2. Jay C. Rivera, PTRP Faculty – Department of Physical Therapy College of Allied Medical Professions University of the Philippines Manila

3.  Discuss the common visual impairments  Discuss the basic techniques to assist people with visual impairments  Discuss the general guidelines in visual rehabilitation

5.  Macular Degeneration  Glaucoma  Cataract  Diabetic Retinopathy

10.  Using visual aids  Enlarging images  Controlling the lighting  Improving color contrast  Finding ways to compensate for changed vision

11.  Enlarging large images ◦ Moving closer ◦ Using large prints and labels  Controlling the lighting ◦ Use direct light focused on the task ◦ Increase the light bulb wattage ◦ Use night lights ◦ Use visors or UV inhibitor sunglasses outdoors

12.  Improving color contrast ◦ Let the person with VI choose the color he/she sees best ◦ Background should contrast with the foreground  Finding ways to compensate for changed vision ◦ Tilting the head on an angle to use remaining side vision ◦ Rotating the head to use the central vision in scanning the periphery

14.  Guide Dogs  Long Canes  Sighted Guides

15.  IMPORTANT: Both the VIP (visually-impaired person) and the dog should have undergone proper training  Effective for VIPs who have very little vision and who can maintain a dog  Avoid distracting the dog by petting it and offering food

16.  Identification Cane  Support Cane  Long Cane

17.  Have the person stand with the arms relaxed by the side.  The top of the cane should come just to the wrist joint.  There should be a 30-degree angle formed at the elbow.

18.  The cane handle should be held at the level of the waist using whichever hand they are most comfortable with.  Wrap the hand around the handle with their index finger pointed along the cane shaft and pointing toward the cane tip, which is resting on the ground

19.  Range of sweep should be shoulder-width to 2 inches beyond the width of the shoulders  As the cane is swept to the right, the left foot advances; and so on

20.  When the step is felt (going up or down), the VI should feel for the handrail and hold onto it  Transfer the cane on the opposite hand; hold the cane vertically in front of the body  Cane feels the depth of the next step  Once a landing or end of steps is reached, transfer the cane to the other hand and then scan again

21.  Refers to a sighted person giving meaningful assistance to a VIP for easier and safer moving around  Sighted guide techniques follow a specific form and has specific applications.

22.  Offer to guide a person who is blind or visually impaired if he or she would like assistance.  If your help is accepted, offer the person your arm.  Relax and walk at a comfortable walking pace.  It is helpful, but not necessary, to tell the VIP about changes in terrain, stairs, narrow spaces, elevators, and escalators.

23.  The standard form of sighted guiding technique may have to be modified because of other disabilities or for someone who is exceptionally tall or short.  When you are acting as a guide, never leave the person in “free space”.  To guide a person to a seat, place the hand of your guiding arm on the seat.

24.  When greeting a VIP, always identify yourself.  Speak directly to the VIP and not through an intermediary.  Speak distinctly, using natural conversational tone and speed.  Address the VIP by name so they will know immediately that you are talking to them.

25.  Be an active listener.  Always answer questions and be specific or descriptive in your responses.  Say when you are leaving and where you are going if it appropriate.  Indicate the end of a conversation with a VIP.

26.  Feel free to use words that refer to vision during the course of a conversation.  Be precise and thorough when you describe people, places, or things.  Don’t avoid visually descriptive language.

27.  If you see a VIP about to encounter a dangerous situation, be calm and clear about warning the person.  Do not take care of tasks for the person that he/she would normally do.  If you are asked to complete a task for someone, always leave things in the same place you found them.  Do not move furniture or things without letting the VIP know.

28.  Always refer to a specific direction.  Indicate the approximate distance.  Give the approximate number of streets.  If possible, provide information about landmarks along the way.

29.  Greet the VIP.  Identify yourself and inquire if assistance is desired.  Touch the back of the person’s hand to signal him to take your arm. Verbal cues may be utilized.

30.  The VIP takes the guide’s arm just above the elbow with firm grip enough to maintain it while walking.  For more support, the person may grasp the guide’s upper forearm from the inside.  For children, it may be best to have them grasp your wrist or hold your hand.

31.  Hold your arm relaxed and steady at your side.  The VIP's arm is at a 90- degree angle and held close to their side.  They should proceed by being one halfstep behind you.  They will follow your movements. Do not steer them.

32.  Move the guiding arm backwards and position it diagonally across your back.

33.  The VIP responds by straightening his gripping arm and stepping behind you.

34.  Assume the narrow passageway technique.  Always try to go through a doorway with the person you are guiding on the hinge side – changing sides if necessary.  Open the door with your guiding arm

35.  As you walk through the doorway the person you are guiding should place their hand flat against the door and slide it along to find the handle. They then follow you, slipping their hand to the handle on the other side of the door and closing it.

36.  Alert the VIP verbally when you are to walk up or down the stairs or curbs.  Approach stairs and curbs squarely with the VIP on the side of the handrail.

37.  Come to a full stop before the stairs and allow the person to hold onto the rail and feel the edge with his foot.  Proceed to move one step ahead of the VIP.  Stop at the end of the stairs and tell the VIP that it’s the last step.

38.  When possible approach a chair from the front or side,  Place the blind person's hand on the back of the chair and/or guide the person to the chair so that his or her knees or shins gently contact the edge of the seat.

39.  Let the VIP stand on one side of the room beside the wall or a stable furniture.  Describe the environment and possible obstacles and hazards.  Instruct him to use the back of their hand to feel around the room as they move towards their destination.

40.  Instruct the VIP to hold the hand at hip level and about a foot from the body.  To protect the upper body, hold the hand higher at the shoulder level, parallel to the floor.  To protect the lower body, hold the hand in front of the abdomen.

41.  Four principles for a safe and organized environment ◦ Increase lighting ◦ Eliminate Hazards ◦ Create color contrast ◦ Organize and label items

42.  Use strong light bulb or three-way bulb to provide non-glare light  Put lamps closer to work area  Install extra lights in frequently used and accident-prone rooms  Ensure reachable switches from doorways and bed  Use night lights

43.  Use thermostat markers.  Use non-skid and non-glare floor polish.  Keep chairs pushed in.  Keep cabinet or room doors fully open or closed.  Keep furniture out of the main traffic area.  Replace worn carpeting and remove area rugs and electrical cords from the walkways.  Use railings in stairs.  Mop up spills immediately.

44.  Use contrasting colors for switches and outlets, furnitures, doors and knobs, and stairs.  Avoid upholstery with patterns.

45.  Group the items that are used together for storage.  Use labels with bold, contrasting letters or tactile codes.  Put small items in a bag.

46.  http://www.afb.org http://www.afb.org  http://campabilities.org http://campabilities.org  http://dhs.wisconsin.gov/blind/adjustment/sight edguide.pdf http://dhs.wisconsin.gov/blind/adjustment/sight edguide.pdf