Blindness

Under blindness is defined as the most prominent form of visual impairment with entirely missing or only very low existing visual perception of one or both eyes. It can be congenital or acquired and is usually irreversible. If a blindness affects both eyes, she is a serious disability, in principle, there is a right to aid in the form of blind money according to German legislation. He is in the country Blind Benefit Act or a blind help the Social Code ( SGB XII, § 72) regulated ( here an example).

Definitions

Tube field to a maximum of 5 ° or graded mixed forms

In Germany applies to the statutory provisions and care guidelines a person as blind if their visual acuity is in the better eye even with optimal eyeglass or contact lens correction at most 1/ 50 = 0.02 ( somewhat misleadingly referred to as " 2% or less " ), or other permanent disorders of vision are available, which are tantamount to such harm. According to the German Ophthalmological Society (DOG) this applies for example to the concentric restriction of the outer field boundaries to a maximum of 5 degrees ( tube -power field). Not to blindness in this sense include color blindness ( achromatopsia ) and night blindness ( amblyopia ).

To illustrate: A visual acuity (visual acuity ) of 1/ 50 = 0.02, which represents the limit to blindness entitled to blind money means that the straight -readable optotypes have 50 times the reference size of 5 Sehwinkelminuten. These are Sehwinkelgrad 4.17, which corresponds to a font size of 2.2 cm at 30 cm reading distance.

A reduction of visual acuity to less than 0.3 in the better eye is referred to as visual impairment. As a severely visually impaired is a person who has the best seeing eye with optimum correction only a visual acuity of not more than 1/ 20 = 0.05.

The definition of blindness or visual impairment occurs in the legal sense always with reference to the affected "person" and not to the eye as "organ". Visual impairment, severe visual impairment and blindness can contrast with the limits specified in each case also one-sided - with normal visual performance of the healthy eye - occur. Although this results from the medical point to a one-eyed ( monocular ) visual impairment or blindness, but the person in question does not apply in the legal sense as blind or partially sighted, so here is also not entitled to benefits in the adoption of an adequate orientation assets despite practical monocular vision.

Amaurosis

Compared with the term " blindness " refers to the medical term amaurosis only the complete lack of light perception of one or both eyes at the loss of any visual stimulus processing (full blindness).

Causes and dissemination

Basically, any failure of a structure of the visual system can lead to blindness.

• Congenital blindness missing elements of the visual apparatus
• Missing link between the eye and brain

• Insufficient differentiation of cortical Sehstrukturen ( amblyopia ), eg by disease squint (strabismus )

• Age-related macular degeneration ( AMD), the most common causes in developed countries, about 50 % D
• Clouding of the eye lens ( cataract), the world's leading cause
• Diabetes, in D is about 17%
• Acute or chronic glaucoma ( glaucoma), in D is about 20%
• Retinal detachment
• Result of a stroke
• Embolism or thrombosis of the blood vessels supplying
• Injuries
• Infections (eg, trachoma )

According to the WHO Report 2004 live in Germany 164,000 (0.2%) blind and 1.066 million (1.3%) visually impaired people. In Germany about 10,000 people go blind every year new ( incidence 12.3 / 100,000 ) and about 160 children are born blind (2 10,000). While there have been between 1990 and 2002 only to a moderate increase of blindness by 9 %, an increase of visual impairment by 80 % was registered. This is mainly due to the increased life expectancy. While the optic atrophy is considered as the most common cause of blindness in people 39 years of age up to, this is in the age group from 40 to 79 years of age, the diabetic retinopathy and from the age of 80, the age- related macular degeneration, followed by glaucoma. Since 48% of all blindness from the age of 80 occur as age-related macular degeneration is overall the most common cause of blindness in Germany. 68% of all Neuerblindungen affect women. His main reason is that women are disproportionately represented in this age group due to their much higher life expectancy.

Harsh orientation, aid dependency, decreased social and occupational opportunities

Blindness is always associated with a limitation of the spatial orientation assets. This can be extended to acoustic and tactile way. A number of blind -specific tools facilitating the daily life, but this can lead to a corresponding dependence in several ways. An independent, independent living is the goal of most of those affected, a relative need for assistance remains are often made. Often cause lack of education resources, job opportunities and reduced autonomous mobility and social contacts about problems that can be expressed in social withdrawal. These conditions are often exacerbated by the public image, which is often marked by prejudice and ignorance.

An infrastructural, social and cultural openness to the needs of people who are visually impaired, it should allow to meet the different needs of all people. One example is the city of Marburg with the resident Blindenstudienanstalt that for decades in promoting and training people who are blind or have low vision, progresses. The key priority is not only the development of appropriate tools such as acoustic traffic lights or menus in Braille, but also the implementation of a consistent inclusion of all people from the beginning, and the inclusion of different needs in the entire infrastructural, social, cultural and urban fabric of a city.

Training, media and tools

Promotion

Since therapeutic options in cases of blindness often do not exist, specific training (rehabilitation) is of great importance. Goal is especially blind people to enable independent and autonomous life, which is generally perceived as a higher quality of life.

Especially with blind and visually impaired children is an early intervention that works immediately after birth, is crucial. Later, these should either by specialized kindergartens and special schools, or integrated into mainstream kindergartens, be continued. Early Intervention is a safe prerequisite to successfully shape the intellectual development, independence and professional opportunities of a person who is born blind or blinded early may.

See also: German Institute for the Blind, Institution for the Blind Nuremberg, Nikolauspflege, Berufsförderungswerk Würzburg, Institute for the Blind Foundation

Media

The 1825 developed by Louis Braille Braille, called Braille, blind people allows reading and writing of texts. Other Braille systems have been almost entirely supplanted by the Braille. The writing of texts is possible, for example with a braille machine such as the Perkins Brailler. The first typewriter for Braille was invented in 1899 by Oskar Picht. Today there are also Braille displays and Braille printer for the PC.

Libraries for the blind and produce profit associations and lend books, journals and texts in audio and Braille format. In the German speaking these libraries and clubs have joined forces for the media community for blind and visually impaired people, short Medibus. There are only three children's books available as a tactile picture books, learning to read books or books for preschool children in Germany. In addition, there is little film collections in file folders. The most common loan are the record medium. Shipping is free of postage as for the blind. Previously, audiobooks and Hörzeitschriften were awarded at today obsolete compact cassette, between 2004 and 2010 was converted to CDs in DAISY format. DAISY is the name of a worldwide standard for navigable and wheelchair accessible multimedia documents. The acronym DAISY stands for "Digital Accessible Information System ". Also commercial audiobooks allow blind people access to literature.

Some TV channels broadcast movies in dual-channel, where on the second channel audio description by the story being told. This method is also used in films, often through headphones, then one speaks of a sound movie.

Tastgrafiken on swell paper and Tactile maps will help blind people, images, and spatial relationships to " understand ". In known structures sometimes tactile models of the plant or buildings are erected.

In addition, send some local radio stations in German-speaking local news for the visually impaired, where local newspapers are read. Especially in English speaking countries there is also the so-called Radio Reading Service ( German: Radio reading service), in the all-day news and literature for the blind are often read to live normally. Some of these services can be received via live stream also with us via the Internet. The podcast has become a popular medium for entertainment and information exchange over the Internet.

Computer use

Blind people can use computers with the help of a so-called screen reader software for Windows such as COBRA or JAWS or NVDA the free and for Apple computers with the free VoiceOver. Screen readers are also available for smartphones based on operating system Google Android and Apple iOS are available, thus offering the possibility of communication and navigation software to use on the move. The screen content and the controls are read by a screen reader or braille output in on a Braille display. On the PC keyboard is written in the ten-finger system and the navigation is done with certain key combinations and the cursor keys instead of a mouse. Printed on paper texts such as books and letters can be read with a scanner and a text recognition software. Blind Internet users rely on a low-barrier design of websites.

Since many people go blind only in old age, and have difficulty learning to operate a personal computer, there are special reading systems, which printed texts can be easily collected, stored and read.

Mobility

Blind people can reasonably independently cope in their environment after an orientation and mobility training (O & M). The correct use of a white long pole protects against collisions and crashes, and can provide valuable information for orientation in the vicinity, as well as hearing and sense of smell. From birth blind them to have a certain advantage over later blinded, most likely because they shared use this neural capacities of the visual cortex ( visual cortex ) in the brain: These so-called active human echolocation can seeing with the eyes partially imitate.

Early Intervention

For the successful development of a child who was born blind, it is crucial to all stages of development and feed rates similar to sighted children age-appropriate to go through '. Mostly have children who are visually impaired or blind, during the sensitive phases are promoted, otherwise with sighted children similar development can be threatened. In addition, the ability for passive and active echolocation by early and regular training should be improved, but it represents only one aspect of targeted support for children who are blind or visually impaired, is: The perception of promotion plays a central role in general in early intervention of children with sensory limitations, especially the promotion of the understanding of space. A pioneer in this area is the Danish psychologist Lilli Nielsen, scientific research in this field for decades, and has also published in this regard conveying materials developed. Lately Daniel Kish found media attention, which has also developed training plans for toddlers who are supposed to represent a new standard in early intervention and mobility training.

Animals

On familiar roads or in familiar territory blind people can get much better geared than in completely unfamiliar surroundings. Guide dogs perform their holder on the optimal path and avoid obstacles. Search for and find on command individual away goals as traffic light posts, mailboxes, entryways or free seats in public transport.

There are attempts to train horses of the breed Falabella to seeing-eye animals. Chance of animals are already in use.

Satellite-based navigation

Satellite-based navigation and spatial information systems that can be used with blind -to-use mobile devices, present a great opportunity for improving mobility and quality of life of blind people dar. As the first satellite-based navigation aids were in German-speaking free software Loadstone -GPS and the commercial product Wayfinder Access utilized. The free program runs on high-order Nokia mobile phones which are operated by using a screen-reader software for the blind. The information of the screen output from a voice over the loudspeaker. In addition to navigation systems such as Kapten Plus or Trekker Breeze, there are some apps for smartphones like the Apple iPhone, which can be used by screen readers such as Voice Over by the blind.

Tactile ground control systems

Soil indicators such as grooves and nubs patches should assist in orientation and navigation in squares, streets, sidewalks and in public buildings or in stations blind long cane users. If in addition to these tactile marking strip also other aids such as labels in Braille and voice announcements in elevators provided, one speaks of a blind control system. Traffic lights with audible or vibrating signals and properly secure construction sites and bottom openings make on the road for blind pedestrians less dangerous.

Identification

→ Main article: labeling for visually impaired and blind people

A labeling of blind people who partake in traffic is legally governed by § 2 ( Limited admission ) the driving license regulations. Blind pedestrians have their disability by a white long cane, make the accompaniment of a guide dog harness in white or yellow armbands with three black dots for other persons identified to be excluded from the principle of legitimate traffic regulations; a legal obligation to label but there is no. Other road users may not use these marks on the road.

General tools

For the everyday life there are many different tools. It starts with simple things such as tactile or talking watches, dictating machines, bill acceptors or Münzsortierboxen for the independent handling of cash and goes adjusted household appliances such as a microwave device with voice output to speaking measuring cups, scales, thermometers, blood pressure or blood glucose monitors for diabetics and small electronic devices for marking items such as CDs with barcode or RFID labels, each with its own voice recording. For some time there skat cards, which are covered with a plastic sheet, so seeing people play as usual and the blind can feel the cards at once. A selection template allows for independent participation in political elections.

Others

Blind people have usually a higher than average trained sense of touch. This particular feature is used for the early detection of breast cancer. As part of the based in North Rhine -Westphalia model project "Discovering hands" ( hands -discovered ) the training course at the Medical Tastuntersucherin was created.

Sleep disorders in blind people

For blind people, who can not perceive the light -dark cycle, it often comes to Circadian sleep-wake rhythm disorders of the type of free-running rhythm and other sleep-wake rhythm disorders, as for synchronizing popularly known as " internal clock" called Circadian rhythm does not work by the timer light -dark cycle properly.

Museums and experience rooms

Experience areas such as the exhibition Dialogue in the Dark, the dialog museum or dark restaurants offer sighted people in a protected environment, a self-experience possible on the subject of blindness.

Blindness in language, art and literature

Blindness appeared frequently as a theme in myths, stories and illustrations of all kinds. Mention may be made about the legendary Greek seer Tiresias and the old Oedipus. John 9:25 tells of the miraculous healing of a blind man through Jesus Christ. The story was picked up by the painter El Greco, but also of John Newton 's famous hymn Amazing Grace. The parable "If a blind man leads another, both shall fall into the ditch " (Matthew 15:14), however, is Pieter Brueghel's picture The Blind Leading the Blind in 1568, is based. Likewise are blind in the center of literary works (eg in Vladimir Nabokov's novel " King Queen Knave " José Saramago's novel or " Blindness ").

In a figurative sense, the ability to see often is the ability to perceive reality at all. The same metaphor applies to the absence of the two abilities:

• " I want to keep the thing in mind " or ". I want to keep an eye on " means: I want to ensure that the matter is progressing satisfactorily.
• " Someone is politics blind or blind to reality " means that he does not understand the interrelationships in politics or reality.
• " Love is blind " means: Whoever loves that recognizes or the lover not the way she or he really is.
• "They were on the right (or left ) eye blind" indicates a partisan attitude which is opposed to the political "right" (or " left" ) tends to tolerance and forbearance.
• ". Which I must go to open the eyes " means: The I want to explain what is really happening and what the related.
• If a case is entirely unique, one says folksy rough: " That looks a blind man with his cane. "
• " Among the blind the one-eyed king " - even something or someone with really only average properties in a field exceeds others that have such properties do not boast.