Visual Impairments,

including Blindness
Julian’ amblyopia, often have to use the
called “lazy weaker eye and
s eye.” As the strengthen its
Story most common communication
cause of vision with the brain.
When Julian problems in Otherwise, the
was almost two children, eye doctor said,
years old, he amblyopia is the the brain would
developed this medical term begin to ignore
adorable habit of used when the images sent
closing one eye vision in one eye by the weaker
when he looked is reduced eye, resulting in
at you. It almost because that eye permanent vision
seemed as if he and the brain are problems in that
were winking. not working eye.
The possibility together
that Julian had a properly.1 Julian Julian took
visual was also very good care of his
impairment farsighted, glasses, but he
didn’t initially especially in the didn’t take well
occur to his eye he’d taken to to the patch,
parents, but closing. unfortunately.
when Julian’s He ripped it off
right eye started Soon Julian every time his
crossing inward had a brand-new parents put it
toward his pair of durable on…and back
nose… glasses suited to on... and back on
his active two- again. So today
Off they year-old self. his eye still turns
went to the eye The inward if he
doctor, who eye doctor also doesn’t wear his
confirmed that, put an eyepatch glasses.
yes, Julian had a over Julian’s
visual better eye, so
impairment— that he would
 Visual 202.884.8200 vision loss goes
(Voice / undetected,
Impai TTY) children are
rment nichcy@fh delayed in
i360.org developing a
s in wide range of
http://nich
Childr cy.org skills. While
en A publication of they can do
NICHCY virtually all the
Vision is Disability Fact activities and
one of our five Sheet #13 tasks that sighted
senses. Being November children take for
able to see gives 2012 granted, children
us tremendous who are visually
access to impaired often
learning need to learn to
about the world
do them in a
around us—
different way or
people’s faces
using different
and the
tools or
subtleties of
materials.2
expression, what
Central to their
different things
learning will be
look like and
touching,
how big they
is the listening,
are, and the
National smelling, tasting,
physical
Disseminatio moving, and
environments
n Center for using whatever
where we live
Children with vision they
and move,
Disabilities. have.3 The
including
assistance of
approaching
parents, family
hazards.
NICHCY members,
1825 When a friends,
Connectic child has a visual caregivers, and
ut Avenue impairment, it is educators can be
N.W. cause for indispensable in
Washingto immediate that process.
attention. That’s More will be
n, DC
because so much said about this in
20009
learning a moment.
1.800.695.028
typically occurs
5 (Voice /
visually. When
TTY)

Types of Visual same, although the

umbrella term “visual
Impairment impairment” may be

Disability Fact Sheet #13 (FS13)

Not all visual used to describe

generally the
impairments are the
consequence of an eye near-sightedness and
condition or disorder. far-sightedness. Less
familiar visual
The eye has impairments include:
different parts that work
together to create our • strabismus, where
ability to see. When a the eyes look in
part of the eye doesn’t different directions
work right or and do not focus
communicate well with simultaneously on a
the brain, vision is single point;
impaired. • congenital
To understand
the particular
visual impairment
a child has, it’s
helpful to
understand the
anatomy of the
eye and the
functions of its cataracts, where
different parts. the lens of the eye is
Rather than go cloudy;
into those details
here, in this • retinopathy of
general fact sheet, prematurity, which
we’re pleased to may occur in
refer you to the premature babies
experts for easy- when the light-
to-understand sensitive retina
explanations and hasn’t developed
diagrams of the sufficiently before
visual system. birth;

★★National • retinitis
Eye Institute | pigmentosa, a rare
Visit the Institute inherited disease
online for a that slowly destroys
diagram of the the retina;
eye, what
different parts • coloboma, where a
are called, and portion of the
what aspect of structure of the eye
vision each part is missing;
is responsible • optic nerve
for.
hypoplasia, which
http://www.nei.nih.
is caused by
gov/health/eyediagr
underdeveloped
am/ index.asp
fibers in the optic
Most of us are nerve and which
familiar with visual affects depth
impairments such as perception,
 sensitivity to light, shape, or color; ability
and acuity of vision; to
and see things at a distance, up
close, or peripherally);
• cortical visual and
impairment (CVI),
which is caused by • how much correction is
damage to the part possible through glasses,
of the brain related contacts, medicine, or
to vision, not to the surgery.
eyes themselves.
The term “blindness”
There are also numerous does not necessarily mean
other eye conditions that can that a child cannot see
cause visual impairment. For anything at all. A child who
a more comprehensive is considered legally blind
glossary of conditions, here may very well be able to see
are two resource pages light, shapes, colors, and
you’ll find helpful: objects (albeit indistinctly).
Having such residual vision
★★American
can be a valuable asset for
Foundation for the
the child in learning,
Blind
movement, and life.
http://www.afb.org/
section.aspx?
FolderID=2&SectionID Signs of a
=93 Visual
★★American Impairment
Academy of Pediatrics It’s very important to
http://www.healthychild diagnose and address visual
ren.org/English/healthiss impairment in children as
ues/conditions/eyes/pag soon as possible. Some
es/Specific- vision screening may occur
EyeProblems.aspx at birth, especially if the
baby is born prematurely or
Because there are many there’s a family history of
different causes of visual vision problems, but baby
impairment, the degree of wellness visits as early as six
impairment a child months should also include
experiences can range from basic vision screening to

NICHCY: http://nichcy.org 2 Visual Impairment, including Blindness (FS

mild to severe (up to, and ensure that a little one’s eyes
including, blindness). The are developing and
degree of impairment will functioning as might be
depend on: expected.

• the particular eye That said, common signs

condition a child has; that a child may have a
visual impairment include:
• what aspect of the visual
system is affected (e.g.,
ability to detect light,
• Eyes that don’t move are Visual
together when following
an object or a face Impairments?
Very common,
• Crossed eyes, eyes that
especially as we grow older.
turn out or in, eyes that
But there are many causes of
flutter from side to side
visual impairments that have
or up and down, or eyes
nothing to do with the aging
that do not seem to
process, and children
focus
certainly can be—and are—
• Eyes that bulge, dance, affected. In the U.S., there
or bounce in rapid are approximately:
rhythmic movements
• 490,420 children with
• Pupils that are unequal vision difficulty (The
in size or that appear term “vision difficulty”
white instead of black refers only to children
who have serious
• Repeated shutting or difficulty seeing even
covering of one eye (as when wearing glasses
noticed with Julian) and those who are
blind.)5
• Unusual degree of
clumsiness, such as • 42,000 children with a
frequent bumping into severe vision
things or knocking impairment (unable to
things over see words and letters in
ordinary newsprint)6
• Frequent squinting,
blinking, eye-rubbing, • 59,341 children who are
or face crunching, legally blind7
especially when there’s
no bright light present Each year
States must
• Sitting too close to the report to the
TV or holding toys and U.S.
books too close to the Department of
face Education how
• Avoiding tasks and many children
activities that require with visual
good vision4 impairments
received
If any of these special
symptoms are present, education and
parents will want to have related services
their child’s eyes in our schools under
professionally examined. the Individuals with
Early detection and Disabilities Education
treatment are very important Act (IDEA), the
to the child’s development. nation’s special
education law. Data
How Common reported in 2011 (for
the school year 2010)
indicate that the
following numbers of visual impairments. So
children were served are the senses of smell,
in the U.S. and its touch, taste, and hearing.
outlying areas: Until the child holds the
“thing” to be learned
• 3,447 children (ages 3- and explores its
5) with visual dimensions—let us say,
impairment8 a stuffed animal, a dog,
a salt shaker, or a CD
• 25,670 children (ages 6- player —he or she
21) with visual cannot grasp its details.
impairment9 That is why sensory
learning is so powerful
Understand for children with visual
ing How impairment and why
they need to have as
Children many opportunities as
with Visual possible to experience
objects directly and
Impairment sensorially.
s Learn
Families, friends, and
Children with visual others can support
impairments can certainly sensorial learning in many
learn and do learn well, ways.
but they lack the easy
access to visual learning “Do you smell
that sighted children dinner?” appeals to
have. The enormous the child’s sense of
amount of learning that smell.
takes place via vision
must now be achieved “Listen to that bird
using other senses and singing outside” calls to
methods. the child’s hearing.
“That’s a robin” gives
Hands are a primary the child a name for the
information-gathering bird that sings the song
tool for children with he or she is hearing.

NICHCY: http://nichcy.org 3
Visual Impairment, including Blindness (FS13)

How IDEA Defines Visual Impairment

IDEA provides the nation with definitions of many disabilities that
can make children eligible for special education and related services
in schools. Visual impairment is one such disability the law defines—
as follows:
Visual impairment including blindness…
…means an impairment in vision that, even with
correction, adversely affects a child’s educational
performance. The term includes both partial sight and
blindness. [§300.8(c)(13)]
“Isn’t the bunny soft? And feel how long his ears are!” speaks to
the child’s sense of touch and helps the child build a picture of
the “whole” from the many details.10

Being able to see enables us to capture the “whole” of an

object immediately. This isn’t so for children with a visual
impairment. They cannot see the “whole,” they have to work
from the details up to build an understanding of the whole.

T
h
e

H
e
l
p

A
v
a
i
l
a
b
l
e
under disability and,
because of the
IDEA disability, need
If you suspect (or special services under
know) that your child IDEA. Those special
has a visual services are:
impairment, you’ll be
• Early
pleased to know there’s intervention
a lot of help available | A system
under IDEA— of services to
beginning with a free support
evaluation of your infants and
child. IDEA requires toddlers with
that all children disabilities
suspected of having a (before their
disability be evaluated 3rd birthday)
without cost to their and their
parents to determine if families.
they do have a
• Special then
education and he
related or
services | she
Services is
available eligi
through the ble
public school to
system for recei
school-aged ve
children, early
including inter
preschoolers venti
(ages 3-21). on
Vi servi
sual ce
impair s
ment, or
includ
ing
blindn
ess, is
one of
the spec
disabil ial
ities educ
specifi ation
cally and
menti relat
oned ed
and servi
define ces
d in unde
IDEA. r
If a IDE
child A
meets (dep
the endi
definit ng
ion of on
visual his
impair or
ment her
in age).
IDEA
as IDEA’s definition of
well visual impairment is
as the given in the box above.
State’
s
criteri
a (if
any),
NICHCY: http://nichcy.org child, parents work together
4 with program professionals to
develop a plan of services the
Accessing early
child will receive based on his
intervention (EI) | To identify
or her needs. In early
the EI program in your
intervention, that plan is
neighborhood, consult
called the IFSP
NICHCY’s State
(individualized family service
Organizations page for your
plan). In special education,
state, online at:
the plan is called the IEP
http://nichcy.org/state-
(individualized education
organization-searchby-state
program). Parents are part of
Early intervention is listed the team that develops their
under the first section, State child’s IFSP or IEP.
Agencies. The agency that’s
identified will be able to put
Visual Impairment, including
you in contact with the early
Blindness (FS13)
intervention program in your
community. There, you can There’s a lot to know
have your child evaluated free about early intervention for
of charge and, if found eligible, infants and toddlers with
your child can begin receiving disabilities and about special
early intervention services education and related services
designed to address his or her for school-aged children.
developmental needs Visit NICHCY’s website and
associated with the visual find out more about these
impairment. crucial services for eligible
children with visual
Accessing special impairments, beginning at:
education and related
services | If your child is • Early
between 3 and 21 years of age, intervention
we recommend that you get in http://nichcy.org/
touch with your local public babies
school system. Calling the
• Special
public school in your
education and
neighborhood is an excellent
related services
place to start. The school
http://nichcy.org/
should be able to tell you the
next steps to having your child schoolage
evaluated free of charge. If
found eligible, your child can Working with
begin receiving services the
specially designed to address
his or her educational needs Medical
and other needs associated with Community
the disability.
If you have a child with a
Developing a written plan visual impairment, you’ll
of services | In both cases—in probably find yourself
early intervention for a baby or dealing with a variety of eye
toddler with a visual care professionals who
impairment and in special become involved to diagnose
education for a school-aged and address your child’s
specific disability or eye A
condition. Wondering who
these professionals might be, d
what qualifications they should a
have, and what kind of
expertise they can bring to your
p
child’s care? t
Family Connect is an i
excellent source of this n
information. Family Connect is
an online, multimedia
g
community created by the
American Foundation for the t
Blind (AFB) and the National h
Association for Parents of
Children with Visual e
Impairments
(NAPVI). We suggest you E
download (or read online)
Family Connect’s toolkit called
n
Working with Medical v
Professionals. i
★★ The toolkit is r
available online in English o
and Spanish, at:
http://tinyurl.com/8an8all n
Need a glossary? |
m
Becoming familiar with e
medical terminology relating to n
the visual system may also
prove helpful, especially when t
talking to medical professionals Making adaptations to
and reading about your child’s the environment where a
impairment. If you’re baffled child with a visual
by the terms you hear, impairment lives, works, or
visit the Glossary of Eye plays makes evident sense,
Terminology, which lists but it may be difficult for
common terms that eye doctors families, daycare
use when discussing providers, or school
symptoms, tests, treatments, personnel to decide what
surgery, diseases and kinds of adaptations are
conditions, and the anatomy of necessary to ensure the
the eye. child’s safety while also
encouraging his or her
★★ The glossary’s online
at:
ability to do things sighted peers, although
independently. they will probably do so in
adapted ways. They must
Two resources you can also learn an expanded set
consult, depending on your of skills that are distinctly
role in the child’s life, are: vision-related, including
learning how to:
★★ Family Connect |
Adapting Your Home • move about safely
http://tinyurl.com/c6gaq7o and independently,
which is known as
★★ IRIS orientation and
Center | Offers mobility (O&M);
a professional
development • use assistive
module for technologies
teachers called designed for
Accommodation children with visual
s to the Physical impairments;
Environment:
Setting up a • use what residual
Classroom for vision they have
Students with effectively and
Visual efficiently; and
Disabilities. • read and write in
http://iris.peabody.vanderb Braille, if
ilt.edu/v01_clearview/ determined
chalcycle.htm appropriate by the
IEP team of the
Educational child after a
Consideration thorough
evaluation.11
s
These are just some of
Children with visual
the skills that need to be
impairments need to learn
discussed by the student’s
the same subjects and
IEP team and included in
academic skills as their

the IEP, if the team decides that’s

appropriate. Each of the above skill
areas—and more—can be
addressed under the umbrella of
special education and related
services for a child with a visual
impairment.

NICHCY: http://nichcy.org 5
Visual Impairment, including Blindness (FS13)
 Tips for Teachers
—Learn as much as you can about thetional goals
specific visual impairment. Whatthe services and
are affected, and howtions he or she is to receive.
move about the classroom, see the board,—Consult
textbook? Parents (and thetors, the O&M
you
student!) can be an excellent source of this
information.supporting this student, ways to adapt
curriculum, and how to address the — Learn
andstudent’s IEP goals in your classroom.
classroom accommodations that truly help students with visual impairm
state or school district has listed a few in the resource section. Strongly
add
help educators support the student by making sure that needed
accommodations are provided for classwork, visual impairments.

homework, and testing. These will help the —Communicate wi

successfully.
Regularly share information about how the
stude
—If you are not part of the student’s IEP team, ask
for a copy of his or her IEP. The student’s educa-
References

1
Centers for Disease Control and Prevention (CDC). (2009,
July). Vision health initiative: Common eye disorders. Atlanta,
GA: Author. Online at:
http://www.cdc.gov/visionhealth/basic_information/eye_disord
ers.htm
2
American Foundation for the Blind. (2011).
Accommodations and modifications at a glance. Retrieved
September 24, 2012 from the Family Connect website:
http://tinyurl.com/7p5b7bk
3
American Foundation for the Blind. (2011). What's
different about the way visually impaired children learn?
Retrieved September 24, 2012 from the Family Connect
website: http://tinyurl.com/9pjyx2d
4
Zundel, I.H. (n.d.). Signs of possible vision problems in
toddlers. Retrieved September 24, 2012 from the EduGuide
website: http://www.eduguide.org/library/viewarticle/932/
5
American Foundation for the Blind. (2012, January).
Children and youth with vision loss. New York: Author. Online
at: http://www.afb.org/section.aspx?
SectionID=15&TopicID=411&DocumentID=4896
 6
Lighthouse International. (n.d.). Prevalence of visual
impairment. Online at:
http://www.lighthouse.org/research/statistics-on-vision-
impairment/prevalence-of-vision-impairment/
7
American Foundation for the Blind. (2012, January).
School experience for children and youth with vision loss. New
York: Author. Online at: http://www.afb.org/section.aspx?
SectionID=15&TopicID=411&DocumentID=4897
8
Data Accountability Center. (2011, July). Table 1-2.
Number of children ages 3 through 5 served under IDEA, Part
B, by disability category and state: Fall 2010. Online at:
https://www.ideadata.org/TABLES34TH/AR_1-2.pdf

References are continued on the next page.

NICHCY: http://nichcy.org 6
Visual Impairment, including Blindness (FS13)
 —Work with the early
interventionists or school staff (depending
on your child’s age) to
—Learn as much as you can about your child’s
build a solid individualized plan of
specific visual impairment. The more you know, the
more you can help yourself and your child. services and supports that address
your child’s unique developmental and
—Understand that your child is receiving small bits educational needs.
of information at a time, not all at once through
vision. Help your child explore new things with his or —Talk to other parents of children who have visual
her senses and build up a concept of the “whole.” impairments similar to your child’s. They can be a
great source of support and insight in the challenges
For example, your child might need to be shown a and joys of raising a child with vision problems.
banana, help you peel it, feel the banana without its Many of the organizations we’ve listed in the
skin, have a bite of it, and then help you mash it in Resources section have state or local chapters you
her bowl to understand the qualities of bananas and can contact.
that bananas can be eaten in different ways.12
You can also visit Parent to Parent, which
—Encourage curiosity and explore new things and specializes in teaming new parents up with veteran
places often with your child. Give lots of opportunity parents of children with similar disabilities. P2P is
to touch and investigate objects, ask questions, and online at: http://www.p2pusa.org/
hear explanations of what something is, where it p2pusa/sitepages/p2p-home.aspx
comes from, and so on.
—Keep in touch with the professionals working with
—Learn how to adapt your home, given the range and your child. Offer support. Demonstrate any assistive
degree of your child’s visual impairment. Help your technology your child uses and provide any
son or daughter explore the house and learn to information teachers will need. Find out how you can
navigate it safely. augment your child’s learning at home.
—Encourage your child’s independence by letting
him or her do things, rather than you doing them.
Teach how to do a chore by using hands-on guidance,
give lots of practice opportunities with feedback.
Now, your child knows the skill, too.

Tips for Parents

References (continued)

9
Data Accountability Center. (2011, July).Table 1-3.
Number of students ages 6 through 21 served under IDEA, Part B,
by disability category and state: Fall 2010. Online at:
https://www.ideadata.org/TABLES34TH/AR_1-3.pdf
10
American Foundation for the Blind. (n.d.). Promoting your
baby’s growth and development. Retrieved September 24, 2012
from the Family Connect website: http://tinyurl.com/92kzgt7
11
American Foundation for the Blind. (n.d.). The expanded
core curriculum. Retrieved September 24, 2012 from the Family
Connect website: http://tinyurl.com/97ora5j
12
American Foundation for the Blind. (2011). What's
different about the way visually impaired children learn? Retrieved
September 24, 2012 from the Family Connect website:
http://tinyurl.com/9pjyx2d

NICHCY: http://nichcy.org 7
Visual Impairment, including Blindness (FS13)
Organizations español:
http://www.familyconnect.or
American Council g/ parentsitehome.asp?
of the Blind lang=esp
800.424.8666 |
http://www.acb.org Foundation Fighting
Blindness
American Find your state chapter
Foundation for the right on the home page.
Blind 800.683.5555 |
Find services in your state 800.683.5551 (TTY)
right on the home page. http://www.blindness.org
800.232.5463 | /
http://www.afb.org
Lighthouse
American Printing International
House for the Blind 800.829.0500 |
800.223.1839 | http://lighthouse.org/
http://www.aph.org/ En español:
http://lighthouse.org/espanol/
Association for
Macular Diseases National Braille Association |
http://www.macula.or http://www.nationalbraille.org/
g/
National Braille Press
Family Connect 888.965.8965 |
http://www.familyconnect. http://www.nbp.org
org/parentsitehome.asp En
Resources of Additional Information
National Federation LOUIS—database of info
of the Blind on more than 386,000
http://www.nfb.org/ titles in accessible formats,
including braille, large
National Library print, sound recording, and
Service for the electronic files.
Blind and Physically http://louis.aph.org
Handicapped,
Library of Congress National Center on
http://www.loc.gov/n Accessible Instructional
ls/ Materials (AIM)—
excellent info for educators
National Eye Institute, and families on getting
National Institutes of Health AIM for students with
| http://www.nei.nih.gov/ visual impairments,
En español: blindness, or other print
http://www.nei.nih.gov/healt disabilities.
h/espanol/ index.asp http://aim.cast.org/

Prevent Blindness Other Helpful Resources

America
Resources for Living—an
800.331.2020 |
entire section of NFB’s
http://www.preventblindness
website that includes state
.org
and local connections for
areas of life such as: aids
and appliances, Braille,
closed circuit TVs, guide
dog schools, low vision,
Accessible Materials and technology.
http://www.nfb.org/living
Bookshare—for those with Education for Students
print disabilities, including with Blindness or Visual
visual impairments or Impairment—an entire
blindness. Offers free section of Perkins School
membership to qualified for the Blind’s website.
U.S. students and schools, http://www.perkins.org/res
and makes more than ources/scout/education/
169,000 titles available
digitally.
https://www.bookshare.org/
Learning Ally—for those
cannot read standard print.
This publication is made
Offers more than 75,000
possible through Cooperative
digitally recorded textbooks
Agreement #H326N110002
and literature titles for between FHI 360 and the
download. Formerly Office of Special Education
Recording for the Blind and Programs, U.S. Department
Dyslexic. | 800.221.4792 | of Education. The contents of
http://www.learningally.org/ this document do not
necessarily reflect the views
or policies of the
Department of Education,
nor does mention of trade
names, commercial
products, or organizations
imply endorsement by the
U.S. Government.