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A DESCENT INTO BLINDNESS Thoughts on

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SHADE This is a new collection with a delicate, cloudlike surface. This charming, innovative paper has echoes of traditional fine Japanese papermaking. Gmund Paper North America 64 Wall Street Floor 2, suite 213 Norwalk, CT 06850 USA Contact Tara Pagano Tel: + 1 888 884 6863 Email: tarapagano@gmund-usa.com www.gmund.com


DEDICATED TO My dear

Myly for helping me

see my potential


I am blinded when

by frustration


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40 ft.

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TABLE OF CONTENTS 10_13

Levels of Blindness blindness 14_1

18_21

Legal Blindness legal

Total Blindness total

26_27

28_29

Visual Acuity Testing testing

Acuity Rating rating


30_31

Adapting your Senses senses

32_33

34_37

Sense of Sound sound

Sense of Touch touch

38_ 39

Production Notes production


genital Amaurosis damages the light

Medicine[18]

in the retina and usually begins sight in early childhood, with vision until complete blindness

e age.

tested the effect of using gene

used a common cold virus to deliver

version of the gene called RPE65

into the eyes of affected patients.

y all 3 patients aged 19, 22 and 25

therapy to help restore the sight of

effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening vision until complete blindness around the age. The study used a common cold virus to deliver

OF LEVELS SBLINDOF DOFBLIND ELS NESS well to the treatment and reported

vision following the procedure.

e age of the patients and the

ive nature of LCA the improvement of

patients with a rare form

of inherited

gene therapy patients is encouraging

rchers. It is hoped that gene therapy

en more effective in younger LCA

who have experienced limited vision

blindness, known as Leber

ell as in other blind or partially

Congenital

ividuals.

Amaurosis or LCA. Leber Congenital Amaurosis damages

the light

receptors in the retina

and usually begins

affecting sight in

cold virus to deliver

WHAT IS BLINDNESS

vision loss as well

as in other blind vision loss as well as in other blind

the retina

Blindness is the condition of one lacking visual perception due to the physiological or neurological factors. Various scales have been developed to describe the extent of vision loss and blindness.


Legal Blindness In order to determine which people may need special assistance because of their visual disabilities, various governmental jurisdictions have formulated more complex definitions referred to as legal blindness.In North America and most of Europe, legal blindness is defined as visual acuity vision of 20/200 (6/60) or less in the better eye with best correction possible. Meaning legally blind individual would have to stand 20 feet (6.1 m) from an object to see it with vision correction with the same degree of clarity as a normally sighted person could.

Total blindness Is the complete lack of form and visual light perception and is clinically recorded as NLP, an abbreviation for no light perception. Blindness is frequently used to describe severe visual impairment with residual vision. Those described as having only light perception have no more sight than the ability to tell light from dark and the general direction of a light source.


Anyone Anyone with vision with vision worseworse than 20/200 than 20/200 that cannot that cannot be improved be improved with corrective with corrective lenseslenses is considered is considered legallylegally blind. In blind. addition, In addition, peoplepeople with awith visual a visual field offield lessofthan less20 than degrees 20 degrees diameter diameter 10 10 degrees degrees radiusradius are also areconsidered also considered legallylegally blind. blind. The American The American Optometric Optometric Association Association statesstates that a that person a person with with 20/2020/20 vision vision can clearly can clearly identify identify a row aofrow 9mm of letters 9mm letters from from 20 feet. 20Afeet. legally A legally blind person blind person with vision with vision of 20/200 of 20/200 has tohas be to be as close as as close 20 as feet 20tofeet identify to identify objects objects that people that people with normal with normal vision vision can spot canfrom spot200 fromfeet. 200So feet. a legally So a legally blind person blind person needsneeds a a distance distance of twooffeet twotofeet spottothe spot letters the letters on a standard on a standard eye chart eye chart that isthat 20 feet is 20away. feet away. Legal Legal blindness is veryiscommon in older because blindness very common in people older people because eyesight tends tends to worsen with time 135 135 eyesight to worsen withand timeage. andApproximately age. Approximately out of out every peoplepeople over the age 65 of are65 considered of 1,000 every 1,000 over theofage are considered legallylegally blind. About 1.3 million Americans fall into blind. About 1.3 million Americans fallthis intocategory. this category. Only about 10% of legally blind people read Braille, and a and much Only about 10% of legally blind people read Braille, a much smallersmaller percentage use white canescanes or guide dogs. dogs. percentage use white or guide Anyone with vision worseworse than 20/200 that cannot be improved with corrective Anyone with vision than 20/200 that cannot be improved with corrective lenseslenses is considered legallylegally blind. In addition, peoplepeople with awith visual field offield lessofthan is considered blind. In addition, a visual less than 20 degrees diameter 10 degrees radiusradius are also legallylegally blind. blind. 20 degrees diameter 10 degrees areconsidered also considered The American Optometric Association statesstates that a that person with 20/20 vision vision The American Optometric Association a person with 20/20 can clearly identify a row aofrow 9mm from 20 feet. legally blind person with with can clearly identify of letters 9mm letters from 20Afeet. A legally blind person vision vision of 20/200 has tohas be as close 20 as feet of 20/200 to be as as close 20 feet to identify objects that people with normal vision vision to identify objects that people with normal can spot a l So gally canfrom spot200 fromfeet. 200So feet. a lblind gallyperson blind person needsneeds a distance of twooffeet spottothe letters on on a distance twotofeet spot the letters a standard eye chart 20 feet a standard eye that chartisthat is 20away. feet away. Legal Legal blindness is veryiscommon in older blindness very common in people older people because eyesight tends tends to worsen with time because eyesight to worsen withand time and age. Approximately 135 out of out every peoplepeople age. Approximately 135 of 1,000 every 1,000 over the age 65 of are65 considered legallylegally blind. About 1.3 million Americans fall into over theofage are considered blind. About 1.3 million Americans fallthis intocategory. this category. Only about 10% of legally blind people read Braille, and a and much smallersmaller percentage use white canescanes Only about 10% of legally blind people read Braille, a much percentage use white or guide dogs. Anyone with vision worseworse than 20/200 that cannot be improved with corrective or guide dogs. Anyone with vision than 20/200 that cannot be improved with corrective lenseslenses is considered legallylegally blind. In addition, peoplepeople with awith visual field offield lessofthan degrees is considered blind. In addition, a visual less20 than 20 degrees diameter diameter 1 0 degrees 1 0 degrees radiusradius are also areconsidered also considered legallylegally blind. blind. The American The American Optometric Optometric Association Association statesstates that a that person a person with 20/20 with 20/20 vision vision can clearly can clearly identify identify a a row ofrow 9mm of letters 9mm letters from 20 from feet. 20Afeet. legally A legally blind person blind person with vision with vision of 20/200 of 20/200 has tohas be as to be close as as close as 20 feet 20tofeet identify to identify objectsobjects that people that people with normal with normal vision vision can spot canfrom spot200 fromfeet. 200So feet. a legally So a legally blind blind personperson needsneeds a distance a distance of twooffeet twotofeet spottothe spot letters the letters on a standard on a standard eye chart eye that chartisthat 20 feet is 20away. feet away. Legal Legal blindness blindness is veryiscommon very common in older in people older people because because eyesight eyesight tends tends to worsen to worsen with time withand time and age. Approximately age. Approximately 135 out 135 of out every of 1,000 every 1,000 peoplepeople over the over age theofage 65 of are65 considered are considered legallylegally blind. blind. AboutAbout 1.3 million 1.3 million Americans Americans fall into fallthis intocategory. this category. Only about Only about 10% of 10% legally of legally blind people blind people read read Braille,Braille, and a and much a much smallersmaller percentage percentage use white use white canescanes or or guide guide dogs. Anyone dogs. Anyone with vision with vision worseworse than 20/200 than 20/200 that cannot that cannot be improved be improved with corrective with corrective lenseslenses is considered is considered legallylegally blind. blind. In addition, In addition, peoplepeople with awith visual a visual field offield lessofthan less20 than degrees 20 degrees diameter diameter 10 degrees 10 degrees radiusradius are also areconsidered also considered legallylegally blind. blind. The American The American Optometric Optometric Association Association statesstates that a that person a person with with 20/2020/20 vision vision can clearly can clearly identify identify a row aofrow 9mm of letters 9mm letters from from 20 feet. 20Afeet. legally A legally blind person blind person with vision with vision of 20/200 of 20/200 has tohas be to be as close as as close 20 as feet 20tofeet identify to identify objects objects that people that people with normal with normal vision vision can spot canfrom spot200 fromfeet. 200So feet. a legally So a legally blind person blind person needsneeds a a distance distance of twooffeet twotofeet spottothe spot letters the letters on a standard on a standard eye chart eye chart that isthat 20 feet is 20away. feet away. Legal Legal blindness blindness is veryiscommon very common in older in people older people because because eyesight eyesight tends tends to worsen to worsen with time withand timeage. andApproximately age. Approximately 135 135 out of out every of 1,000 every 1,000 peoplepeople over the over age theofage 65 of are65 considered are considered legallylegally blind. About blind. About 1.3 million 1.3 million Americans Americans fall into fallthis intocategory. this category. Only about Only about 10% of 10% legally of legally blind people blind people read Braille, read Braille, and a and much a much


Anyone Anyone with vision with vision worseworse than 20/200 than 20/200 that cannot that cannot be improved be improved with corrective with corrective lenseslenses is considered is considered legallylegally blind. In blind. addition, In addition, peoplepeople with awith visual a visual field offield lessofthan less20 than degrees 20 degrees diameter diameter 10 10 degrees degrees radiusradius are also areconsidered also considered legallylegally blind. blind. The American The American Optometric Optometric Association Association statesstates that a that person a person with with 20/2020/20 vision vision can clearly can clearly identify identify a row aofrow 9mm of letters 9mm letters from 20 from 20 feet. Afeet. legally A legally blind person blind person with vision with vision of 20/200 of 20/200 has tohas be as to be as close as close 20 as feet 20tofeet identify to identify objectsobjects that people that people with normal with normal vision vision can spot canfrom spot200 fromfeet. 200So feet. a So a legallylegally blind person blind person needsneeds a distance a distance of twooffeet twotofeet to spot the spot letters the letters on a standard on a standard eye chart eye that chartisthat 20 feet is 20away. feet away. Legal blindness The American is very Optometric common in older Association people because states eyesight that a person tends with to worsen 20/20with vision time can and clearly age. Approximately identify a row 135 of 9mm out of letters every 1,000 from 20 people feet. A over legally the blind age ofperson 65 arewith considered vision oflegally 20/200 blind. hasAbout to be 1.3 as close millionasAmericans 20 feet tofall identify into this objects that category. people Onlywith about normal 10%vision of legally can spot blind from people 200 read feet. Braille, So a legally and a much blind person smaller needs percentage a distance use white of twocanes feet to or spot guidethe dogs. letters on a standard eye chart that is 20 feet Anyone away. with vision worse than 20/200 that cannot be improved with corrective lensesLegal is considered blindnesslegally is veryblind. common In addition, in olderpeople peoplewith because a visual eyesight field oftends less than to 20 degrees worsendiameter with time 10and degrees age. Approximately radius are also135 considered out of every legally 1,000 blind. people over The American the age of Optometric 65 are considered Association legally states blind. thatAbout a person 1.3 with million 20/20 Americans vision fall into can clearly this category. identify aOnly row about of 9mm 10% letters of legally from 20 blind feet. people A legally readblind Braille, person and awith much vision smaller of 20/200 percentage has to beuse as white close canes as 20 or feet guide to identify dogs. Anyone objects with that people vision worse with than normal20/200 vision can thatspot cannot frombe200 improved feet. Sowith a legally corrective blindlenses personisneeds considered a distance legally blind. of twoInfeet addition, to spotpeople the letters with aonvisual a standard field ofeye lesschart thanthat 20 degrees is 20 feetdiameter away. 10 degrees Legal radius blindness are is also very considered common in legally olderblind. people because eyesight tends to worsen The with American time andOptometric age. Approximately Association 135 states that out of aevery person 1,000 withpeople 20/20over vision thecan ageclearly of 65identify a are considered row of 9mm legally letters blind. from About 20 feet. 1.3 million A legally blind Americans person fallwith intovision this category. of 20/200 Only has about to be10% as close of legally as 20 blind feet people to identify read objects Braille, and thatapeople much with smallernormal percentage vision can use spot whitefrom canes 200 or feet. guideSo a legally dogs. Anyone blind person with needs vision worse a distance than of 20/200 two feet to spot that cannot the letters be improved on a standard with corrective eye chartlenses that isis20 feet considered away. legally blind. In addition, people with a visual field of less than 20 degrees diameter 10 degrees Legal radius blindness are alsois considered very common legally in older blind. people because eyesight tends to worsen with time and The American age. Approximately Optometric135 Association out of every states 1,000 that people a person over with the 20/20 age ofvision 65 are canconsidered clearly identify legally a blind. row ofAbout 9mm 1.3 letters million fromAmericans 20 feet. Afall legally into blind this category. person with Onlyvision aboutof10% 20/200 of legally has toblind be as people closeread as 20 feet Braille, to identify and aobjects much smaller that people percentage with normal use white visioncanes can spot or guide from dogs. 200 feet. Anyone So awith legally vision blind worse personthan needs 20/200 a distance that cannot of two be feetimproved to spot the withletters corrective on a lenses standard is considered eye chart that legally is 20blind. feet In away. addition, Legal people blindness with is avery visual common field ofinless older than people 20 degrees becausediameter eyesight10 tends degrees to worsen radiuswith are time also and considered age. Approximately legally blind. 135 out of every 1,000 people over the age of 65 The are considered American Optometric legally blind. Association About 1.3 states millionthat Americans a person with fall into 20/20 this category. vision can Only clearly about identify 10% of a row legally of 9mm blind letters peoplefrom read Braille, 20 feet. and A legally a muchblind smaller person percentage with vision useofwhite 20/200 canes hasorto be guide as dogs. close Anyone as 20with feetvision to identify worseobjects than 20/200 that people that with cannot normal be improved vision can withspot corrective from 200 lenses feet.isSo considered a legally blind legally person blind. needs a In addition, distance people of two withfeet a visual to spot field theofletters less than on a20 standard degrees eye chart diameter that10 is 20 degrees feet away. radius are also considered legally blind. The American Legal blindness Optometric is very Association common in states olderthat people a person because with 20/20eyesight vision can tends clearly to worsen identifywith a row time of and 9mmage. letters Approximately from 135 20 feet. outAof legally everyblind 1,000 person people with over vision the age of 20/200 of 65 are hasconsidered to be as close legally as 20 blind. feetAbout to identify 1.3 million objects Americans that people fallwith intonormal this category. vision Only can spot about from 10% 200 of feet. legally Soblind a legally people blind read person Braille, needs and a much distance smaller of two percentage feet to spot use the white letters canes on aorstandard guide dogs. eye chart that is 20 feet away.


gland Journal of effect of using gene the sight of patients

erited blindness,

al Amaurosis or LCA.

sis damages the light and usually begins

y childhood, with

complete blindness

cold virus to deliver gene called RPE65

of affected patients.

ts aged 19, 22 and 25

reatment and reported

ng the procedure.

atients and the

LCA the improvement of

patients is encouraging

hoped that gene therapy

ive in younger LCA

ienced limited vision

r blind or partially

Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening vision until complete blindness around the age. The study used a common cold virus to deliver a normal version of the gene called RPE65 directly into the eyes of affected patients. Remarkably all 3 patients aged 19, 22 and 25 responded well to the treatment and reported improved vision following the

tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening vision until complete blindness around the age. The study used a common cold virus to deliver a normal version of the gene called RPE65 directly into the eyes of affected patients. Remarkably all 3 patients aged 19, 22 and 25 responded well to the treatment and reported improved vision following the

Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening vision until complete blindness around the age. The study used a common cold virus to deliver a normal version of the gene called RPE65 directly into the eyes of affected patients. Remarkably all 3 patients aged


LEGAL BLINDNESS Anyone with vision worse than 20/200 that cannot be improved with corrective lenses is considered legally blind. In addition, people with a visual field of less than 20 degrees diameter 10 degrees radius are also considered legally blind. The American Optometric Association states that a person with 20/20 vision can clearly identify a row of 9mm letters from 20 feet. A legally blind person with vision of 20/200 has to be as close as 20 feet to identify objects that people with normal vision can spot from 200 feet. So a legally blind person needs a distance of two feet to spot the letters on a standard eye chart that is 20 feet . Legal blindness is very common in older people because eyesight tends to worsen with time and age. Approximately 135 out of every 1,000 people over the age of 65 are considered legally blind. About 1.3 million Americans fall into this category. Only about 10% of Braille,

and a

use white

legally blind people much smaller

percentage

canes or

read

guide dogs.


diameter degrees radius are also considered corrective legally blind. lense The American Optometric Association states that a person with vision legally can blind. clearly In a standard withnaof visual has to fie be as close as feet to identify objects that people with normal vision can degrees spot from diam feet. So a legally blind person needs a distance of two feet to spot the radius letters areonals a standard eye chart that is feetlegally away. ThetoAmerican worsen with time and age. Approximately 135 out of every people over Association the age ofstate are considered legally blind. About million Americans fall into this category. with vision Only about can c 10% of legally blind people read Braille, and a much smaller percentage row ofuse 9mm white lett caneslegally or guide blind dogs. per Anyone with vision worse than that cannot be improved with corrective of haslenses to be is as considered legally blind. In addition, people with a visual field of lesstothan identify degrees objec diameter degrees radius are also considered withlegally normalblind. visio Legal blindness vision feet.can So clearly a legal identify a row of 9mm letters from feet. A legally blind person with needs vision of a distanc has to ntify objects that people with normal visionspot can the spotletters from Association states that a person distance of two feet to spot the eye letters charton that a standard eye chart that Legal is feet blindness away. Legal blindness is very common in older people because eyesight tends in to older worsen peop with time and age. Approximately 135 out of every people over eyesighttends the age of are time category. and age. OnlyA about 10% of legally blind people read Braille, and a much smaller percentage 135 out of use eve Anyone with vision worse than that cannotthe be improved age of are people because eyesight tends to worsen blind. In addition, peoplelegally with a blind. visualA field of less than degrees diameter degrees radius are also considered Americans legally blind. fall in Association states that a person with vision Only can about clearly 10% n with vision of haspeople to be read as close Bra as feet to identify objects that people with normal vision can spot from smaller feet. percen So a legally blind person needs a distance of two feet to spot the letters on acanes standard or g eye chart that Anyone is feetwith away. vis Americans fall into this category in older people because eyesight that cannot tends be to worsen with time and age. Approximately out of every people overcorrective the age oflense are considered legally blind. About million Americans fall into this category. legally Only blind. about In a of legally blind people read Braille, and a much smaller percentage with ause visual white fie improved degrees diam with corrective lenses is considered legally blind. In addition, people with a radius visual field are als of less than degrees diameter degrees radius are also considered legallylegally blind. states that a person with vision The can American clearly of 9mm letters from feet. A legally blind person withAssociation vision of has state to be as close as feet to identify objects that people with normal vision with canvision spot can fromc of two feet to spot row the of letters 9mmonlett a considered legally blind. In addition standard eye chart that legally is feet blind away. per Legal blindness is very common in older people because eyesight tends of has to to worsen be as with time and age. Approximately out of every people over thetoage identify of 65objec are with . normal Only about visio of legally blind people read Braille, and a much smaller percentage use feet. white So acanes legal or guide dogs. Vision can clearly identify a row of 9mm letters from needs feet. aAdistanc legally s feet to identify objects spotthat thepeople letters with normal vision can spot from feet. So a legally blind person needs eyeachart distance that use white canes or guide dogs. Anyone with Legal vision blindness worse less than degrees diameter d legally in older blind. peop In addition, people with a visual field of less than degrees diameter degrees eyesight radius tends are also considered time legally and blind. age. A addition, people with a visual field of less than degrees states that a person with vision 135can outclearly of eve letters from feet. A legally blind person with vision the age of has of are to be as close as feet to identify objects that people with normal visionlegally can spot blind. from Ab feet. So a legally blind person needs a distance of two feet to spotAmericans the letters fall on in a standard eye chart thatOnly is feet about away. 10 common in older people because eyesight tends blindtopeople worsen re


es is considered .diameter degrees radius are also considered legally blind. peopleOptometric Association states that a person with vision can clearly yaddition, The American of less thanof oeld identify a row meter m be asdegrees close as feet to identify visual considered aso feet. So a legally blind person needs a distance of two feet to ystandard blind. eye chart that is feet away. Optometric nnLegal blindness is very common in older people because eyesighttends to worsen that a person ees with time and age. Approximately 135 out of every that a person with vision can clearly tclearly identify a

feet. Ablind people read Braille, and a much smaller percentage use white eters 10%from of legally vision dogs. .rson caneswith or guide close as feetvision worse than that cannot be improved with corrective lenses is ssAnyone with that people scts considered legally blind. In addition, people with a visual field of less than degrees addition, people with a visual fie on can spot from radius are also considered legally blind. .diameter degrees blind personOptometric Association states that a person with vision can clearly ylly The American of twoafeet oce identify row to of 9mm letters from onas a standard msbe close as feet is feet atfeet. So away. a legally blind person needs a distance of two feet to spot the letters on a is very common standard eye chart that is feet away. because nple Common in older people because eyesight tends to worsen with time and age. to worsen with 135 out of every people over the age eApproximately objects that people with yApproximately About 1.3 million Americans fall into people over eery people read Braille, and a much smaller percentage use white canes or guide dogs. considered de Anyone with vision worse than that cannot be improved with corrective lenses is with vision million lAbout considered legally nto . this category. Americans fall into this category % of legally blind yAssociation states a muchblind person with vision of eaille, from.and A legally ntage usethat white aobjects people with normal vision can spot from feet. So dguide needsdogs. a distance of two feet to spot the letters on a standard eye chart that is feet sion worse than away. worse than that cannot be improved improved with is very common in oLegal blindness is consideredout of every people over the age of are considered legally blind. ees Approximately people taddition, About million Americans fall into this category. Only about of Braille, less than eeld read and Americans fall into this category meter degrees hAnyone with vision worse than that cannot be improved with corrective lenses is so considered fconsidered legally blind. In addition, people w y.diameter blind. degrees radius are also considered legally blind. Optometric ynThe American Optometric Association states that a person with vision can clearly that aa person oes identify row of 9mm letters from f identify mclearly be as close as afeet to identify objects that people with normal vision can spot from A aters feet.from So afeet. legally with eye vision .rson standard chart that is feet away. close as feet in older people because eyesight tends to worsen nsVery common that people ects Approximately on can spot from tAbout million Americans fall into this category. Only about of legally blind people every people over the age blind person slly read Braille, and a much smaller use white of clearly two feet to yce can identify a row of 9mm letters a standard esofonhas to be as close as feet to i percentage use white is feet away. etspot from feet. So a leg is very on common eletters a standard eye chart that is feet away. because nple smaller percentage use white canes or guide dogs. Anyone with vision worse to worsen with be improved with ethan that cannot .Approximately addition, people with a visual field of less than degrees diameter degrees radius over yery arepeople also considered legally blind.The American considered oe a person with vision can clearly identify a row of letters from. A legally blind person million mbout with 1.3 vision of has to be standard eye chart thiscanes category. anto white or guide dogs. Anyone with vision worse than that legally lenses is considered legally blind. In addition, people with a visual .0% withof corrective nead fieldBraille, of lessand than degrees diameter degrees radius are also considered legally blind.


Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber hed in the Congenital New and Journal Amaurosis of or 18] tested LCA. theLeber of usingCongenital gene o help restore Amaurosis ht of patients damages a rare form the of light ted blindness, receptors in known as the Leber retina l Amaurosis and or usually ber Congenital begins is damages the affecting t receptors sight in in na and usually early ffecting childhood, sight rly childhood, with with worsening worsening until complete vision until ess around complete the blindness age. around the used a common age. rus to deliver The of study mal version e called used RPE65a common into thecold eyesvirus to deliver cted patients. normal markably aall 3 version of ts aged 19, 22 gene respondedthe well called treatment and RPE65 directly orted improved following into thethe eyes re. Due to of the affected f the patients patients.

Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening vision until complete blindness around the age. The study used a common cold virus to deliver a normal version of the gene called RPE65 directly into the eyes of affected patients. Remarkably all 3 patients aged 19, 22 and 25 responded well to the treatment and reported improved vision following the procedure. Due to the age of the patients and the degenerative nature of LCA the improvement of vision in gene therapy patients is encouraging for researchers. It is

Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening until complete Published in vision the New blindness around the England Journal of age. Medicine[18] tested the The study used a common effect of using gene virus to deliver therapy to help cold restore a normal version of the sight of patients gene with a rare the form of called RPE65 directly into the eyes inherited blindness, of Leber affected patients. known as Remarkably all 3 Congenital Amaurosis or patients LCA. Leber Congenital aged 19, 22 and 25 responded well Amaurosis damages the to thein treatment and light receptors the retina and reported usually improved vision following the begins affecting sight procedure. Due to the in early childhood, age of the patients with worsening and the degenerative vision until complete nature of LCA the blindness around the improvement of vision age. incommon gene therapy The study used a cold virus to patients deliver is encouraging for researchers. It a normal version of is hoped that gene the gene called RPE65 therapy directly into the eyes may be even more effective in of affected patients. younger Remarkably all 3 LCA patients who have patients aged 19, 22 experienced limited and 25 responded well vision loss as well and as in other blind to the treatment or partially blind reported improved individuals. vision following the procedure. Due to the age of the patients


Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or

TOTAL BLINDNESS Total blindness is the complete lack of form and visual light perception and is clinically recorded as NLP, an abbreviation for no light perception. Blindness is frequently used to describe severe visual impairment with residual vision. Those described as having only light perception have no more sight than the ability to tell light from dark and the general direction of a specific and direct light source. In order to determine which people may need special assistance because of their visual disabilities, various governmental jurisdictions have formulated more complex definitions referred to as legal blindness. In North America and most of Europe, defined as visual acuity vision of 20/200 6/60 or less in the better eye with best correction possible. This

means

that would

from

a

totally

have

an

object

blind

to

stand

20

individual

feet

6.1

m

to

see it with vision correction with the same degree

of

clarity person

as

a

normally

sighted

could from

200 feet

61

m.


is means a totally individual would have This that means that ablind totally blind individual would have to stand 20 feet 6.1 m from an object to see it h vision withcorrection vision correction with thewith same thedegree same degree of clarityofas clarity a normally as a normally sighted sighted person person could from could 200 from feet 200 feet m. In61 many m. Inareas, manypeople areas, with people average with average acuity who acuity nonetheless who nonetheless have a visual have afield visual of field less than of less 20than 20 greesdegrees the norm thebeing norm180 being degrees 180 degrees are alsoare classified also classified as beingaslegally being blind. legally blind. proximately Approximately ten percent ten percent of thoseofdeemed those deemed legally blind, legally blind, any measure, by any measure, have nohave vision. noThe vision. restThe have rest some havevision, somefrom vision, light from perception light perception alone toalone relatively to relatively od acuity. goodLow acuity. vision Lowisvision sometimes is sometimes used toused describe to describe visual acuities visual acuities from from The The rest rest havehave some some vision, visf /70 to 20/70 20/200. to 20/200. Total blindness Total blindness is the complete is the complete lack of form lack of and form visual andlight visual light perception perception alone alone to relative to rela ception and is clinically recorded as NLP,as anNLP, abbreviation for no light perception. Blindness is perception and is clinically recorded an abbreviation for no light perception. Blindness is quently used toused describe severe visual with residual vision. Those as having frequently to describe severeimpairment visual impairment with residual vision.described Those described as having y light perc eption nohave morenosight than thethan ability tell light from dark and theand general only light perchave eption more sight thetoability to tell light from dark the general ectiondirection of a light ofsource. a light source. orderIntoorder determine which people need assistance becausebecause of their of visual to determine which may people mayspecial need special assistance theirdisabilities, visual disabilities, Degrees are a Degrees ious various governmental jurisdictions have formulated more complex definitions referredreferred to as legal governmental jurisdictions have formulated more complex definitions to as legal blind,blind, by any by m a ndness. In NorthInAmerica and most ofmost of blindness. North America and urope,Europe, legal blindness is defined as visualasacuity 20/200 legal blindness is defined visualvision acuityofvision of 20/200 60 or6/60 less in witheye best correction possible.possible. This means a totally individual or the lessbetter in theeye better with best correction This that means that ablind totally blind individual uld have to have standto20 feet 20 feet 6.1 m from an object to see it with vision correction would stand h thewith same of clarityofas a normally sighted sighted person person could from 200 feet 61 feet m. In61 many thedegree same degree clarity as a normally could from 200 m. Inareas, many areas, ople with average acuity who nonetheless have a visual of field less than 20than 20 people with average acuity who nonetheless have afield visual of less greesdegrees the norm degrees are alsoare classified as beingaslegally ten thebeing norm180 being 180 degrees also classified being blind. legallyApproximately blind. Approximately ten centpercent of thoseofdeemed legally blind, any measure, have nohave vision. restThe have some those deemed legallybyblind, by any measure, noThe vision. rest havevision, somefrom vision, from ht perception alone toalone relatively good acuity. vision sometimes used toused to light perception to relatively goodLow acuity. Lowisvision is sometimes scribedescribe visual acuities from Total blindness is the complete visual acuities from Total blindness is the complete ck of form and visual perception and is clinically recorded as NLP,as anNLP, abbreviation for lack of form andlight visual light perception and is clinically recorded an abbreviation for light no perception. Blindness is frequently used toused describe severe visual with residual light perception. Blindness is frequently to describe severeimpairment visual impairment with residual on.Those described as having light perc eption nohave no more sight than the ability to tell light vision.Those described as only having only light perchave eption m dark and theand general directiondirection of a light from dark the general ofsource. a light source. orderIntoorder determine which people need assistance becausebecause to determine which may people mayspecial need special assistance their of visual various various governmental jurisdictions have formulated more complex definitions theirdisabilities, visual disabilities, governmental jurisdictions have formulated more complex definitions erredreferred to as legal blindness. In NorthInAmerica and most ofmost Europe, legal blindness is defined to as legal blindness. North America and of Europe, legal blindness is defined visualasacuity visualvision acuityofvision 20/200 of 20/200 6/60 or6/60 less in or the lessbetter in theeye better witheye with st correction best correction possible.possible. This means This that means a totally that ablind totally individual blind individual would would ve to have standto20 stand feet 20 6.1feet m from 6.1 m anfrom object anto object see ittowith seevision it withcorrection vision correction with thewith same thedegree same degree of of rity as clarity a normally as a normally sighted person could from 200 feet m. In61 many m. Inareas, manypeople areas, with people average with average acuity who acuity nonetheless who nonetheless have a visual have afield visual of field less than of less 20than 20 greesdegrees the norm thebeing norm180 being degrees 180 degrees are alsoare classified also classified as beingaslegally being legally nd. Approximately blind. Approximately ten percent ten percent of thoseofdeemed those deemed legally blind, legallybyblind, any measure, by any measure, have nohave vision. noThe vision. The t have rest some havevision, somefrom vision, light from perception light perception alone toalone relatively to relatively 61 m. In many areas, pe od acuity. goodLow acuity. vision Lowisvision sometimes is sometimes used toused describe to describe visual acuities visual acuities from 20/70 from to 20/70 20/200. to 20/200. degrees the norm being 18 degrees the norm being s means This that means a totally that ablind totally individual blind individual would hav would e tohav stand e to20 stand feet 20 6.1feet m from 6.1 m anfrom object anto object see itto see it h vision withcorrection vision correction with thewith same thedegree same degree of clarityofas clarity a normally as a normally sighted sighted person person could from could 200 from feet 200 feet m. In61 many m. Inareas, manypeople areas, with people average with average acuity who acuity nonetheless who nonetheless have a visual have afield visual of field less than of less 20than 20 greesdegrees the norm degrees are alsoare classified as beingaslegally thebeing norm180 being 180 degrees also classified being blind. legally blind. proximately ten percent of thoseofdeemed legally blind, Approximately ten percent those deemed legally blind, any measure, have nohave vision. restThe have some light perception alone toalone relatively by any measure, noThe vision. rest havevision, somefrom vision, from light perception to relatively od acuity. vision sometimes used toused describe visual acuities from from goodLow acuity. Lowisvision is sometimes to describe visual acuities /70 to 20/70 20/200. to 20/200. Total blindness Total blindness is the complete is the complete lack of form lack of and form visual andlight visual light ception perception and is clinically and is clinically recorded recorded as NLP,as anNLP, abbreviation an abbreviation for no light for no perception. light perception. Blindness Blindness is is quently frequently used toused describe to describe severe visual severeimpairment visual impairment with residual with residual vision. Those vision.described Those described as having as having y light only perc light eption perchave eption nohave morenosight more than sight thethan ability thetoability tell light to tell from light dark from and dark theand general the general ectiondirection of a light ofsource. a light source. orderIntoorder determine to determine which people which may people need mayspecial need special assistance assistance becausebecause of their of visual theirdisabilities, visual disabilities, ious various governmental governmental jurisdictions jurisdictions have formulated have formulated more complex more complex definitions definitions referredreferred to as legal to as legal


sion, fromfrom lightlight ely atively

are also classified as being legally Approximately ten percent of those deemed legally also classified as being legally blind.blind. Approximately ten percent of those deemed legally any measure, no vision. some vision, measure, havehave no vision. The The rest rest havehave some vision, fromfrom

Approximately ten percent of those deemed

Of their visual disabilities legal blindness. of Europe, legal blindness is defined as visual acuity vision of 20/200 eye with best correction possible. This means that a totally blind individual would

legally blind, by any

those deemed

whowho nonetheless havehave a visual fieldfield of less thanthan 20 20 eople with average acuity nonetheless a visual of less 80 degrees are also classified as being legally blind.blind. g 180 degrees are also classified as being legally


VISUAL Published in the New England Journal of Medicine[18] tested the effect of using gene therapy to help restore the sight of patients with a rare form of inherited blindness, known as Leber Congenital Amaurosis or LCA. Leber Congenital Amaurosis damages the light receptors in the retina and usually begins affecting sight in early childhood, with worsening until complete Published in vision the New blindness England Journal of around the age. the Medicine[18] tested The gene study used a common effect of using virus to deliver therapy to help cold restore a normal version of the sight of patients gene with a rare the form of called RPE65 directly into the eyes inherited blindness, of affected patients. known as Leber Remarkably all 3 Congenital Amaurosis or patients aged 19, 22 LCA. Leber Congenital and 25 responded well Amaurosis damages the to thein treatment and light receptors the retina and reported usually improved vision following the begins affecting sight procedure. Due to the in early childhood, age of the patients with worsening and the degenerative vision until complete nature of LCA the blindness around the improvement of vision age. in gene The study used a common therapy cold virus to patients deliver is encouraging for researchers. It a normal version of is RPE65 hoped that gene the gene called therapy may be even directly into the eyes more effective in of affected patients. younger Remarkably all 3 LCA patients who have patients aged 19, 22 experienced limited and 25 responded well vision loss as well and as in other blind to the treatment or partially blind reported improved individuals. vision following the procedure. Due to the age of the patients and the degenerative nature of LCA the

ACUITY TESTING

Published in the New England Journal of Medi

the effect of using gene therapy to help res

patients with a rare form of inherited blind

Leber Congenital Amaurosis or LCA. Leber Con

damages the light receptors in the retina an

affecting sight in early childhood, with wor until complete blindness around the age.

The study used a common cold virus to delive

of the gene called RPE65 directly into the e

patients. Remarkably all 3 patients aged 19,

responded well to the treatment and reported

following the procedure. Due to the age of t

the degenerative nature of LCA the improveme

gene therapy patients is encouraging for res


EDFCZP FELOPZD DEFPOTEC LEFODPCT F D P LT C E O

THE SNELLEN SCALE The traditional Snellen chart is printed with eleven lines of block letters. The first line consists of one very large letter, which may be one of several letters, for example E, H, or N. Subsequent rows have increasing numbers of letters that decrease in size. decrease in size. A patient taking the test covers one eye, and reads aloud the letters of each row, beginning

icine[18] tested

Only the ten Sloan letters C, D, E, F, L, N, O, P, T, Z are used in the traditional Snellen chart. The perception of five out of six letters or similar ratio is judged to be the Snellen fraction. Wall-mounted Snellen charts are an inexpensive to and are sometimes used for rough assessment vision, e.g. in a primary-care physician’s office.

store the sight of

at the top. The smallest row

dness, known as

that can be read accurately

assessed

ngenital Amaurosis

indicates the patient’s visual

an

acuity in that specific eye

nation

that is studies.

is

nd usually begins

rsening vision

er a normal version

eyes of affected

, 22 and 25

d improved vision

the patients and

ent of vision in

The

symbols

acuity

chart

known

as

the

searchers. It is

tional the

of

and however,

of

In

tradi-

the

block

doctor’s or

a

as

in

might

to a

They

intended

letters

from

typographer’s

as to

any

used ap-

that

font.

that

the

attempt

can in

a

variety

of

present

randomized

letters. be

there

deceive the examiner motor vehicle

ters

letters,

ordinary

be

license office, equipment is

are read

must

exami-

where

possibility

examinee

chart,

have

eye

formally

the

Snellen

optotypes

not,

are

an

“optotypes.”

case

pearance

are

on

Whenever acuity carefully as in

of

seen

and

the

let-

patterns.


20

20

20

20

15

20

30

40

ACUITY RATING

Is a quantitative measure of the ability to identify black symbols on a white background at a standardized distance as the size of the symbols is varied. It is the most common clinical measurement of from which to distinguish them—the distance The denominator is the distance the distance in feet from which a person can reliably distinguish a pair of objects. person with standard VA (that is, with 20/20 vision) would be able a white to distinguish them—the distance at which their separation angle is 1 arc minute. The metric equivalent is 6/6 vision where the distance is 6 meters. Twenty feet is essentially infinity from an optical perspective the difference in optical power required to focus.


a white

20

20

20

20

50

60

70

80

to identify standardized distance as the size of the

ha

unction. the numerator refers to the distance in feet from which a person can reliably the distance from which a person with standard VA

e

equivalent is 6/6 vision where the distance is 6 meters. Twenty feet i

symbols is varied. It is the In the term which a person distinguish a pair of objects. The denominator is standard able e distance at which their


SENSE OF SOUND Previous event-related potential (ERP) studies have also suggested a possible participation of the visual cortex of the blind in a auditory processing. In the truth present study, somatosensory and auditory ERPs of blind and sighted subjects were recorded when to a subjects were instructed to attend to stimuli of one modality and to ignore those of the other. Both modalities were and stimulated with frequent (ldquostandardrdquo) and infrequent

stimuli, which differed from one another in their s patial locus of a origin. In the sighted, deviant a to stimuli of the attended and modality elicited N2 type of deflections (auditory N2b and somatosensory N250) over the lateral scalp areas. I n contrast, in the blind, these ERP components to were centroposteriorly but also distributed, suggesting an involvement of posterior the specific brain.

stimuli, which one another in their s patial locus of a ori sighted, devi ant a to stimuli of the attended and modalsighted, d ity of deflections (auditory and somatosensory N250) the over the lateral scalp areas. In contrast, in the ERP components to were centroposteriorly distributed,

but

also


In addition, the mismatch negativity, by deviant auditory stimuli the somatosensory stimuli were attended, was larger devi than in the sighted. This appears to indicate enpresent of aud stimulus changes the blind. and

somatosensory

itory in

Thus, data suggest compensatory in both

the several

present

auditory and

somatosensory

after the onset of early deprivation. This appears to indicate proof in the blind. suggest

several compensatory in both

changes


visual

add

that a person with vision can clearly

Americans fall into this category

objects that worse than that people with cannot be improved

with vision


dition, people with a visual field

percentage use white

every people over the age

Americans fall into this category


SENSE OF TOUCH Braille is a system of touch reading and writing for blind persons in which raised dots represent the letters of the Braille alphabet. also contains equivalents

for

punctuation marks

By using braille, blind people can review and study the written word. They can become aware of different such

written

conventions

as spelling, punctuation,

and

paragraphing and

provides symbols to

show footnotes.


Most of all, blind individuals can have access to a wide range of reading materials including educational and recreational reading but it and practical a contracts,

manuals.

important

Equally

are

regulations, insurance

directories, appliance by instructions and cookbooks.

policies,

the

Various other methods had been an attempted over the years to enable blind people to read, many of them raised versions of print letters. It is generally accepted that the braille system has succeeded because

it

on

a

of

signs

is

at

rational

based

sequence

devised

for

the fingertips, imitating

signs

rather

than

devised for

the

eyes.


PAGE BREAKDOWNS This book was printed on the Shade paper line by Gmund fine papers and printed on an Epson 1280 four color desktop publishing printer.

pages 08 _ 13

pages 18 _ 21

d

d e

d

e d

pages 14 _ 17

pages 22_ 25

d e

d e

d

d


pages 26_ 27

pages 28_ 29

d e

e d

pages 30_ 43

e d

d

d


GMUND PRODUCT LINES At Gmund we have been giving and keeping this promise with our products for almost 180 years. The basis for this confidence in our expertise and in the aesthetic power of our paper is an active company philosophy that is reflected in every detail of the B端ttenpapierfabrik Gmund. We set high standards in Gmund in the choice of materials, which we acquire from all over the world. For our production we use exclusively selected raw materials that are characterised by the highest purity and stability. These include chlorine-free bleached and an FSC cotton

certified

high-quality

Dyes

rags.

lightfast from

special

as

pulp and

possible

heavy

metals

or

natural

pigments

a

as

naturally and

to

for

the

free

so

minerals requirements acid-free,

non-ageing

quality

of our

paper


PAPER LINES


Designer Konstantine Pangalos Class Type 3 Instructior Ariel Gray Image resources for this book are listed below: Flickr.com Compfight.com Google Images Information and Data Provided By www.i-see.org www.wikipedia.org www.nyise.org www.goingblindmovie.com www.gmund.com


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