Secondary prevention addresses treating established diseases before they cause irreversible eye damage. Having general physical checkups can also detect systemic diseases such as diabetes or high blood pressure. Control of diabetes is very important in preserving sight.