Low Vision in Nigeria: Independence Day for the Blind and Visually Impaired

In the fourth century AD the earliest recorded asylum specifically for the care of the blind was created in Caesarea. In the early days the most that sightless people could hope for as far as employment, would be to become a successful begger. But, like Martin Luther King, Jr. the people born sightless or diminished vision had a dream to be all that they could be and set the dream in motion with the opening of several schools for the blind.

The first school was opened in 1791 in Liverpool; the second was opened in 1799 in London, the third 1805 in Vienna, and the fourth, mentioned in this article, in 1806 in Berlin. These schools sought to improve the lot of the sightless, and to prevent the sighted from becoming sightless. As mentioned in the definitions section of this research paper there are three major eye conditions that greatly affect African/African Americans, once again they are: Glaucoma, Diabetic Retinopathy, and Cataract.

In the following paragraphs I will discuss each disease in detail (who.int).

Cataract

According to WHO, cataract is responsible for up to 60% of the blind in the sub-region, or some 1.2 million people, with an estimated 300 000 new cases of blinding cataracts each year. "The cataract surgery rate (CSR) in the sub-region is still among the lowest in the world - only between 200 and 400 per 1 million of the general population compared to 3500-5000 in the developed countries," said Dr Alain Auzemery, Director of IOTA Cataracts are among the most misunderstood diseases of the eye. A Cataract is an opacity or haziness that develops in the lens of the eye. There are three types of Cataract:

1. Nuclear Sclerotic Cataract
2. Cortical Cataract
3. Posterior Sub capsular Cataract

Individuals who have a nuclear cataract generally have trouble seeing at a distance, while people who have a cortical cataract suffer from a chemical imbalance that causes water to be drawn into the outer cortex. People with this type of Cataract often complain of double vision, and finally, with a posterior cataract changes can occur rapidly and tend to be much more advanced in one eye. His type of Cataract forms an opaque growth on the back surface of the eye.

People with this form of Cataract may incur problems with focusing and distortion, and affects reading vision because of its central location in the eye. Now that we have discussed the three major vision disease affecting African Americans let us now turn our attention to devices that can help alleviate the stresses of visual impairments.

Glaucoma

Glaucoma affects about 2.2 million Americans age 40 and over, and another 2 million don't even realize they have it. Glaucoma is most often called the silent thief of vision, and is the leading cause of blindness in African/African American over age 40 (healthgap.gov).

There are two forms of Glaucoma: acute closed angle glaucoma and open angle glaucoma. In acute angle glaucoma the pressure in the eye progresses rapidly and causes acute pain. This form of glaucoma hits suddenly and requires immediate surgery. It should be noted that this form of glaucoma is rare.

Open angled glaucoma is more common and can go undetected for years. While undetected the pressure in the eye continues to build and can cause irreversible vision loss, because the pressure damages the optic nerve fibers. Peripheral vision is most often affected by glaucoma. Advanced cases can lead to total blindness. The following list indicates the high risk factors for developing glaucoma:

1. Being over 55
2. Having a family history of glaucoma
3. Being very nearsighted
4. Having diabetes
5. Being African American/ African descent
6. Being Native American Cassel, Chapter 8)

If you fall into any of the previous six categories, make it a point to visit and discuss this information with your ophthalmologist. The next disease I would like to address is Diabetic Retinopathy.

Diabetic Retinopathy

Diabetic Retinopathy is the term used for the many vision related complications that result from one having diabetes. Diabetic Retinopathy affects more than 5.3 million Americans 18 and older. Diabetic retinopathy affects whites more than any other races prior to age 40. It is more prevalent in African /African American and Hispanic people over the age of 40.

This disease is the leading cause of blindness in person affected by diabetes. It is caused by the damaging of tiny blood vessels by diabetes. Like Glaucoma Diabetic Retinopathy generally goes unnoticed, but over time it can vision loss, and it usually affects both eyes. Diabetic Retinopathy occurs in four stages:

1. Mild Non proliferative Retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
2. Moderate Non proliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
3. Severe Nonproliferative Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
4. Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye (nih.gov).

The last disease that affects African/African Americans and the last disease I will address in this paper is Cataract.

There are two types of low vision aid optical and no optical I will discuss optical devices first.

Services Available

The following links are websites that deal specifically with blindness and other vision related problems. Please fell free to follow the link and learn of all the many services available to those who are blind or visually impaired. These sites also provide useful information for those who work with people affected by some degree of vision loss.

• nichcy.org
• aph.org
• afb.org
• lcweb.loc.gov
• nfb.org

Conclusion

"The right to sight is a basic human right. Nevertheless, it is an unaffordable luxury for almost 45 million people in the world, 6 million of whom live in Africa. The elimination of avoidable blindness by 2020 is a lofty goal and a tall target.