Seeing the bigger picture of blindness

Posted on 31 July 2014

We spoke to Dr RA Joseph, an ophthalmologist at Mediclinic Plettenberg Bay, about some of the causes and effects of blindness.

What are some of the causes of blindness?
There are many causes of blindness, some reversible and others permanent. The most common are cataracts, glaucoma (high pressure in the eyes), trachoma (a bacterial infection that causes severe corneal scarring) and refractive error.

Who can get their sight back and who can’t?
There are many causes of non-reversible blindness. A major cause of congenital reversible blindness is congenital glaucoma, which has to be surgically treated.

How is being born blind different from ‘going’ blind?
Being born blind is exceptionally rare and, once again, there are many causes for it – some reversible, some not. People who are born blind have all their other senses heightened: touch, taste and smell will all develop to accommodate for loss of vision. These patients learn to read braille from a young age and adapt very quickly.

Going blind, however, has devastating psychosocial implications and is a massive adjustment for a previously seeing individual. But this is usually as a result of permanent or irreversible causes of blindness.

What psychological side effects of being blind have you come across?
The psychosocial impact of blindness is enormous, both for people who are born blind and those who become blind – whether it is one or both eyes. One sees a patient through all the stages of grief. It is important for a clinician to have a multidisciplinary approach that involves ophthalmologists, optometrists, psychologists or psychiatrists, social workers and occupational therapists.

In South Africa, what are the criteria for being defined as legally blind?
Legal blindness is defined according to visual acuity and field of vision. We use a formal Snellen chart to record visual acuity. Acuity of less than 6/60 in the better-seeing eye means that the person sees at six metres what a normal sighted individual will see at 60 metres. They are, therefore, legally blind. In regards to visual fields, the better-seeing eye must have a field of vision less than 20 degrees for a person to be confirmed as legally blind.

Apart from guide dogs, what sort of aids do blind people use to help them go about their daily lives?
Visual aids are generally in the form of magnifying spectacles – especially if the disorder affects the macula, which is responsible for one’s central vision. Spectacles are most commonly used in a disorder called macula degeneration, which typically affects white females over the age of 60. It’s a genetic disorder. There are a few centres around the country that specialise in making these visual aids. They are for partially sighted people, not for those who are completely blind. Mobile technology is also changing the way for visually impaired people.

How does Mediclinic’s ophthalmology department compare with others worldwide?
Mediclinic as a group is very focused on exceptional health care delivery and quality of care, and Mediclinic Plettenberg Bay is no different. I really enjoy working here and my ophthalmic practice offers all the state-of-the-art equipment I need to do my work.

Being born blind hasn’t stopped Hein Wagner – read his story about how he lives a life of high adventure despite being blind.

 

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.