ETEC 535

Visual Disability Awareness by Bryant, Jesse, Rita, and Larry

Characteristics of Visual Impairment

Limitations in range and variety of experiences Limitations in mobility Limitations in environmental interactions Can effect: incidental learning social interactions leading to isolation career development

*Children often times have difficulty verbalizing or explaining a vision concern. Look for symptoms in three areas: physical changes, changes in vision, and changes in behavior.

Physical Changes
Eyes that are wandering, bloodshot, encrusted or have re - occurring redness or watering Eyes turn inward, outward, upward or downward

Eyes are very sensitive to light

Pain or itching in the eyes

Rubbing eyes frequently

Frequent headaches, tiredness or dizziness after doing hard work

Frequent blinking, squinting, facial distortion or frowning

Has sties frequently

Viewing things at a distance or very closely

Trips and bumps easily - loss of balance

Changes in Vision & Behavior

Vision
Complains about things being blurry (awareness of objects but unable to identify them)

Behavior
Irritable when looking at things far away or when doing written work on their own

Holds hand close to eyes or moves it in front of them

Short attention span when watching something happening from across the room Closes eyes while listening Moves head from side to side while listening Uses touch to identify objects

Tilts head or covers one eye to see Needs to enlarge text to be able to read it

Causes/Types of Visual Disabilities

Albinism
Albinism is a trait that is inherited through autosomal recessive or sexlinked transmission and results in characteristics that affect the pigmentation of the skin and hair as well as the iris and retina. Persons with albinism have a decrease in visual acuity (fine detail) due to macular aplasia. Accommodations/Assistive Technology Low-vision devices, including strong microscopic reading lenses, magnifiers, absorptive lenses, and telescopic lenses

Cataracts & Glaucoma

A cataract is opacity or clouding of the lens that may develop as a result of aging, trauma, hereditary factors, birth defects, or diabetes Cataracts are a normal part of aging Greater than 50% of Americans age 80 and older have cataracts Basically three types of glaucoma Chronic open-angle glaucoma: elevated pressure over time eventually affects the optic nerve and visual field Acute (closed-angle) glaucoma: rapid increase or spiking of the intraocular pressure that may be accompanied by intense pain and even nausea or vomiting Low-tension glaucoma: may be caused by a decrease in blood flow to the optic nerve Accommodations/Assistive Technology Low-vision devices, including spectacles, hand and stand magnifiers, closed circuit TV, and lighting Absorptive lenses enhance the apparent brightness of the scene and often aid in mobility Modifications in the work space may be required, with high technology, including voiceoutput devices

Diabetic Retinopathy & Hemianopsia

This is caused by diabetes. Diabetes affects the retinal blood vessels and causes bleeding which blocks transmission of light through the eye. Approximately 40-45% of diabetics will develop low-vision or blindness. This impairment is caused by a malfunction or damage to one side of the optic tract. This causes halfvision.

Corneal Disease
The cornea is a structure that is prone to dystrophies, deposition, noninflammatory progressive thinning (keratoconus), infection, viral diseases, and trauma. Interference with corneal integrity can result in a blurred or distorted image on the retina May experience severe glare, cloudy vision, and reduced acuity.

Vocational goals will be dependent on the degree to which the retinal image is compromised

Macular Degeneration
Macular degeneration is caused by degenerative changes to the macular area of the retina that result in atrophy, hemorrhage, exudates, fibrovascular scars, or cyst formations The function of the macula allows for sharpness of vision Central vision loss Accommodations/Assistive Technology Lenses and magnification devices Talking books Bold, felt-tip pens Talking clocks (and other talking devices and appliances)

Retinitis Pigmentosa
A progressive eye disease that affects the pigmentary layer of the retina, and most commonly affects the periphery or midperiphery of the retina Most common cause of inherited blindness In addition, 30% of people with RP report some degree of hearing loss The cause of this disease is unknown but is suspected to be an enzyme is the retina. Results in peripheral vision loss Accommodations/Assistive Technology Closed-circuit TV to enable the person to control the brightness and contrast of the image viewed Prism lenses to increase the awareness of the periphery The Nightsope might be able to be used for mobility under dim illumination Mobility devices, such as a traveling cane, special laser cane, sensory device, or Seeing Eye dog

Incidence
Over 285 million people worldwide have some sort of visual impairment Over 39 million people in the world that are blind: 58% are age 60+ 32% are age 45-59 7% are age 15-44 4% are age 14 and under 246 million have moderate to severe visual impairment: Amblyopia reduced vision in an eye Strabismus commonly known as crossed eyes. Daltonism -- Color blindness Reduced visual field lack of peripheral vision (tunnel vision) Low vision vision in the range of 20/70 to 20/160

The number of people with partial sight today (135 million) is expected to double by the year 2020

The world through their eyes:

age-related macular degeneration

cataracts

diabetic retinopathy

glaucoma

myopia

tear film and the cells that make them

Tools for the Visually Impaired

JAWS
(Job Access With Speech)

One of the worlds most popular screen readers that works with entire Windows OS and 3rd party programs Multiple languages supported Easy navigation throughout OS Huge list of shortcuts Ability to program custom commands Compatibility with most browsers

Magnification options Popular not with just visually impaired students, but also those with Dyslexia and ADD/ADHD. Remote access and server capabilities Supports touch screen monitors Huge support base Compatibility with digital braillers

NVDA
(NonVisual Desktop Access)

Open source screen reader that is completely free Over 40+ languages supported Easy navigation throughout OS Huge list of shortcuts Ability to program custom commands Compatibility with most browsers

Support with Java applications Compatibility with digital braillers Speech recognition Support for command console Huge support base Updated regularly Can be loaded through a USB drive

Kurzweil 3000

Among the most trusted of software for textto-speech translation Multiple languages supported Supports multiple file types capability to convert other files to its native file Built in references, dictionaries, and ability to highlight and export text to audio formats Ability for instructors to add notes to documents for students reference

Can be used in conjunction with Mozilla Firefox for efficient internet browsing Popular not with just visually impaired students, but also those with Dyslexia and ADD/ADHD. One of the most sophisticated OCR (Optical Character Recognition) engines Complies with NIMAS (National Instructional Materials Accessibility Standard)

Operating System Tools

Windows Ease of Access (Narrator) Apple OS X (VoiceOver)

Windows: Ease of Access (Narrator)

Accessibility Features Loaded by Default Option for Windows Ease of Access to be booted upon startup Multiple languages supported Speech Recognition Huge list of shortcuts Ability to program custom commands Compatibility with most browsers Scalable User Interface Elements High Contrast Selection Tool On screen keyboard tool for touchscreen monitors and tablets (Windows 7 & 8 only)

Apple OS X: VoiceOver
Accessibility Features Loaded by Default Option for Windows Ease of Access to be booted upon startup Multiple languages supported Speech Recognition Huge list of shortcuts Ability to program custom commands Compatibility with most browsers Scalable User Interface Elements High Contrast Selection Tool Special gestures on mouse/trackpad for quick access to tools Supports over 50 refreshable braille display models from various manufacturers Features beyond those of visual impairment - native support for hearing and motor skill impaired, as well Same features within iOS

Screen Readers that are Trending

Refreshable Braille Displays

These devices, though relatively new and expensive, offer a digital experience with a traditional braille feel. The braille is replicated by a series of pins that actuate according to what is highlighted/selected on the computer screen. The pins form the braille and the user has both a screen reader and a more familiar tactile experience. Many commercial screen readers, as well as Apples native VoiceOver, are starting to accommodate these devices by adding special drivers and commands.

Refreshable Braille Displays

Just remember . . .
We should not leave students with disabilities out. At some point in your professional career you will encounter someone with a visual impairment. Keep ideas for Universal Design in mind when making information available. Resources are available with a varying price range.

Resources:
Aldrich, C. (2013). National eye institute. Retrieved from http://www.nei.nih.gov/ Apple Computers, (2014). Accessibility: VoiceOver. Retrieved from: http:// www.apple. com/accessibility/osx/voiceover Carrin, J. (2014). Florida division of blind services. Retrieved from http://dbs.myflorida.com/ Education.com Inc., (2006). Visual Impairments. Retrieved from: http://www.education. com/reference/article/visual-impairments1/ Ferfoglia, L. (2008). Lighthouse international. Retrieved from: http://www.lighthouse.org/ Gunn, G. (2013). Prevent blindness Northern California. Retrieved from: http://northerncalifornia. preventblindness.org/ Hall, S. (2014). The national research and training center on blindness and low vision. Retrieved from http://www.blind.msstate.edu/ Hecker, S. (2013). Prevent blindness. Retrieved from http://www.preventblindness.org/ Jackson, A. (2014). Glaucoma research foundation. Retrieved from http://www.glaucoma.org/ Jaws. (n.d.). Retrieved from http://freedomscientific.com Kurzweil 3000. (n.d.). Retrieved from http://www.kurzweiledu.com Levine, M. (2010). Research to prevent blindness. Retrieved from http://www.rpbusa.org/rpb/ Lighthouse International, (2014). Prevalence of Vision Impairment. Retrieved from website: http: //www.lighthouse.org/research/statistics-on-vision-impairment/prevalence-of-vision-impairment/ Loy, B. (n.d.). Job accommodations network. Retrieved from http://askjan.org/index.html National dissemination center for children with disabilities. (2013). Retrieved from http://nichcy.org/ Nvda. (n.d.). Retrieved from http://www.nvaccess.org Schepens Eye Research Institute, (2014). Vision Disorder Simulations. Retrieved from website: http: //www.schepens.harvard.edu/vision-disorder-simulations/the-eye/vision-disorder-simulations.html Sun, E. (2010). Amd alliance international. Retrieved from http://www.amdalliance.org/ Tech-Ease 4 All. (2014, February). How to Use Narrator in Windows 7. Retrieved from website: http: //etc.usf.edu/techease/4all/vision/how-do-i-use-narrator-the-screen-reader-included-with-windows-7/ White, W. (2014). American Academy of Ophthamology. Retrieved from http://www.aao.org/aao/