The human eye is like a camera that collects, focuses, and
transmits light through a lens to create an image of its
surroundings. In a camera, the image is created on film or an image
sensor. In the eye, the image is created on the
retina
, a thin layer of light-sensitive tissue at the back of the
eye.
Like a camera, the human eye controls the amount of light that
enters the eye. The
iris
(the colored circular part of the eye) controls the amount of light
passing through the pupil. It closes up the pupil in bright light
and opens it wider in dim light. The
cornea
is the transparent, protective surface of the eye. It helps focus
light, as does the
lens
, which sits just behind the iris.
When light enters the eye, the retina changes the light into
nerve signals. The retina then sends these signals along the
optic nerve
(a cable of more than 1,000,000 nerve fibers) to the brain. Without
a retina, the eye can't communicate with the brain, making
vision impossible.
What Is Visual Impairment?
Many people have some type of visual problem at some point in
their lives. Some can no longer see objects far away. Others have
problems reading small print. These types of conditions are often
easily treated with eyeglasses or contact lenses.
But when one or more parts of the eye or brain that are needed
to process images become diseased or damaged, severe or total loss
of vision can occur. In these cases, vision can't be fully
restored with medical treatment, surgery, or corrective lenses like
glasses or contacts.
The American Foundation for the Blind estimates that 10 million
people in the United States are visually impaired.
Visual impairment
is a term experts use to describe any kind of vision loss, whether
it's someone who cannot see at all or someone who has partial
vision loss.
Some people are completely blind, but many others have
what's called
legal blindness
. They haven't lost their sight completely but have lost enough
vision that they'd have to stand 20 feet from an object to see
it as well as someone with perfect vision could from 200 feet
away.
What Causes Visual Impairment?
People rarely lose their eyesight during their teen years. When
they do, it's usually caused by an injury like getting hit in
the eye or head with a baseball or having an automobile or
motorcycle accident.
Some babies have
congenital blindness
, which means they are visually impaired at birth. Congenital
blindness can be caused by a number of things - it can be
inherited, for instance, or caused by an infection (like German
measles) that's transmitted from the mother to the
developing fetus during pregnancy.
Conditions that may cause vision loss after birth include:
-
Amblyopia
(pronounced: am-blee-
oh
-pee-uh) is reduced vision in an eye caused by lack of use of
that eye in early childhood. Some conditions cause a child's
eyes to send different messages to the brain (for example, one
eye might focus better than the other). The brain may then turn
off or suppress images from the weaker eye and vision from that
eye then stops developing normally. This is also known as a
"lazy eye."
Strabismus
(misaligned or crossed eyes) is a common cause of amblyopia,
since the brain will start to ignore messages sent by one of the
misaligned eyes.
-
Cataracts
are cloudy areas in part or all of the lens of the eye. In people
without cataracts, the lens is crystal clear and allows light to
pass through and focus on the retina. Cataracts prevent light
from easily passing through the lens, and this causes loss of
vision. Cataracts often form slowly and usually affect people in
their 60s and 70s, but sometimes babies are born with congenital
cataracts. Symptoms include double vision, cloudy or blurry
vision, difficulty seeing in poorly lit spaces, and colors that
seem faded.
-
Diabetic retinopathy
(pronounced: reh-ton-
ah
-pa-thee) occurs when the tiny blood vessels in the retina are
damaged due to diabetes. People with retinopathy may not have any
problems seeing at first. But if the condition gets worse, they
can become blind. Teens who have diabetes should be sure to get
regular eye exams because there are no early warning signs for
this condition. To help prevent retinopathy, people with diabetes
should also avoid smoking, keep their blood pressure under
control, and keep their blood sugar at an even level.
-
Glaucoma
is an increase in pressure inside the eye. The increased pressure
impairs vision by damaging the optic nerve. Glaucoma is mostly
seen in older adults, although babies may be born with the
condition and children and teens can sometimes develop it as
well.
-
Macular degeneration
(pronounced:
mah
-kyoo-lur dih-jeh-nuh-
ray
-shun) is a gradual and progressive deterioration of the
macula
, the most sensitive region of the retina. The condition leads to
progressive loss of central vision (the ability to see fine
details directly in front). Macular degeneration is often age
related (it occurs in older people, especially older than 60),
but sometimes it can occur in younger people. Excessive exposure
to sunlight and smoking can increase the risk for age-related
macular degeneration. Symptoms may include increased difficulty
reading or watching TV, or distorted vision in which straight
lines appear wavy or objects look larger or smaller than
normal.
-
Trachoma
(pronounced: truh-
ko
-muh) occurs when a very contagious microorganism called
Chlamydia trachomatis
causes inflammation in the eye. It's often found in poor
rural countries that have overcrowded living conditions and
limited access to water and sanitation. Blindness due to trachoma
has been virtually eliminated from the USA.
What Do Doctors Do?
If you, your parent, or your doctor suspects a visual problem,
you'll probably pay a visit to an
ophthalmologist
(pronounced: af-thal-
mah
-luh-jist), a medical doctor who specializes in examining,
diagnosing, and treating eyes and eye diseases. When someone goes
for an examination, the ophthalmologist will look at the structure
of that person's eye.
Other simple tests an ophthalmologist may perform include:
-
Visual acuity test.
A person reads an eye chart to measure how well he or she sees at
various distances.
-
Visual field test.
Ophthalmologists use this test to measure side, or peripheral,
vision.
-
Tonometry test.
This test determines the fluid pressure inside the eye to
evaluate for glaucoma.
If your doctor determines that you have an eye condition that is
likely to cause visual impairment, many treatments are available.
Options may include eyeglasses, contact lenses, and eye drops or
other medicines. In some cases, surgery may be required. For
instance, cataracts are often treated by removing the clouded lens
and replacing it with an intraocular lens (an artificial plastic
lens that requires no special care and restores vision).
Other methods can compensate for vision loss. Guide dogs
can help people get from place to place independently. Braille
allows those with visual impairment to read and write. Special
equipment such as microscopic and telescopic glasses and
voice-recognition software can make school and homework easier.
What's It Like to Be Visually Impaired?
Just as you don't think about your eye color every day,
people with visual impairment don't always think about their
condition every day either.
Someone with sight problems can become isolated from others
more easily, though. If a visually impaired person asks for
assistance, don't hesitate to help. But someone who uses a cane
or a guide dog is probably self-sufficient and may not need
help.
Reviewed by:
Elana Pearl Ben-Joseph, MD
Date reviewed: January 2007
Originally reviewed by:
Sharon Lehman, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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