Impaired Vision

 Refractive errors
 Can be corrected by lenses that focus light rays on the retina
 Emmetropia: Normal vision
 Hyperopia: Farsighted
 Astigmatism: Distortion caused by irregularity of the cornea
- Refractive errors may be very slight to severe and result in impaired vision and loss of
function. Eye shape determines visual acuity in refractive errors.

Low Vision and Blindness

 Low vision
 Visional impairment that requires device and strategies in addition to corrective lenses
 Best corrected visual acuity (BCVA) of 20/70 to 20/200
 Blindness
 BCVA 20/400 to no light perception
 Legal blindness is BCVA that does not exceed 20/200 in better eye or widest field of vision is 20
degrees or less
 Impaired Vision often is accompanying by functional impairment
- Low vision and blindness define visual impairment and allows individuals with these findings
to receive assistance through governmental, disability programs.

Glaucoma

 A group of ocular conditions in which damage to the optic nerve is related to increased
intraocular pressure or IOP caused by congestion of the aqueous humor
 is a condition that affects sight and is usually caused by a buildup of pressure within the eye. The
eyeball contains a fluid called 'aqueous humor' which is constantly produced by the eye, with
any excess drained though tubes. "Glaucoma develops when the fluid cannot drain properly and
pressure builds up, known as the intraocular pressure."
Intraocular pressure can damage the optic nerve, which sends signals from the eye to the brain.
 Incidence increases with age
- Risk factors:
- It is estimated that 3 million Americans have glaucoma and approximately 50% are
undiagnosed

TYPES OF GLAUCOMA

- Open-angle glaucoma. Many people don’t have any symptoms until they start to lose their
vision, and people may not notice vision loss right away.

- Experts aren’t sure what causes open-angle glaucoma, but it may be caused by pressure
building up in your eye. If the fluid in your eye can’t drain fast enough, it creates pressure
that pushes on the optic nerve in the back of your eye.
 - Over time, the pressure damages the optic nerve, which affects your vision. This can
eventually lead to blindness. People with high blood pressure or diabetes are at higher risk
for this type.
 Glaucoma is often called the silent thief of sight as many patients are unaware
of their diagnosis until they note vision loss or changes


Presbyopia

- Loss of ability to clearly see objects that are close or have a small print. Usually corrected with
reading glasses and contact lenses. is a normal condition in which your eyes gradually become
less able to focus on nearby objects as you get older? Presbyopia is often referred to as the
aging eye condition. Presbyopia is due to an age-related loss of lens accommodation that results
in an inability to focus at near distances and is the cause of universal near vision impairment
with advancing age. People often notice changes in their near vision around the age of 40.
Usually, you notice that reading and focusing on objects close-up becomes more difficult,
although you will still see distant objects clearly. Presbyopia is a natural part of ageing occurring
in the adult eye and is normally corrected with the use of glasses or contact lenses.

Floaters

- Tiny spots, blobs or specks the float across your vision when you look at the sky or a white wall.
Most eye floaters are caused by age-related changes that occur as the jelly-like substance
(vitreous) inside your eyes liquifies and contracts. Scattered clumps of collagen fibers form
within the vitreous and can cast tiny shadows on your retina. The shadows you see are called
floaters

Cataracts

- These are cloudly areas that cover the entire or part of the lens inside the eye. Usually removed
by surgery
- Are an opacity of the lens of the eye cataracts are an age-related cause of vision loss affecting
more than half by the age of 80 years. Three most common types of cataracts are traumatic,
congenital and age related. Patients with cataracts present with painless, blurry vision and
complaints of dimness. Other visual changes and decreased visual acuity or common.

Corneal Dystrophies

- Result in deposits and corneal layers leading to vision loss through corneal edema and blurring
your vision. Keratoconus and Fuchs endothelial dystrophy are two types. Keratoconus is more
common and is usually noted in puberty. Most people with keratoconus can correct their vision
problems by wearing glasses, soft contact lenses, or special hard contact lenses that change the
shape of the cornea. Your doctor may also recommend a procedure called corneal cross-linking
to strengthen your cornea. If your keratoconus causes severe corneal scarring or you have
trouble wearing contact lenses, you may need a corneal transplant. Fuchs is most commonly
not noted until age 50 both affect women more than men. Both can be treated with different
types of contact lenses in early stages. ost people with Fuchs’ dystrophy start to have symptoms
around age 50 to 60. This disease makes a type of cornea cells (called endothelial cells) stop
 working. When these cells stop working, the cornea swells and gets thicker. These cornea
changes can cause vision problems.

Retinal Vein or Artery occlusion

- Are the acute loss of vision from occlusion of the retinal artery or vein. This is associated with a
chronic condition of atherosclerosis, cardiac valvular disease, venous stasis, hypertension, or
increased blood viscosity. Other risk factors are diabetes, glaucoma and aging.

Age-Related Macular Degeneration

- Macular degeneration accounts for 54% of all blindness in older adults. This condition is divided
into two types; dry or non-exudative which accounts for 85 to 90 percent of cases or the wet
type. Non exudative age-related macular degeneration is the slow breakdown of the layers of
the retina with the appearance of drusen, which is tiny yellowish spots beneath the retina. The
wet type of age-related macular degeneration is associated with abrupt onset and is associated
with proliferation of abnormal blood vessels under the retina.
 AMD: Drusen and progression of vision loss
- These images show drusen associated with age-related macular degeneration and the
progression of vision loss with both types of age-related macular degeneration.
-