Introduction

Visual impairment can be simply defined as impaired vision or decreased ability to see. People with
visual impairment Include people with low vision and total blindness. According to the PWD act 1995
“blindness” refers to a condition where a person suffers from any of the following conditions, namely;-i)
total absence of sight; or ii). Visual acuity not exceeding 6/60 or 20/200 (Snellen) in the better eye with
correcting lenses; or iii). Limitation of the field of vision subtending an angle of 20 degree or worse; and
a person with low vision” means a person with impairment of visual functioning even after treatment or
standard refractive correction but who uses or is potentially capable of using vision for the planning or
execution of a task with appropriate assistive device. These values of visual acuity vary in different
policies as the time and assistive technologies change. Visual acuity simply means the ability to see fine
details of objects or persons.

Factors the affect visual acuity are-

i) Level of background illumination

ii) The contrast of target against its background
iii) The distance between the eye and target

Causes of visual impairment may involve genetic factors in which one or Both the parents pass certain
genes which can cause visual impairment during foetal development. Factors affecting the baby during
the process of birth can also cause visual impairment, for example premature birth of the baby where a
high amount of oxygen is needed to keep the baby alive, can lead to retinopathy of prematurity which is
complete blindness. Neurological disorders can lead to visual impairment by damaged visual messaging
pathways, It may occur before, during or after birth and can be a result of a disease or injury. In
childhood other reasons responsible can be viral infections, brain tumours and injury.

Types of visual impairment-

Refractive errors like myopia (short-sightedness), hypermetropia (long-sightedness) and astigmatism. In

myopia or short-sightedness the eyeball is too long so that parallel light rays coming from a distance do
not focus on the retina at fovea but before it that is why distance vision is blurred. Hypermetropia or
long-sightedness is a condition in which the eyeball is too short and light rays focus behind the retina so
that results in blurred vision. Both of these conditions can be manageable with the help of corrective
lenses. But when these conditions occur along with other issues like cataract visual acuity cannot be
managed even when the prescribed lenses are worn. An uncorrected refractive error may cause sight
loss.

In astigmatism, the main cause is that the lens or the cornea of the eye has irregularities in its curvature
which affects its refractive power and a distorted image is formed on the macula. A cylindrical correction
built into the lens of spectacles can rectify this, but again if this impairment occurs with conditions like
hypermetropia it results in reduced vision.

A cataract is an opaqueness or cloudiness of the lens of the (it may occur in the centre or periphery of
the lens) preventing some light rays passing to the retina. Blurred images are formed if the illumination
is not adjusted according to the needs. Although it usually occurs in people above 65, it can also be a
side-effect of diabetes.
Nystagmus is a repetitive rhythmic involuntary movement of the eyes often accompanied by other visual
impairments such as congenital cataracts. In this condition a person continuously moves their eyes and
as they cannot focus on something they will always move Their head.

Retinitis pigmentosa refers to a group of progressive conditions affecting the retina, in particular the
peripheral area that contains cells (rods) sensitive to vision in dim light. This leads to night blindness and
so-called tunnel vision. It is a kind of progressive disability which eventually develops Into blindness. It
can be simply understood as loss of peripheral vision or girls of vision becomes narrower.

Macular degeneration causes loss in the centre of the field of vision. In this person cannot understand
facial expressions and in order to get any sort of view they need to look off from what they want ro see
to get indication of peripheral edges of the face. This brings to the affected people difficulties in social
and emotional well Being.

Interrupted visual field- They can have vision of a thing interrupted in different ways. People with this
condition show unusual way of holding Their head to get the view of a particular thing. The strategy
these people most of the time employ is to compromise to have the best view of something to avoid
social stigma which increases their problem.

Albinism May result in a pale and a faded image on the retina. The reason could be limited production
of melanin, a genetically inherited condition. People affected with this condition also face a lot of social
stigma.

References

Book- sensory impairment and physical disability by Michael Farrell

Royal blind learning hub.

Social context of disability-

Visual impairment (VI) affects physical, psychological, and emotional well-being, and social life as well.
Visual function is important for normal functional and social life and has effects on physical,
psychological, mental and emotional well-being. Impaired vision significantly reduces activities
associated with participation in society and religion, mobility, recreational and daily living etc.

when children having low vision are not able to pick up on non verbal clues or are unable to make eye
contact thay may appear disinterested and eventually will have reduced social interaction. According to
Piaget's theory of cognitive development children explore their environment by using their sensory
organs, when this exploration is hampered it affects their cognitive development.

Needs of a person with loss of vision can also be understood by looking at Maslow’s need of hierarchy;
physiological needs correspond to basic necessities like food, water, which could be difficult for a
visually impaired person to accomplish in the beginning; safety needs which also require sensorimotor
qualifications like when that person is unable to cross streets like sighted people, this gives the sense of
insecurity; love and belongingness is the next level here which is not accomplished by most of the
visually impaired people because they feel isolated most of the time; esteem can be low as they have to
depend on others for regular tasks; self actualization is highest level in this, which can be accomplished
after achievement of all the needs.

Greatest support that a person with disability can have is that from family. When a child is born with a
disability it brings all kinds of emotions for the family like shock, helplessness, lack of fortune, fear of
stigma from society, anxiety about the future of the child, guilt that parents themselves can be
responsible for that. In such a case if the family doesn’t have enough access to information and
awareness about the disability and from where they can seek help, they tend to dislike the child or just
deny the existence of disability which blocks the way for early intervention. In this case either the child
ends up abandoned or just surviving on mercy of others without having a dignified life. According to a
study conducted by WHO in Pakistan; when it comes to satisfaction with family members, (52.5%)
students were found satisfied with family members, (25%) were satisfied to some extent and (22.5%)
were not satisfied at all.

When family has information and awareness they prove to be the great support for the person with
disability, they also give the person the strength to fight the disability and live life with dignity. Also the
emotional and financial burden and depression experienced by primary care giver and the family also
need to be talked about. Their mental health and rehabilitation should also be given due emphasis so
that they can help a person with disability to have a bit easier life.

When even a person with disability is able to carry out daily tasks, perception of society for a disability
makes them uncomfortable in the public sphere. People without disability are sometimes just not aware
of how to interact with a person with disability. There is an awkward moment when sighted people first
meet people with blindness. They come across the dilemma, should they greet a person with blindness
with a hand shake as they cannot see the extended hand. This creates apprehension of discomfort and
clumsiness which their presence imposes on sighted people. Yes people with disabilities do need help
sometimes but consistent affection and sympathy cause them to avoid social contact and hence they
develop a sense of social seclusion from the society.

Perception of society for a disability also varies across culture, as per a study children with disability in
western world are more satisfied then in parts south Asian countries. This may be partly because of
acceptance in the society and also to the assistive technology accessible to people with disability.

References

https://doi.org/10.1186/1472-6963-14-345

https://www.teachingvisuallyimpaired.com/impact-on-development--learning.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859038/#!po=32.6087

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056544/

POLICY AND PROVISION

 The main three factors that contribute to the study of visual impairment; First, it is essential to study
what kinds of provision and support are given and what should be continued or changed so that we can
support blind students to the extent that their blindness has as little impact on their study as possible
point out that People may not consider their impairment substantially affects their every activities if
they are well supported Second, previous researches show that “qualitative research focusing on the
voices of individuals with disabilities is limited” and most of them describe only the educators or
parents‟ words (Obiakor, Bakken & Rotatori 2010, ) Shakespeare (2006) claims that “disability studies
should pay attention to the views and perspectives of disabled people” Whereas they agree to listening
that students with physical disabilities is one of the means to best support and educate disabled
students as well as all students. As far as blind students are concerned, Gentle (2008) points out that
blind people are living resources and documents in the field of blindness. As a result, in this qualitative
study, three blind people were interviewed regarding their experience and their perspectives on
provision and support they received in schools when they were students. This study is consequently
significant in a way that the voice from blind people are highly valued.

Third and the last, by applying qualitative interviewing, this study attempted to show how to include
blind people into educational research. Many researches have been conducted to explore how inclusion
is achieved for people with different types of visual impairment in society. However, little attention has
been paid to how a research can be inclusive to blind informants. It is significant for researchers to show
the importance of including blind people in education, employment and the society. The first step of
doing so is to carry out research which shows respect to informants, listen to what they really want to
share and what the meanings are attached to their shared experience The twentieth century heralded
many significant milestones in the provision of services for both children and adults with visual
impairment. In 1920, the Smith-Fess Act appropriated state and federal funds for the vocational
rehabilitation of people with physical handicaps. Later in 1940, the National Federation of the Blind was
formed. This federation began advocating for individuals with blindness and continues to prepare and
place people with blindness in suitable jobs. Finally, in 1975 the Education for All Handicapped Children
Act was passed. This act guaranteed a free and appropriate education for all children regardless of
disability In the early 1900s most students with blindness were educated in residential schools; at the
beginning of the twenty-first century most attend regular classes with periodic support from a teacher
for the visually impaired. However, some professionals still advocate for special schools and programs,
arguing that students with blindness need specific services and supplies that cannot be offered in
regular classrooms. The use of braille declined dramatically in the last half of the twentieth century. In
opposition to this trend, many professionals, along with the National Federation of the Blind, have
argued that knowledge of braille is essential for independent living and that too few teachers are
proficient in braille. In the 1997 reauthorization of Public Law 94-142, the U.S. Congress mandated
braille services for all students with blindness unless all members of the educational team deemed the
services unnecessary. Students with visual impairment also require mobility training. Historically, white
canes were not available to young children; however, some experts now contend that cane training
should begin as soon as the child is walking independently. This training should be a critical component
of preschool programming. In India, the total population of persons with disabilities is pegged around
2.1 percent of the total population by the Census (2001). The National Sample Survey Organization
(NSSO) which collects data on the incidence and prevalence of disability at every 10 years intervals in
1991 quoted the percentage of persons with disability as 1.9 percent and the latest 2002 NSSO
estimates 1.98 percent of the population having one or the other disability. Singh (2006) concluded that
considering that one source of data is a sample survey and the other is through census, the variation is
not too marked. Thus one could assume that people with disabilities constitute approximately 2 percent
of the population. Blindness has profound human and socioeconomic consequences in all societies.
Disabled people in India are a silent and invisible group in spite of their significant number. We know
almost nothing about the existential experience of persons who live with visual disability. Despite this,
very few research studies have been undertaken in the field of visual disability. There is no dearth of
literature on disability. However, these studies cover all disabled persons and not exclusively the visually
disabled. In this regard, in the present study an attempt has been made to assess the visual disability in
India. From the analysis, it can be concluded that there is marked inter-state variation in visual disability
in major states of India and also by background characteristics. The age of onset of visual disability found
the highest prevalence at after age 70. Old age, cataract and other eye diseases found to be the major
causes of visual disability. One-quarter of visually disabled persons did not take any treatment and less
than one percent attended special school, which needs contextual and need based programmes for its
rehabilitation. Different causes reported for this particular disability need focused programmes to rectify
them. It needs future research to find out factors and determinants influencing visual disability.