ABC’s of Vision
Impairments and
Communications Styles

Vision Impairments
• Cataracts
• Retinal Detachment
• Retinitus Pigmentosa
• Usher Syndrome
• Macular Degeneration
• Glaucoma

Normal View of Picture

Cataracts

Cataracts
Clouding of the lens of the eye
Caused by buildup of protein in the lens
Types of cataracts include:
Age-related - develop with age
Congenital - found in babies born with an
infection, injury or poor development before
birth, or develop during childhood
Secondary - develop as a result of other
medical conditions such as diabetes or exposure
to toxic substances, drugs, ultraviolet lights or
radiation
Traumatic - develop after injury to the eye

Cataracts (con’t)
Symptoms:
-vision that is cloudy, blurry, foggy, or filmy
-progressive nearsightedness in older people
-changes in view of color
-glare problems when driving at night
-glare problems during the day
-double vision
-sudden changes in glasses prescription
Cataracts are diagnosed through an eye exam
Treatment for cataracts
-eyeglasses to correct vision
-surgery if glasses correction is not enough

Normal View of Picture

Retinal Detachment

Retinal Detachment
Very serious eye condition that occurs when the
retina separates from the tissue around it
Must be repaired immediately or can cause
permanent vision loss
Symptoms:
-flashes of light
-seeing “floaters” (small flecks or threads)
-darkening of your peripheral vision
Diagnosed through an eye exam

Retinal Detachment (con’t)
Treatments:
-Laser or freezing - both will repair the tear if caught
early enough
-Pneumatic retinopexy - (used if tear is small and easy to
close) a small gas bubble is injected into the eye and will
rise pressing against retina closing the tear. Laser or
freezing is then done to seal the tear.
-Scleral buckle - involves surgically sewing a silicone band
(buckle) around the sclera (white of the eye) to push the
sclera toward the tear until the tear heals. This band
can not be seen and is permanently attached. Laser or
freezing might be done to seal the tear.
-Vitrectomy - used for large tears and is requires
surgery. The doctor removes the vitreous and replaces it
with a saline solution.

Normal View of Picture

RP/Ushers Syndrome

Retinitis Pigmentosa (RP)
group of genetic eye conditions leading to
incurable blindness
starts with night blindness and moves into
tunnel vision (progression is different for
everyone)
can run in families and can be caused by a
number of genetic defects

RP (con’t)
Symptoms:
-decreased vision at night or in low light
-loss of peripheral vision
-loss of central vision
Tests for diagnosis:
-color vision
-dilation of the pupils to look at the retina
-fluorescein angiography (fluorescent dye injected into
bloodstream which allows blood vessels in the back of
the eye to be photographed)
-pupil reflex response
-visual field test
-visual acuity

RP (con’t)
Treatment:
-no effective treatment for this condition
although wearing sunglasses to protect retina
from ultraviolet light may help preserve vision
-high doses of vitamin A may slow the disease
but could cause damage to the liver
-clinical trials are in place to test new
treatments such as DHA (omega-3 fatty acid)

Usher Syndrome
• An inherited disease causing a hearing loss and
degeneration of the retina
• Earliest symptom is a loss of hearing usually at
birth
• Later a reduction of side vision leaving only
center vision
• Later developing into “tunnel vision”
• Many people with Usher Syndrome also have
severe balance problems.

Usher Syndrome
(three different types)

RP/Ushers/Glaucoma

Glaucoma
disease in which the optic nerve
is damaged
associated with the increased
pressure of fluid in the eye
2nd most common cause of
blindness in the United States

Glaucoma (con’t)
Types of Glaucoma:
Open-angle (chronic) - most common type with an
increase of eye pressure that occurs over time pushing on
the optic nerve
Angle-closure (acute) - when the exit of the aqueous
humor fluid is suddenly blocked causing quick, severe, and
painful rise in the pressure of the eye (this is an eye
emergency)
Congenital - present in babies at birth and is caused by
abnormal eye development
Secondary - caused by drugs such as corticosteroids, eye
diseases such as uveitis, systemic diseases or trauma

Glaucoma (con’t)
Symptoms:
Open-angle - most people have no symptoms, once vision
loss occurs the damage is already severe, there is a slow
loss of peripheral vision, advanced glaucoma can lead to
blindness
Angle-closure - may come and go at first, quick and
severe pain in one eye, decreased or cloudy vision, nausea
and vomiting, halos around lights, red eye, eye feels
swollen
Congenital - noticed in babies a few months old,
cloudiness of the front of the eye, eyes look enlarged,
red eye, sensitivity to light, tearing

Glaucoma (con’t)
Tests for diagnosis:
-complete eye exam including dilation
-tonometry (pressure test of the eye)
-gonioscopy (special lens to look at eye)
-optic nerve imaging
-examination of the retina in the back of the
eye
-slit lamp examination
-visual acuity
-visual field measurement

Glaucoma (con’t)
Treatment:
-goal of treatment is to lower eye pressure so
might be given eye drops or pills to lower
pressure
-iridotomy (laser therapy)
-eye surgery

Seeing the world with advanced tunnel
vision.

Advanced Tunnel Vision
http://www.youtube.com/watch?v=v9CawJSUy2c

Normal View of Picture

Early Stage Macular Degeneration
with Center Vision

Late Stage Macular Degeneration
with Center Vision

Macular Degeneration
with Incomplete Scotoma

Macular Degeneration
with Ring Scotoma

Macular Degeneration
with Absolute Scotoma

Floaters from
Macular or Diabetes

Macular Degeneration
loss of vision in the center of the visual field (the macula) due to
damage to the retina
difficult to read or recognize faces due to the loss of central vision
peripheral vision remains allowing for other daily activities to
continue
leading cause of legal blindness in people over 55 in the United
States
Two forms: Dry (atrophic) which is a result of the gradual
breakdown of cells in the macula. Wet (exudative or neovascular)
which is a result of newly created abnormal blood vessels growing
under the center of the retina.

Macular Degeneration (con’t)
Symptoms:
-blurred or decreased central vision
-blind spots
-straight lines look irregular or bent
-objects appear different colors and shapes in each eye
Tests for diagnosis:
-Amsler grid - test to determine defects in center vision
(if have macular degeneration lines on test might appear
faded, broken, or distorted)
-exam of the back of the eye
-angiogram - dye injected into blood stream so that
images of blood vessels can be taken
-tomography - imaging test to see areas of the retina

Macular Degeneration (con’t)
Treatments:
-no cure found for the dry form although
studies have shown antioxidants may protect
the retina from damage
-laser treatment may help with the wet form
of macular degeneration possibly stopping or
lessening the vision loss in the early stages of
the disease

Methods of
Communicating & Interpreting
• At close range
• At far range
• Tactile – one or both hands
• Tracking
• Tadoma
• Braille
• Print on palm or back

At Close Range

At Far Range

Tactile
(one handed or
two handed)

Tactile
http://www.youtube.com/watch?v=l8yXWactj38&feature=related

Tracking

Tadoma

Tadoma
http://www.youtube.com/watch?v=U_QMS-hzRMs

Braille

Print on Palm

Print on Back

The Interpreting
Assignment
• Mobility – What are the requirements of the
Deaf-Blind person and how will it affect the
interpreter?
• Length of the assignment – Will you need a
partner interpreter?
• Familiarizing the Deaf-Blind person with the
room and surroundings
• Special needs – food, medication, restrooms,
seating, etc.

The Interpreting
Assignment
• Codes – restroom, coffee breaks, exercise
breaks, meal breaks
• Seating arrangements – Who faces the speaker?
• Clothing – dark clothing with high necks may be
most appropriate
• Lighting – How much residual vision does the
Deaf-Blind person have?

The Interpreting
Assignment
• Participation – How should comments or
questions be added to presentation?
• Social Situations – Are you “off duty” at lunch
time?
• Personal Hygiene – body odors or bad breathe,
perfume, etc

Resources
Braille
http://www.omniglot.com/writing/braille.htm
Deaf-Blind
http://theinterpretersfriend.org/pd/ws/db/text/html
Cataracts
http://www.webmd.com/eye-health/cataracts/health-cataracts-eyes
http://www.nei.nih.gov/health/cataract/cataract_facts.asp
http://www.allaboutvision.com/conditions/cataracts.htm
http://www.medicalnewstoday.com/articles/157510.php
Glaucoma
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002587/
http://www.webmd.com/eye-health/glaucoma-eyes
http://www.allaboutvision.com/conditions/glaucoma.htm

Resources (con’t)
Images
http://images.google.com/
Macular Degeneration
http://www.emedicinehealth.com/macular_degeneration/article_em.htm
http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
http://www.webmd.com/eye-health/macular-degeneration/age-related-
macular-degeneration-overview
http://www.mayoclinic.com/health/macular-degeneration/DS00284/
DSECTION=treatments-and-drugs
Photos
http://nei.nih.gov/photo/
Retinal Detachment
http://www.medicinenet.com/retinal_detachment/article.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001027.htm
http://www.webmd.com/eye-health/eye-health-retinal-detachment

Resources (con’t)
Retinitis Pigmentosa
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002024/
http://emedicine.medscape.com/article/1227488-overview
http://ghr.nlm.nih.gov/condition/retinitis-pigmentosa
Usher Syndrome
http://ghr.nlm.nih.gov/condition/usher-syndrome
http://www.medicinenet.com/usher_syndrome/article.htm
http://www.deafblind.com/usher.html