Blind
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For people who are blind or visually impaired, the loss of sight is only the beginning of a life-changing reality. As the simplest to the most complex everyday tasks become daunting, these individuals often become depressed, anxious and isolated.
Join leaders and other collaborators at the 2023 AFB Leadership Conference (AFBLC)! Focusing on Digital Inclusion, AFBLC convenes policymakers, business leaders, advocates, and the public to discuss the challenges and collaborate on opportunities that exist for people who are blind or low vision.
The AFB Blind Leaders Development Program is creating more opportunities for individuals who are blind or have low vision to engage in leadership roles, creating a positive, upward trend in the employment rate of people with visual impairments.
Join leaders and other collaborators at the 2023 AFB Leadership Conference (AFBLC)! The 2023 AFBLC will focus on Empowering Digital Inclusion. Join us as we discuss innovative ways to create true inclusion and create a world of no limits for people who are blind
The most common causes of visual impairment globally are uncorrected refractive errors (43%), cataracts (33%), and glaucoma (2%).[1] Refractive errors include near-sightedness, far-sightedness, presbyopia, and astigmatism.[1] Cataracts are the most common cause of blindness.[1] Other disorders that may cause visual problems include age-related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and a number of infections.[12] Visual impairment can also be caused by problems in the brain due to stroke, premature birth, or trauma, among others.[13] These cases are known as cortical visual impairment.[13] Screening for vision problems in children may improve future vision and educational achievement.[14] Screening adults without symptoms is of uncertain benefit.[15] Diagnosis is by an eye exam.[2]
The World Health Organization (WHO) estimates that 80% of visual impairment is either preventable or curable with treatment.[1] This includes cataracts, the infections river blindness and trachoma, glaucoma, diabetic retinopathy, uncorrected refractive errors, and some cases of childhood blindness.[16] Many people with significant visual impairment benefit from vision rehabilitation, changes in their environment, and assistive devices.[2]
As of 2015[update], there were 940 million people with some degree of vision loss.[5] 246 million had low vision and 39 million were blind.[1] The majority of people with poor vision are in the developing world and are over the age of 50 years.[1] Rates of visual impairment have decreased since the 1990s.[1] Visual impairments have considerable economic costs both directly due to the cost of treatment and indirectly due to decreased ability to work.[17]
In the UK, the Certificate of Vision Impairment (CVI) is used to certify patients as severely sight impaired or sight impaired.[20] The accompanying guidance for clinical staff states: \"The National Assistance Act 1948 states that a person can be certified as severely sight impaired if they are 'so blind as to be unable to perform any work for which eye sight is essential'\". Certification is based on whether a person can do any work for which eyesight is essential, not just one particular job (such as their job before becoming blind).[21]
In the United States, any person with vision that cannot be corrected to better than 20/200 in the best eye, or who has 20 degrees (diameter) or less of visual field remaining, is considered legally blind or eligible for disability classification and possible inclusion in certain government sponsored programs.
In the United States, the terms partially sighted, low vision, legally blind and totally blind are used by schools, colleges, and other educational institutions to describe students with visual impairments.[22] They are defined as follows:
An individual shall be considered to be blind for purposes of this title if he has central visual acuity of 20/200 or less in the better eye with the use of a correcting lens. An eye which is accompanied by a limitation in the fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered for purposes of the first sentence of this subsection as having a central visual acuity of 20/200 or less. An individual shall also be considered to be blind for purposes of this title if he is blind as defined under a State plan approved under title X or XVI as in effect for October 1972 and received aid under such plan (on the basis of blindness) for December 1973, so long as he is continuously blind as so defined.[26]
People with significantly reduced acuity may benefit from training conducted by individuals trained in the provision of technical aids. Low vision rehabilitation professionals, some of whom are connected to an agency for the blind, can provide advice on lighting and contrast to maximize remaining vision. These professionals also have access to non-visual aids, and can instruct patients in their uses.
Those with worsening sight and the prognosis of eventual blindness are at comparatively high risk of suicide and thus may be in need of supportive services. Many studies have demonstrated how rapid acceptance of the serious visual impairment has led to a better, more productive compliance with rehabilitation programs. Moreover, psychological distress has been reported to be at its highest when sight loss is not complete, but the prognosis is unfavorable. Therefore, early intervention is imperative for enabling successful psychological adjustment.[50]
Blindness can occur in combination with such conditions as intellectual disability, autism spectrum disorders, cerebral palsy, hearing impairments, and epilepsy.[51][52] Blindness in combination with hearing loss is known as deafblindness.
About 90% of people who are visually impaired live in the developing world.[1] Age-related macular degeneration, glaucoma, and diabetic retinopathy are the leading causes of blindness in the developed world.[55]
Cataracts are the greying or opacity of the crystalline lens, which can be caused in children by intrauterine infections, metabolic disorders, and genetically transmitted syndromes.[57] Cataracts are the leading cause of child and adult blindness that doubles in prevalence with every ten years after the age of 40.[58] Consequently, today cataracts are more common among adults than in children.[57] That is, people face higher chances of developing cataracts as they age. Nonetheless, cataracts tend to have a greater financial and emotional toll upon children as they must undergo expensive diagnosis, long term rehabilitation, and visual assistance.[59] Also, according to the Saudi Journal for Health Sciences, sometimes patients experience irreversible amblyopia[57] after pediatric cataract surgery because the cataracts prevented the normal maturation of vision prior to operation.[60] Despite the great progress in treatment, cataracts remain a global problem in both economically developed and developing countries.[61] At present, with the variant outcomes as well as the unequal access to cataract surgery, the best way to reduce the risk of developing cataracts is to avoid smoking and extensive exposure to sun light (i.e. UV-B rays).[58]
Childhood blindness can be caused by conditions related to pregnancy, such as congenital rubella syndrome and retinopathy of prematurity. Leprosy and onchocerciasis each blind approximately 1 million individuals in the developing world.
Central corneal ulceration is also a significant cause of monocular blindness worldwide, accounting for an estimated 850,000 cases of corneal blindness every year in the Indian subcontinent alone. As a result, corneal scarring from all causes is now the fourth greatest cause of global blindness.[65]
Eye injuries, most often occurring in people under 30, are the leading cause of monocular blindness (vision loss in one eye) throughout the United States. Injuries and cataracts affect the eye itself, while abnormalities such as optic nerve hypoplasia affect the nerve bundle that sends signals from the eye to the back of the brain, which can lead to decreased visual acuity.
Cortical blindness results from injuries to the occipital lobe of the brain that prevent the brain from correctly receiving or interpreting signals from the optic nerve. Symptoms of cortical blindness vary greatly across individuals and may be more severe in periods of exhaustion or stress. It is common for people with cortical blindness to have poorer vision later in the day.
Blinding has been used as an act of vengeance and torture in some instances, to deprive a person of a major sense by which they can navigate or interact within the world, act fully independently, and be aware of events surrounding them. An example from the classical realm is Oedipus, who gouges out his own eyes after realizing that he fulfilled the awful prophecy spoken of him. Having crushed the Bulgarians, the Byzantine Emperor Basil II blinded as many as 15,000 prisoners taken in the battle, before releasing them.[66] Contemporary examples include the addition of methods such as acid throwing as a form of disfigurement. 59ce067264
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