Impact Of Visual Impairment Flashcards
What is the International Classification of impairment disability and handicap 1980 (ICIDH)?
A classification system to define health and health rated states
What is definition of impairment?
A loss or abnormality of PSYCHOLOGICAL or ANATOMICAL structure or function
What is the definition of disability?
A restriction or lack of ability to perform an activity in the manner or within the range considered for a normal person
What is the definition of a handicap?
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
What is the ICF 2001?
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
With AMD, what is the impairment faced by patients?
loss of central vision
With AMD, what is the disability faced by patients?
Reading, recognising faces
With AMD, what is the handicap faced by patients?
loss of independence
With cataract, what is the impairment faced by patients?
Loss of contrast, glare, poor acuity
With cataract, what is the handicap faced by patients?
Night time driving
With cataract, what is the disability faced by patients?
Detail, low contrast targets, bright environments
With glaucoma, what is the impairment faced by patients?
contracted field
With glaucoma, what is the disability faced by patients?
mobility
With glaucoma, what is the handicap faced by patients?
getting about
What are some effects on the individual of visual loss?
- 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
What are two depression screening questions you should ask according to NICE guidelines?
Also if they say yes to them what should you do?
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
What are 3 well being impacts px’s face being visually impaired?
Increased number of injuries resulting from fall
more likely to visit GP
increased risk of death form injuries
What are 2 social impacts px’s face being visually impaired?
Reduced participation in social activities, more likely to be single and never married
what is one of the most feared results of ageing?
loss of vision
What are effects on the carer of a visually impaired person? (3)
Depressive symptoms, economic impact, psychological impact
What is the KUBLER-Ross-model?
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
Which stages of the kubler-Ross model are we likely to see in the low vision clinic?
Depression and acceptance
Name seven factors affecting adjustment to visual impairment.
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
What are five types of loss?
Congenital
Adventitious and long standing
Adventitious and recent onset
Blind
Low vision
What are some cultural and family reactions?
Anger and resentment if the breadwinner becomes impaired, social stigma, Pity and over protection
What is Charles bonnet syndrome?
Visual hallucinations in px with a normal intellect
what is Charles bonnet syndrome associated with?
bilateral VI
living alone
which diseases are Charles bonnet syndrome associated with?
AMD
DR
glaucoma
cataract
Is Charles bonnet syndrome more prevalent in women or men ?
Women
What hallucinations do px with Charles bonnet syndrome have?
-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
How do you establish if they are having hallucinations?
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?”
If a px has Charles bonnet syndrome, what should you do?
Explain CBS and reassure + rule out aetiologies for visual hallucinations
-also advise on charities eg Esme’s Umbrella
What are some practical strategies to help with CBS?
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
why would calling the macular society help a px who has Charles bonnet syndrome?
they get peer support as it is run by volunteers - therefore people who have had CBS can sympathise
what is Esme’s umbrella?
charity supporting the awareness of CBS
good for px’s and their support group
is CBS longstanding or does it go as you adjust to the condition?
LONGSTANDING - it CAN go as you adjust but majority of ppl is longstanding
how did Covid-19 negatively affect px’s with CBS?
- hallucinations increased
- reduced access to Low vision clinics –> backlog
- difficulty maintaining social distancing
is it possible to run low vision clinics remotely?
yes !! positive affect from covid-19 - makes peer support group meetings easier to attend
