Visual Impairment, including Blindness
Visual impairment is the consequence of a functional loss of vision, rather than the eye disorder itself. Eye disorders which can lead to visual impairments can include retinal degeneration, albinism, cataracts, glaucoma, muscular problems that result in visual disturbances, corneal disorders, diabetic retinopathy, congenital disorders, and infection (NICHCY, 2004)
Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines visual impairment as follows:
“…an impairment in vision that, even with correction, adversely affects a child's educational performance. The term includes both partial sight and blindness.”
[34 Code of Federal Regulations §300.8(c)(13)]
The rate at which visual impairment occur in individuals under the age of 18 is 12.2 per 1,000. Severe visual impairments (legally or totally blind) occur at a rate of .06 per 1,000. (NICHCY, 2004). 285 million people are visually impaired worldwide. About 90% of the world's visually impaired live in developing countries. Globally, uncorrected refractive errors are the main cause of visual impairment; cataracts remain the leading cause of blindness in middle- and low-income countries. The number of people visually impaired from infectious diseases has greatly reduced in the last 20 years. 80% of all visual impairment can be avoided or cured. (WHO, 2011)
Visual impairments are usually caused by traumatic injury like getting hit in the eye or head with a baseball or having an automobile or motorcycle accident. Some babies are born with congenital blindness, which means they are visually impaired at birth. Congenital blindness can be inherited or caused by an infection, like measles, that is transmitted from the mother to the developing fetus during pregnancy.
Common pediatric eye disorders include:
Prevention of visual impairment, when possible, is related to the cause. Prevention includes the following:
The effect of visual problems on a child’s development depends on the severity, type of loss, age at which the condition appears, and overall functioning level of the child. Many children who have multiple disabilities may also have visual impairments resulting in motor, cognitive, and/or social developmental delays. A young child with visual impairments has little reason to explore interesting objects in the environment and, thus, may miss opportunities to have experiences and to learn. This lack of exploration may continue until learning becomes motivating or until intervention begins. Because the child cannot see parents or peers, he or she may be unable to imitate social behavior or understand nonverbal cues. Visual disabilities can create obstacles to a growing child’s independence (NICHCY, 2004).
There may be ways to improve sight. Glasses and contact lenses are the most common ways to improve vision. Children with a lazy eye may wear an eye patch on one eye, or may use surgery to help with weak eye muscles. Therapists who have been trained in vision problems can suggest exercises that may improve some vision problems. Surgery and medication may also be appropriate, as in glaucoma. Those who have cataracts and some other conditions are "cured" or improved by surgery or medications. If vision cannot be improved, training and special devices may help the person adjust to the impairment.
It is possible to live a nearly normal lifestyle with most visual impairments. Many people use eyeglasses or magnifiers so they can still perform certain activities. To function safely, affected people may, however, need to rely on signals other than sight. For example, some lighted signals at a crosswalk also make beeping sounds to indicate when it is safe to cross the street. People who have severe vision problems or are blind can benefit from special devices and training. A white cane and a guide dog are familiar aids for helping blind people function on their own. Computers are now able to recognize speech and can talk to the person. Keyboards with Braille symbols, Braille books, and books on audio tape are also available. (WHO, 2011)
The prognosis generally relates to the severity of the impairment and the ability of the aids to correct it. A good low vision exam is important to be aware of the latest low vision aids. (National Eye Institute, 2012)
Children with visual impairments should be assessed early to benefit from early intervention programs, when applicable. Technology in the form of computers and low-vision optical and video aids enable many partially sighted, low vision, and blind children to participate in regular class activities.
Students with visual impairments may need additional help with special equipment and modifications in the regular curriculum to emphasize listening skills, communication, orientation and mobility, vocation/career options, and daily living skills. Students with low vision or those who are legally blind may need help in using their residual vision more efficiently and in working with special aids and materials. Students who have visual impairments combined with other types of disabilities have a greater need for an interdisciplinary approach and may require greater emphasis on self care and daily living skills. (NICHCY, 2004).
See the NICHCY website related to blindness/vision impairment for additional resources and links for educators. http://nichcy.org/disability/specific/visualimpairment
Resources for Helping Visually Impaired Music Students
An overview of the music Braille system is provided for the music educator in search of music programs and resources for visually impaired students. Braille music aids students in learning to read and play music, enabling the student to read music independently, participate in ensemble groups, or perform as a soloist to the extent that his or her musical ability allows. A list of organizations, information for college bound individuals and transcription resources are available on this site.
This site highlights three main music technology programs for the blind and visually impaired. Among these are:
This organization sponsors projects for the blind and visually impaired such as the Bold Note Project and Braille Transcription Project. The Braille transcription project educates Braille transcribers in literary and music Braille for the completion of projects for the Library of Service for the Blind and Physically Handicapped. The Bold Note project assists those with partial vision by creating musical scores with enlarged print.
11 Penn Plaza, Suite 300
New York, NY 10001
For publications call: 800.232.3044
The American Foundation for the Blind (AFB) is a national nonprofit that expands possibilities for people with vision loss. AFB's priorities include broadening access to technology; elevating the quality of information and tools for professionals who serve people with vision loss; and promoting independent and healthy living for people with vision loss by providing them and their families with relevant and timely resources. AFB's work in these areas is supported by the strong presence the organization maintains in Washington, DC, ensuring the rights and interests of people with vision loss are represented in our nation's public policies.
155 15th St. N.W., Suite 1004
Washington, D.C. 20005
The American Council of the Blind is the nation's leading membership organization of blind and visually impaired people. It was founded in 1961 and incorporated in the District of Columbia. The Council's membership numbers in the tens of thousands. The majority of its members belong to one or more of its 71 affiliated organizations. There are also members-at-large. Membership is not limited to blind or visually impaired individuals. There are many sighted members. Legal blindness, however, is a requirement to serve on the ACB Board of Directors
The American Nystagmus Network, Inc. is a nonprofit organization founded in 1999 to serve the needs and interests of those affected by nystagmus. ANN seeks to provide technical and experiential information about nystagmus and its manifestations, but not medical advice. Information relates to a wide range of concerns including without limit, diagnosis, type, visual effects, non-visual effects, tests and available treatment. It also covers heredity, research, and known statistical data on nystagmus. ANN also seeks to provide help in coping with nystagmus through the exchange of information and ideas, guidance and counseling. ANN not only seeks to serve those affected by nystagmus, but also to provide useful information to persons with a professional or personal interest as well. These include health care providers, educators, researchers, and other relevant private and public institutional personnel.
4120 Marathon Street
Los Angeles, CA 90029-0159
The Blind Children’s Center is a family-centered agency which serves children with visual impairments from birth to school-age. The center-based and home-based programs and services help the children acquire skills and build their independence. The Center utilizes its expertise and experience to serve families and professionals worldwide through support services, education, and research. The organization was founded to serve children from birth to school-age who are blind or severely visually impaired. The Center’s goal is to provide a comprehensive program of specialized education and training which will optimize the blind or visually impaired child’s development and consequent opportunities to lead a meaningful and productive life.
P.O. Box 317
Watertown, MA 02472-0317
The National Association for Parents of Children with Visual Impairments (NAPVI) is a non-profit organization of, by and for parents committed to providing support to the parents of children who have visual impairments. NAPVI is a national organization that enables parents to find information and resources for their children who are blind or visually impaired, including those with additional disabilities. NAPVI provides leadership, support, and training to assist parents in helping children reach their potential. NAPVI is dedicated to: giving emotional support; initiating outreach programs; networking; advocating for the educational needs of children who are blind or visually impaired.
22 West 21st Street, 6th Floor
New York, NY 10010
NAVH is the only non-profit health agency in the world solely dedicated to providing assistance to those with partial vision loss or, as we say, the "HARD OF SEEING"®. The organization does receive federal subsidies or United Way funds, but rather, rely upon the contributions of Members and Friends. Its purpose is to work with the visually impaired so that those affected can live with as little disruption as possible. No one is ever denied services of any kind if they are unable to make a donation.
3 Townline Circle
Rochester, NY 14623-2513
The mission of the National Braille Association, Inc. is to provide continuing education to those who prepare Braille, and to provide Braille materials to persons who are visually impaired. Among its resources is a link which is a gateway many useful websites for Braille.
500 E. Remington Road
Schaumburg, IL 60173
Founded in 1908, Prevent Blindness America is the nation's leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness America touches the lives of millions of people each year. The organization carries out important roles such as screening, providing educational programs, advocacy, research, and training for screening instructors.
Library of Congress
Washington, DC 20542
(202) 707-0712 FAX
A free national library program of braille and recorded materials for blind and physically handicapped persons is administered by the National Library Service for the Blind and Physically Handicapped (NLS), Library of Congress. Under a special provision of the U.S. copyright law and with the permission of authors and publishers of works not covered by the provision, NLS selects and produces full-length books and magazines in braille and recorded formats. Reading materials are distributed to a cooperating network of regional and subregional (local) libraries where they are circulated to eligible borrowers. Reading materials and playback machines are sent to borrowers and returned to libraries by postage-free mail. Braille books, magazines, and music materials are also made available on the Internet through Web-Braille. Established by an act of Congress in 1931 to serve blind adults, the program was expanded in 1952 to include children, in 1962 to provide music materials, and again in 1966 to include individuals with other physical impairments that prevent the reading of standard print.
Music section: The special music collection consists of more than 30,000 braille and large-print music scores, texts, and instructional recordings about music and musicians on cassette. Persons interested in music materials may receive them directly from the Music Section of NLS. The collection consists of scores in braille and large print; textbooks and books about music in braille and large print; music appreciation cassettes, including interviews and opera lectures; and self-instructional cassettes for voice, piano, organ, electronic keyboard, guitar, recorder, accordion, banjo, harmonica, and other instruments. Braille scores and books are also available on the Internet.
20 Roszel Road
Princeton, NJ 08540
Recording for the Blind & Dyslexic, a nonprofit volunteer organization, is the nation's educational library serving people who cannot effectively read standard print because of visual impairment, dyslexia, or other physical disability. Our mission is to create opportunities for individual success by providing, and promoting the effective use of, accessible educational materials. Our vision is for all people to have equal access to the printed word.