Impact Of Visual Impairment

Question 1

What is the International Classification of impairment disability and handicap 1980 (ICIDH)?

Answer 1

A classification system to define health and health rated states

Question 2

What is definition of impairment?

Answer 2

A loss or abnormality of PSYCHOLOGICAL or ANATOMICAL structure or function

Question 3

What is the definition of disability?

Answer 3

A restriction or lack of ability to perform an activity in the manner or within the range considered for a normal person

Question 4

What is the definition of a handicap?

Answer 4

A disadvantage for a given individual resulting from an impairment or a disability that limits or prevents the fulfilment of a role that is normal for that individual

Question 5

What is the ICF 2001?

Answer 5

International classification of function, disability and health, which is used more commonly as it describes conditions of both health and disease whereas the ICIDH only describes consequence of disease

Question 6

With AMD, what is the impairment faced by patients?

Answer 6

loss of central vision

Question 7

With AMD, what is the disability faced by patients?

Answer 7

Reading, recognising faces

Question 8

With AMD, what is the handicap faced by patients?

Answer 8

loss of independence

Question 9

With cataract, what is the impairment faced by patients?

Answer 9

Loss of contrast, glare, poor acuity

Question 10

With cataract, what is the handicap faced by patients?

Answer 10

Night time driving

Question 11

With cataract, what is the disability faced by patients?

Answer 11

Detail, low contrast targets, bright environments

Question 12

With glaucoma, what is the impairment faced by patients?

Answer 12

contracted field

Question 13

With glaucoma, what is the disability faced by patients?

Answer 13

mobility

Question 14

With glaucoma, what is the handicap faced by patients?

Answer 14

getting about

Question 15

What are some effects on the individual of visual loss?

Answer 15

• only 34% are in employment
• Less likely to work than people with other disabilities
• Loss of independence
• Cannot drive, mobility problems, problems while cooking
• Struggle with reading, household activities, personal care
• Mental health issues such as depression + risk of suicide
• Poorer sleep quality

Question 16

What are two depression screening questions you should ask according to NICE guidelines?
Also if they say yes to them what should you do?

Answer 16

During the last month, have you often been bothered by feeling down, depressed or hopeless?
During the last month, have you often been bothered by having little interest or pleasure in doing things?

If yes is answered refer to GP

Question 17

What are 3 well being impacts px’s face being visually impaired?

Answer 17

Increased number of injuries resulting from fall
more likely to visit GP
increased risk of death form injuries

Question 18

What are 2 social impacts px’s face being visually impaired?

Answer 18

Reduced participation in social activities, more likely to be single and never married

Question 19

what is one of the most feared results of ageing?

Answer 19

loss of vision

Question 20

What are effects on the carer of a visually impaired person? (3)

Answer 20

Depressive symptoms, economic impact, psychological impact

Question 21

What is the KUBLER-Ross-model?

Answer 21

Stages a px may go through when being told they are losing their vision
1. Denial
2. Anger
3. Bargaining (they think if they give something up that they will get better)
4. Depression
5. Acceptance

Question 22

Which stages of the kubler-Ross model are we likely to see in the low vision clinic?

Answer 22

Depression and acceptance

Question 23

Name seven factors affecting adjustment to visual impairment.

Answer 23

1) Type of loss
2) Cultural and family reaction
3) Life stage (have they had it since a young age?)
4) Significant life event (illness and loss of loved ones)
5) Px expectation (stage of vision loss? Previous experience?)
6) Self concept (low self esteem)
7) Px personality

Question 24

What are five types of loss?

Answer 24

Congenital
Adventitious and long standing
Adventitious and recent onset
Blind
Low vision

Question 25

What are some cultural and family reactions?

Answer 25

Anger and resentment if the breadwinner becomes impaired, social stigma, Pity and over protection

Question 26

What is Charles bonnet syndrome?

Answer 26

Visual hallucinations in px with a normal intellect

Question 27

what is Charles bonnet syndrome associated with?

Answer 27

bilateral VI
living alone

Question 28

which diseases are Charles bonnet syndrome associated with?

Answer 28

AMD
DR
glaucoma
cataract

Question 29

Is Charles bonnet syndrome more prevalent in women or men ?

Answer 29

Women

Question 30

What hallucinations do px with Charles bonnet syndrome have?

Answer 30

-Adults, faces
-Animals, plants, shapes, spots, flashes (less common)
All vivid colour and clearly- sometimes more than what they can acc see with VI on a normal day

Question 31

How do you establish if they are having hallucinations?

Answer 31

Establish rapport and ask :
“ Anything else unusual about your vision?”
“ have you had any unusual visual experiences?”
“ px with VI often see patterns and faces they know are not there, has this happened to you?”

Question 32

If a px has Charles bonnet syndrome, what should you do?

Answer 32

Explain CBS and reassure + rule out aetiologies for visual hallucinations
-also advise on charities eg Esme’s Umbrella

Question 33

What are some practical strategies to help with CBS?

Answer 33

Looking away,
blinking,
increasing illumination,
hitting/shouting at the hallucination,
distraction,
watching tv,
listening to the radio

Telephone counselling service: macular society
Esme’s umbrella
ECLO

Question 34

why would calling the macular society help a px who has Charles bonnet syndrome?

Answer 34

they get peer support as it is run by volunteers - therefore people who have had CBS can sympathise

Question 35

what is Esme’s umbrella?

Answer 35

charity supporting the awareness of CBS
good for px’s and their support group

Question 36

is CBS longstanding or does it go as you adjust to the condition?

Answer 36

LONGSTANDING - it CAN go as you adjust but majority of ppl is longstanding

Question 37

how did Covid-19 negatively affect px’s with CBS?

Answer 37

• hallucinations increased
• reduced access to Low vision clinics –> backlog
• difficulty maintaining social distancing

Question 38

is it possible to run low vision clinics remotely?

Answer 38

yes !! positive affect from covid-19 - makes peer support group meetings easier to attend