1

Visual Impairment Awareness

SNFWB

2

Programme

1. Introduction and Quiz2. Anatomy of the eye: Common eye conditions that

challenge functional vision3. Accessibility: the physical environment4. Activities of daily living, problems solutions and

emotional responses5. Communications Exercise6. Sighted Guide AwarenessTraining7. Accessibility and information: how to ensure

information is accessible for people with a visual impairment

8. Summary.

3

Aims

• This training course is about visual impairment. The aims of the course are to give participants a better understanding of the issues affecting people with a visual impairment. It also covers challenges and solutions for those who are learning to provide effective assistance. It is designed to improve inclusive practice and suggest solutions to make life better for everybody.

4

Learning outcomes for the morning session

• Participants will be able to:– List at least three eye conditions and explain how they

could affect functional vision using handouts– List 3 factors which make for an inclusive environment

using handouts– Experience six tasks of daily living under simulation– Discuss and give details of any difficulties

experienced and emotional reactions to the simulation– List at least 4 aids to daily living and their uses, using

handouts provided.

5

Structure of the Eye The Structure of the Eye

Iris

Aqueous

Cornea

Pupil

Lens

Retina

Fovea

Macula

Optic Nerves

Choroid

Sclera

Optic Disk

6

Functions of Vision• Focus : the lens of the eye brings the image into focus at the back

of the eye much like the lens of a camera• Movement: Eye movement is controlled by muscles around the

eye• visual acuity: This term refers to the ability to see fine detail• visual field: This is the area your vision covers, normally about 180

degrees• stereoscopic vision: The ability to see with both eyes allows

judgments to be made about distance• colour vision: The ability to distinguish different colours• contrast sensitivity: Black on a white background provides good

contrast. Some people need better contrast than others to assist with vision

• light sensitivity: the pupil expands and contracts to allow light into the eye, this can be painful for some people.

• visual perception: the ability of the brain to make sense of visual information.

7

How do we See?

Tricks we can do

8

9

10

11

Eye Conditions

• Macular degeneration: Loss of central vision affects ability to see fine detail

• Glaucoma: Loss of peripheral vision, opacity, can affect fine detail

• Diabetic retinopathy: Causes patchy vision• Nystagmus: Difficulty in focusing• Retinitis Pigmentosa: Loss of peripheral vision,

night blindness• Cataracts: Reduced detail vision• Neurological Vision Loss: causes loss of

visual field in both eyes.

12

Visual Acuity 1

Loss of detail Vision: Here we see the same scene from the point of view of someone with perfect vision and someone with a loss of visual acuity. Consider how bright light or glare, and changing lighting levels might affect someone with this type of sight loss. This

type of loss might be caused by cataracts.

13

Visual Acuity 2

Here is an everyday object seen from different perspectives with different degrees of visual acuity. Notice how colour and contrast is important in deciphering the nature of the object

14

Visual Acuity 3

What is helpful in this picture for people with a visual impairment?

15

Field Loss 1

Here is a street scene viewed at different times of the day, the picture on the right shows a peripheral field loss. Consider the difficulties that this might cause. This type of field loss might be a result of Retinitis Pigmentosa and could lead to night blindness

16

Field Loss 2

Road Crossing with a severe sight loss. In this example we can see how difficult mobility can be with a severe tunnel vision.

17

Field Loss 3

In this picture we see how central field loss can affect vision. As central vision is also responsible for clear vision, we can see how this type of loss affects acuity, causing problems with recognition of faces and reading. This type of visual loss can be a result of macular degeneration.

18

Field Loss 4

Here we see two pictures illustrating retinal scarring, with patchy vision, which can result from diabetic retinopathy or retinal damage.

19

Field Loss 5 ( set of 4)

Here we see a loss of half the visual field in each eye, in the following slides we can see some of the effects of this.

20

21

22

23

Access to the Physical Environment

• Exercise 1. Discussion topic. Split into four groups. What factors might affect vision and someone’s ability to get around.

• Exercise 2. In your groups look at the pictures and identify any helpful and unhelpful features for someone with a sight loss. Where there are unhelpful features what improvements could be made?

• Exercise 3. In your groups consider your own workplace and identify 3 features that could be improved and three positive design features for each place of work.

24

Factors affecting accessibility and vision

• Quality and fluctuation of light and lighting

• Reflected light and glare

• Audible information

• Tactile information

• Contrast and design

• Weather

• Eye condition and functional vision

25

Access 1

Consider any difficulties that someone with a visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

26

Access and Design 1

• Signage board easier to read at eye level

• Lettering should contrast with background

• Tactile lettering and Braille are accessible

• A non reflective surface eliminates glare

• Shaded patterns make the lettering difficult to read. Place sign where there is no shade.

27

Access 2

Consider any difficulties that someone with a visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

28

Access and Design 2

• Clear line of travel• Well maintained pavement• Low bollards on left of pavement are a trip

hazard as contrast is poor – good contrast is necessary

• Parked vehicles to left of bollard are a hazard for visually impaired people – Parking policies need to be enforced

• Pavement parking is always a problem

29

Access 3

Consider any difficulties that someone with a visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

30

Access and Design 3

• White contrast on risers generally a good point• Separate well lit flight of steps for people with a

visual impairment would be better• In this case steps lead to obstacle in shape of

ramp• Wheelchair ramp results in steps of uneven

height• No lighting for dark nights• Poor design a result of catch all policy designing

for two different disabilities

31

Access 4

Consider any difficulties that someone with a visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

32

Access and Design 4

• Urinals should contrast with background• Hand drier should contrast with the

background• Contrasting blue wall provides an

indication of line of travel• White décor could result in glare from

shiny surfaces – use matt surfaces whenever possible

• Lighting is even with no patchy areas

33

Access 5Consider any difficulties that someone with a

visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

34

Access and Design 5

• All wall mounted features contrast well with the background and can be easily picked out

• Lighting is even and there are no confusing shadows

• Floor and walls are plain with no confusing patterns

• Good use made of window light with frosted glass to minimise glare

35

Access 6Consider any difficulties that someone with a

visual impairment might experience with this situation. How could it be improved? Are there any good design features here?

36

Access and Design 6

• Good colour contrast between rail and walls

• Lighting designed for even coverage• Signage clear and well positioned• Vertical Blinds good for controlling daylight• Glass entrance door could cause

confusing patterns on carpet in bright sunlight

• Tactile clues underfoot given by floor mats

37

An Inclusive Environment

• Evenly lit with good task lighting• Consistent well designed signage• Tactile surfaces incorporated• Indoors window light controlled by vertical blinds• Non reflective surfaces• Audible signage• Smooth well maintained surface to walk on• Clear unobstructed path• Use of colour contrast e.g. stair edges• Plain unpatterned design for surfaces

38

Aids to Daily Living: Exercise

• Working in groups of twos or threes take turns at each of the following exercises under simulation:– Pouring liquids– Writing with a writing frame– Reading a newspaper with sim specs and magnifier– Filling in a questionnaire with sim specs– Telling the time using a small dial watch– Examining the table with aids and devices and

consider their possible functions

39

Aids to Daily Living

• Patience and understanding• Talking/audible devices – clock, radio,

newspapers, books, rain alert, Liquid level indicator etc

• Tactile devices – Writing Frame, Braille, Moon, rotating cone, signature guide etc.

• Magnifiers• High tech solutions: Computer Programmes,

Video Magnifier, Braille computer etc.

40

Daily Living: Hints and Tips

• Allow people plenty time as tasks of independent living can take longer and require more care

• be understanding: Loss model – grieving for loss of ability can be like a bereavement

• Always take time to listen to the person• Encourage independence by allowing people to

do things for themselves, even if this does take more time

• Do not underestimate people’s abilities to do things for themselves.

41

Objectives/Learning Outcomes for afternoon session

• Participants will be able to:– Discuss and identify at least three practical

interventions which demonstrate good practice in communications

– Demonstrate the guiding grip and position, narrow spaces, inward turn, doors, stairs and seating. These are guiding techniques

– List at least 3 Principles of good print design using handouts

– List at least three alternative formats for information production

– List two features of an accessible website.

42

Communication Exercise

• Discussion Exercise: The group should discuss a controversial topic e.g.– 1. Should blind children be placed in special

schools or integrated into mainstream education?

– 2. Should elderly blind adults be placed in care homes or remain in their own homes?

– 3. Do you think that there should be an extra tax on blind people for healthcare?

43

Communication Exercise

• What was the volunteers experience of this situation

• What was the rest of the groups experience of the situation

• What made the situation difficult for participants

• What would make this situation easier for all concerned

44

Communications: Hints and Tips

• Some people say they feel awkward about talking to a blind or partially sighted person, however they do not really need to if they remember a few simple things.

• asking permission to record their sight loss on their records (if appropriate) so that other staff can know is helpful

• Announce that you are in the room and identify yourself and any other person you are with to a person with a visual impairment.

• Say what you are doing, for example, coming to get something.

• Talk directly to the person - not through a companion.• Stand where you can be seen or let the person know

where you are. Try to avoid talking from behind the person.

45

Communications: Hints and Tips• Speak distinctly to the person. You do not need to raise

your voice.• Always answer questions and be specific and descriptive

in your responses.• Say when you are leaving and where you are going if it is

appropriate, for example, going to the kitchen to get a cup of tea.

• If you offer assistance, wait until the offer is accepted. Then listen to or ask for instructions.

• Don't be afraid to ask questions when you're unsure of what to do.

• Relax. Don't be embarrassed if you happen to use common expressions that seem to relate to a person's disability. Such as "See you later" or "did you watch TV last night?" These are commonly used expressions and rarely cause offence.

46

Sighted Guide Awareness

• Sighted Guide is a form of communication• Verbal communication is central to good guiding• The guide should lead in almost all

circumstances• Being able to guide properly builds a trusting

relationship and is a positive contribution• Respect people’s wishes at all times unless they

are putting themselves or you in danger.

47

Designing Printed Materials

• Large Print 16 Point• San Serif Font e.g. arial• Matt surface – no reflection• Uncluttered background• Good contrast between print and

background• Simple layout• Consider individual requirements

48

Alternative Formats

• Braille

• Moon

• Large Print

• Audio

• Electronic Format

49

Learning outcomes for the morning session

• Participants will be able to:– List at least three eye conditions and explain how they

could affect functional vision using handouts– List 3 factors which make for an inclusive environment

using handouts– Experience six tasks of daily living under simulation– Discuss and give details of any difficulties

experienced and emotional reactions to the simulation– List at least 4 aids to daily living and their uses, using

handouts provided.

50

Objectives/Learning Outcomes for afternoon session

• Participants will be able to:– Discuss and identify at least three practical

interventions which demonstrate good practice in communications

– Demonstrate the guiding grip and position, narrow spaces, inward turn, doors, stairs and seating. These are guiding techniques

– List at least 3 Principles of good print design using handouts

– List at least three alternative formats for information production

– List two features of an accessible website.