British Journal of Visual Impairment

The purpose of the study is to test a simple approach for characterizing subjective perception in patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). This multi-center study was performed in four private ophthalmology practices including 20 patients with CNV. Subjects were presented the original image on the affected eye and afterwards modified candidate images to the contralateral eye. Then they chose one image that most closely matched the perception on the affected eye. This was repeated with three different images representing three everyday life scenes manipulated to mimic visual perception with reduced color perception (image 1), central scotomas (image 2), and blurring with four varying sizes (image 3). The frequency of response to the forced choice questionnaire experiment for each image was recorded. Our results show that images manipulated using a Gaussian blur filter, a brightness filter, and a sinusoidal distortion filter were selected by 9, 10, and 1 patients, respectively. Size of modification was not associated with visual acuity in image 1 or image 3. In image 2, however, the size of the modification was dependent on visual acuity (p = .01). In conclusion, subjective perception in patients with AMD may significantly differ between individual patients. A better understanding of the visual disturbance will facilitate communication and involvement of patients in treatment decisions.

Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group (n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 (SD = 0.089) and 0.827 (SD = 0.044), respectively, (p < .002). In the dimensions of move (p < .05), see (p < .001), breath (p < .05), usual activities (p < .001), depression (p < .05), and distress (p < .05), the study participants scored statistically significantly lower than the control group. However, the participants had better mental function scores (0.856 vs 0.773, p < .05). Among the participants, there was no difference in the 15D by gender (men 0.755, women 0.774, p > .05), habitation (alone 0.768, with someone 0.770, p > .05), or age (r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.

We decided to conduct a study to determine the prevalence of visual impairment, blindness, refractive errors, and other visual functions in nursing homes of Iran. In this cross-sectional study, 133 elderly persons were selected from seven nursing homes using proportional-to-size random sampling. A Snellen chart was used to measure visual acuity (VA). Refraction was measured in all participants using autorefractometry and retinoscopy. A cover test was applied to assess ocular deviation. Stereopsis, color vision, and contrast sensitivity were evaluated with distance glasses. The prevalence (95% confidence interval [CI]) of visual impairment (VI) (<20/60), low vision (<20/60 to <20/400), and blindness (⩽20/400) was 41.88% (32.81–50.95), 32.48% (23.87–41.09), and 9.40% (4.03–14.77), respectively, based on best-corrected visual acuity (BCVA). The prevalence of myopia (spherical equivalent (SE) < −0.5 D), hyperopia (SE < 0.5 D), and astigmatism (cylindrical power < 0.5 D) was 53.50% (44.19–62.58), 36.84% (28.38–46.19), and 86.84% (79.17–91.97), respectively. VI and refractive errors had no association with age and sex (p-value > .05 for all). The prevalence of other ocular diseases was as follows: cataract 66.06% (57.02–75.09), glaucoma 1.52% (1.85–5.40), one eyed caused by injury 6.10% (2.67–11.67), and corneal opacity 3.81% (1.25–8.68). The prevalence of VI was 4–20 times and the prevalence of cataract was 3–4 times higher in NHRs compared with community-dwelling older people, indicating the grave situation of vision in these people. It is necessary to conduct further studies to find the reasons behind this disparity and perform interventions, including periodic and screening examinations upon entry to nursing homes to decrease the burden of ocular diseases in NHRs.

It is accepted that support for children with visual impairment should aim at mitigating for the functional impact experienced. Assessment for support should focus on this functional impact. However, it is now common practice that children in Australia are assessed in clinical environments that do not adequately reflect a child’s everyday functional performance. This article presents a preliminary trial that investigated VIS-Ability – a new approach aimed at identifying behaviours that indicate the functional impact of childhood visual impairment. VIS-Ability is a tool that derived from an e-Delphi study in which professionals experienced in the management of children with visual impairment identified four key areas related to functional impact. The behaviours believed to indicate this impact were also identified and included in VIS-Ability, as simple statements that questioned impact on use of vision in the immediate environment, on spontaneous and continuous use of vision, and on coordination of vision with other tasks. A total of 12 children with visual impairment and no additional disabilities consented to participate in the VIS-Ability preliminary trial. All participants completed VIS-Ability (based on behaviours), and an aggregated result was then compared to the child’s performance on a validated, self-reported (activity-based) questionnaire named the Functional Vision Questionnaire for Children and Young People, 36 items (FVQ_CYP 36). When participant results on VIS-Ability were compared to FVQ_CYP (36) scores, an association between the assessment of functional impact made by each instrument (VIS-Ability: FVQ_CYP 36) was evident. Support systems for children with visual impairment must be founded in assessment that reveals the child’s true needs. The preliminary trial presented a new approach to identifying functional impact named VIS-Ability, an approach that identifies impact through the presence of behaviours rather than clinical measurements. Further evaluation of VIS-Ability will reveal whether this approach assists with the development of better clinical and educational understanding of childhood visual impairment.

This phenomenological study explored how individual young adults understood their lived experience of acquiring life skills with congenital total blindness (CTB). Four young adults with CTB, and five parents of the young adults, participated in the study. In depth, semi-structured interviews were used to gather information from the research participants. The interviews were analysed using interpretative phenomenological analysis (IPA). Five superordinate themes emerged from the IPA: (1) life skills acquisition as ‘a means to an end’, (2) appraising life skills acquisition, (3) acquiring disability-specific skills, (4) reaching adulthood with life skill gaps, and (5) making sense of independence. The findings revealed that the young adults had reached adulthood with significant gaps in their acquisition of basic life skills. This indicates that more needs to be done, to improve the efficacy and meaning of life skill acquisition programmes provided in childhood and adolescence, to young people living with CTB.

Orientation and navigation skills are considered as crucial prerequisites for efficient wayfinding in the surrounding environment and in community both for sighted and blind individuals of all ages. In case of partial or total loss of vision, navigation and wayfinding become more challenging. The acquisition of proficient orientation and navigation by visually deprived individuals is possible when accurate guidance and training are available, and the central nervous system is intact. In cases of head trauma, neurological lesions (specifically, right hemispheric lesions), or genetic factors, the acquisition of orientation and navigation becomes a disturbed process. In some severe cases, the individuals become, literally, “space-less.” This profound disorientation leads to inefficient functional outcomes, especially when the environment is unfamiliar. These spatially disoriented individuals with loss of independence in both indoor and outdoor wayfinding skills need a long-term, persistent individual guidance by caregivers to prevent risks, a reality that limits daily functions and participation in life roles. Alternative and differential strategies for individual training methods of teaching orientation and navigation are needed. This article discusses this issue on the basis of the theoretical level and proposes practical methods and strategies for enhancing the very initial foundations of orientation and navigation for this specific “space-less” group. Functional impacts and practical implications are further discussed.

We designed a cerebral visual impairment (CVI)–experience toolbox containing simulation exercises to let professionals experience the complexity of visual information processing and to get an impression of what it means to have CVI. We measured the benefits of the CVI Experience toolbox by using questionnaires during three CVI seminars with professionals (n = 69). These seminars started with a slide presentation on CVI followed by the CVI experience toolbox. We presented the professionals with the same survey on their knowledge of CVI at the start of the seminar, after the presentation, and after the toolbox.

Professionals with more previous CVI experience started on average with a higher score. The final end score, however, did not seem to depend on previous experience. Furthermore, the added value of the experience toolset was quite independent of the added value of the presentation.

The results indicate that both the presentationand the experience toolboxadd to the understanding of CVI.