Blindness refers to a complete or near loss of vision. Although blindness is often irreversible, partial therapeutic success is possible.
What is blindness?
Blindness is described as a visual impairment in which a person’s vision is either nonexistent or very severely impaired. If the definition of blindness is based on German legislation, blindness exists, among other things, when there is a residual visual acuity of 2% or less in the better eye (despite the use of optical aids such as glasses or contact lenses). Blindness in the narrower sense does not include the clinical pictures of night blindness or color blindness. The German Social Security Code (Sozialgesetzbuch) provides for a claim for aid by an affected person in the case of blindness, since blindness is considered a severe disability. In distinction to the term blindness exists in medicine the expression of amaurosis; in the case of amaurosis any form of optical perception is missing in the affected person (one speaks then also of full blindness).
Causes
Possible causes of blindness are varied; for example, blindness may be either congenital or acquired during life. Congenital blindness, for example, may be due to a lack of important structures of the visual system or to undeveloped connections between the brain and the eye. In early childhood, blindness can develop, among other things, if the brain structures related to perception do not differentiate sufficiently. A person may also have genetic predispositions at birth that can cause blindness in the course of life. The most common cause of so-called acquired blindness in industrialized countries is degeneration of the macula (the point of sharpest vision) due to aging processes. Other causes include diseases such as cataracts, glaucoma, and diabetes.
Symptoms, complaints, and signs
In most cases, the complaints and symptoms of blindness are relatively clear. The affected persons can see thereby no more and orient themselves thereby also no more correctly. The blindness can be either already present since birth or acquired. If it occurs as a result of another disease or an accident, those affected usually suffer from other complaints and symptoms in addition to blindness. The disease significantly restricts the child development of the patient and can therefore lead to significant discomfort even in adulthood. Above all, the daily life of the affected person is significantly restricted, resulting in limitations in movement. As a result, most patients are also dependent on the support of other people in their daily lives and can no longer perform many everyday tasks without further assistance. Often, blindness thus also leads to psychological complaints or depression. In general, the patient’s risk of accidents is increased by the disease. If the blindness is caused by a tumor, it often leads to other complaints in the area of the head. However, no general prediction can be made about the course of these complaints.
Diagnosis and course
Often, blindness is irreversible (that is, it cannot be corrected by appropriate measures). In very rare cases, there may be a sudden blindness that disappears after a short time; in this case, the medical term is amaurosis fugax. The course of blindness depends mainly on the cause underlying the blindness. If blindness is present, it can be particularly important in the further course to provide the affected person with skills and aids for independent living within the framework of rehabilitation measures. Blindness is usually diagnosed on the basis of ophthalmological examinations in which, for example, visual acuity and pupil reactions are measured. In some cases, blindness is also diagnosed using imaging techniques (for example, MRI) or neurological examinations.
Complications
In blindness, a further course of the disease is unfortunately foldig difficult to predict and always depends on the individual situation of the affected person. As a rule, there is unfortunately no particularly positive course of this disease here. Blindness occurs in very many people from birth and can be cured only in very rare cases.For some people, blindness also occurs during life. This has to do either with genetic changes in the eye or with an accident which might occur. Even in such cases, unfortunately, there is no positive course of the disease. The patient has to learn to live with blindness and to cope with his life even with this disease. Very often, sudden blindness leads to severe depression, which should then be treated by a psychologist. If the blindness has existed since birth, usually psychological help is not necessary. In these cases, the patient learns very quickly to cope and live with blindness. In science, research in this direction is currently being carried out at full speed in order to possibly bring light into the lives of blind people after all.
When should you go to the doctor?
Spontaneous blindness or severe loss of vision in one or, in rare cases, both eyes is always a medical emergency that must be treated immediately. Affected individuals should by no means classify this phenomenon as harmless and temporary, as there is always a very serious cause behind these symptoms. Sudden blindness is often due to processes in the brain. Possible causes are hemorrhages, edema, or vascular occlusions that can be life-threatening, which makes seeing a doctor immediately all the more urgent. Bleeding under the retina or vitreous body as well as retinal detachment are also possible causes of sudden blindness. Especially in the case of retinal detachment, fast action is required. Affected persons should therefore already react adequately to the first signs. An incipient retinal detachment can be recognized by a number of symptoms. Patients often perceive flashes of light or black dots. In the next stage, the visual field narrows from the edge. In the event of such signs, an ophthalmologist or the nearest hospital must always be consulted immediately. The same applies if injuries to the eye have occurred, even if an impairment of vision is not immediately noticeable. A doctor or the optometrist should also be consulted promptly as a precaution in the event of difficulties or pain after removing a contact lens.
Treatment and therapy
The therapy of blindness also depends mainly on the cause of this blindness. If diseases of the retina or optic nerve are responsible for blindness, it is usually not possible to completely correct blindness. If degeneration of the retina takes place in a patient, which can be hereditary and which can result in blindness, one therapeutic option is, for example, permanent administration of vitamin A; in this way it may be possible to slow down the development of blindness. Gene therapy is a new therapeutic method for combating blindness; it has shown initial success with certain forms of amaurosis (total blindness). If blindness is triggered very suddenly (such as by the occlusion of a vessel), therapeutic approaches can also show moderate success in this case; for example, measures that promote blood circulation can help improve vision in this case.
Outlook and prognosis
In most cases, the prognosis for blindness is not very optimistic. Thanks to scientific and medical advances, many improvements have already been made in this field in recent years. Some causes of inadequate vision can already be successfully treated with surgical interventions thanks to developments in recent years. Nevertheless, in the case of damage to the retina or optic nerve, a cure has been considered virtually impossible up to now. Only in rare cases, for example, the insertion of a chip into the eye can lead to a return of eyesight and adequate vision. Due to the overall very poor prognosis prospects for blindness, treatment is often based on the individual sequelae of the patient. These are often of a psychological nature. Since the patient is dependent on the permanent help and support of another person to cope with everyday life, it is necessary to learn how to deal with the disease. To strengthen the general well-being, but also to prevent mental illness, the support of a therapist can be helpful.If mental or emotional stresses and personality and behavioral disorders already exist, medical support is necessary. This is the only way to ensure that the patient’s general state of health does not deteriorate by one more.
Prevention
To prevent blindness acquired during life, it may be useful to prevent various risk factors that can lead to blindness. For example, experts recommend regular ophthalmological checkups to detect diseases, dysfunctions or injuries of the eye at an early stage. This can possibly counteract subsequent blindness. To avoid injuries to the eye that can lead to blindness, it is recommended to ensure adequate protection of the eyes during dangerous activities.
Aftercare
In many cases, existing blindness has been present since birth, so follow-up examinations are not necessary. The optic nerve cannot be restored, so affected individuals must live with this disability. However, regular visits to therapists are recommended in order to be able to cope with everyday life accordingly. The situation is different if the blindness only occurs in the course of life. In such a case, it is much more difficult for affected persons to live with this sudden restriction. Follow-up examinations with appropriate therapists and psychologists are urgently required in order to come to terms with this drastic experience. Regular visits to the ophthalmologist are also imperative in order to continue to ensure the chances of recovery. In the case of an existing blindness, the chances of a complete recovery are not very positive. If the blindness has been present since birth, then usually no further treatment measures need to be taken. If the blindness develops only in the course of life, then regular follow-up examinations can have a positive effect on the entire healing process. For this reason, the affected person should not forgo such follow-up examinations. Visits to therapists and psychologists can also help to live with chronic blindness or even to pursue an activity.
Here’s what you can do yourself
Blindness, with its complete lack of visual perception or only a low degree of visual perception, is usually accompanied by a pronounced need for assistance on the part of those affected. In order for the blind to get through life more easily and to be able to master their everyday lives largely independently, they usually make use of small aids. The mobility of the blind can be improved by means of a long cane or a guide dog. The long cane as a navigation aid helps the blind to determine the materials in their near environment. Guide dogs are intensively trained animals that can lead the blind people past dangerous obstacles. In order for the blind to be recognized at a glance by those around them, they wear a yellow armband with three black dots. Blind people can read by means of Braille despite their limited visual perception. Braille is made up of small dots that can be felt and deciphered with the fingers. Using speech output or the Braille display, blind people can also surf the Internet and find out about news. To make life easier for blind people, there are various aids for everyday life. Thanks to bill validators and coin sorting boxes, the blind can handle cash independently. Adapted household appliances, such as microwave ovens with voice output, talking measuring cups or scales, are also a great help in the household.