What is it and how is the diagnosis made?
Visual acuity, i.e. the ability to distinguish the details of an image, near or far, is measured, in adults, with a large board of letters, called a Snellen’s board, placed at a distance of 6 meters. The normal eye is able to read letters quickly, and the person scores 100% (1.0). When we see less well, the score is lower. If the score is 30% (0.3) or less, the person is officially visually impaired. In the presence of a score lower than 5%, one speaks of blindness.
Glaucoma (which is characterized by increased pressure inside the eye) is one of the leading causes of visual impairment worldwide. In industrialized countries, diabetes is a major cause of visual impairment and blindness due to the damage it causes to the retina.
In small children and babies, eye exams use other techniques. In babies, the doctor in the ONE’s consulting room will check the eyesight by checking the baby’s eye contact and reaction to a smile. Normally, eye contact is possible at 6 weeks of age, and a smile elicits a response no later than 12 weeks. In Flanders, the Kind en Gezin organization also examines eyesight at an older age: an eye test is carried out especially for children at around 12 months and at around 30 months.
What is their frequency?
The elderly form the largest group of people with visual impairments. Usually, they still have other functional deficits.
Children with a visual impairment also have other disabilities in 6 to 7 cases out of 10. An eye exam will therefore also be performed in any child who has a motor development disorder, hearing impairment or brain injury.
How to recognize them?
THE’eye exam allows the detection of specific disorders of the field of vision. For example, part of the sight may have disappeared, in the center or on the periphery of the field of vision. Sometimes a quarter or half of the field of vision is gone, sometimes the person is completely blind. It may or may not be associated with other limitations in everyday life.
A adult person with a normal field of vision but no central image sees everything on the periphery of the field of vision, but nothing straight ahead. She can easily orient herself in the space, but cannot read or see the facial expressions of her acquaintances across the street.
A person with tubular vision, on the other hand, has an intact central field of vision, but sees nothing in the periphery. She needs to bring a white cane to orient herself in space, but she can read a book (even if it’s printed small), and she recognizes the expression on one person’s face on the other. across the street.
Sometimes parents have the feeling that their child’s sight is not normal, for example if they do not respond to smiles.
Often the most important aspect in assessing vision is the impact on daily functioning, and not so much the exact score of a test. The purpose of the examination is to determine the usefulness and necessity of visual devices for normal functioning in society. This is why different aspects are assessed in any person with a visual impairment: ability to gather knowledge and apply it, general tasks and requirements, communication, mobility, personal care, home life, interactions and interpersonal relationships, important areas of life, community and citizen life.
In children, we use a table with four entries. The use of sight is controlled in four areas: communication and interaction, orientation in space and movement, daily activities, and close-up tasks that require precision, such as reading and crafts.
What can health care providers do?
Rehabilitation preferably begins as early as possible. It is certain that in case of suspicion of reduced vision in a (small) child, it must be quickly sent to a specialized center. In general, the rehabilitation team is made up of different caregivers, each specialized in a specific discipline: ophthalmologists, opticians, psychologists, experts in early rehabilitation, school services and social services. The goal is the best possible integration into normal life.
At school age, special technical tools are used for rehabilitation, such as magnifying glasses and computers with a very large font size.
For adults, the workplace will be adapted, tasks will be redistributed, and continuous training will be provided. A professional reorientation is also possible.
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