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Student Information and Activities SM Students for Sight is a Foundation Fighting Blindness program Welcome to Students for Sight, a school assembly program where you’ll learn about some common causes of blindness and low vision and hear a firsthand account of what it is like to live with impaired vision. You will also have the opportunity to experience what it is like to be a visually impaired student. Students for Sight is a program developed by the Foundation Fighting Blindness to help increase student awareness about blindness and learn about blindness sensitivity. The Foundation Fighting Blindness is a national non-profit organization that is working to save, restore and protect vision from retinal degenerative diseases. Since 1971, the Foundation Fighting Blindness has raised more than $300 million in support of its mission to find preventions, treatments and cures for many blinding diseases that affect more than ten million people in the United States. The Foundation is the largest non-governmental supporter of retinal disease research in the world. The learning objectives for today’s program are: • To increase your awareness of the everyday challenges of blindness • To understand the concept of “blindness sensitivity” • To acquire new skills for interacting with and helping classmates and other people with low vision • To educate you about the Foundation Fighting Blindness and how you can get involved and make a difference in society • To improve your team-building skills by actively involving you in FFB’s VisionWalk, a fun event that also raises money for research Foundation Fighting Blindness Students for Sight 1 About the Foundation Fighting Blindness What does the Foundation Fighting Blindness do? • The Foundation supports and works closely with retinal specialists and researchers around the world to further retinal research. A Scientific Advisory Board that is made up of doctors and research experts from all over the world guides these efforts. • The Foundation Fighting Blindness funds medical research at prominent institutions and universities around the world through fundraising to help find cures for retinal diseases. Since 1971, FFB has raised more than $300 million dollars to support this research. • FFB provides resources, support and hope to patients by keeping members up-to-date on the latest advances in scientific research through our website, print and online newsletters and educational seminars. • FFB has a national network of 50 chapters that raise funds, increase public awareness and provide support to their communities. Today, it is no longer a question of if these diseases will be cured but when. In today’s program, we are going to mainly focus on macular degeneration, a disease that causes loss of central vision, and retinitis pigmentosa, a disease that causes peripheral (side) vision loss. Both of these conditions can lead to blindness. The urgent mission of the Foundation Fighting Blindness is to drive the research that will provide preventions, treatments and cures for people affected by retinitis pigmentosa, macular degeneration, Usher syndrome and the entire spectrum of retinal degenerative diseases. Foundation Fighting Blindness Students for Sight 2 The Eye Retinitis pigmentosa and age-related macular degeneration are diseases that affect the retina and macula, which are located in the back of the eye. eyelid iris lens fovea pupil macula vitreous humor cornea sclera optic nerve choroid retina Photo from National Eye Institute Foundation Fighting Blindness Students for Sight 3 The Visual System The human eye is composed of many parts that work together. They receive visual images, focus them properly, and send messages to the brain. To have vision, you must have three things: (1) eyes, (2) a brain, and (3) light. So hows does all this work? We start with light. Light rays bounce off an object you are looking at. Let’s say the object is a dog. The light reflects off the dog’s image and comes back to your eye. Light then enters through the outer part of the eye, called the cornea. The cornea is clear like a window. The cornea helps the eye to focus. “To focus” means to make things look sharp and clear. Next, the light rays go through an opening called the pupil. The pupil is the dark round circle in the middle of the colored part of your eye. The colored part is called the iris. The pupil is really a hole in the iris. The iris controls how much light goes into your eye. Continued on next page Foundation Fighting Blindness Students for Sight 4 The Visual System When the light is bright, the iris closes the pupil until the right amount of light gets in. When the light is dim, the iris opens the pupil to let in more light. All of this happens automatically. You do not have to tell your eye to do it! Your eye has a lens to focus the rays of light. The lens of the eye is behind the iris. Light passes through the lens on its way to the back of the eye. The back of the eye is very important. Lining the inside of the eye is the retina. The retina includes 130 million tiny light-sensitive cells that send messages to other cells. These cells come together at the back of the eye to form the optic nerve. The optic nerve is part of the brain. Fortunately for you, your brain decides how you see. The retina sees the world upside down, but the brain turns it right side up. When you look at an object, each eye sees a slightly different picture. The brain combines the images, or pictures, that each eye sees and makes them into one picture. Foundation Fighting Blindness Students for Sight 5 Retinal Degenerative Diseases Age-Related Macular Degeneration (AMD) • AMD is a retinal disease that can cause severe loss of central vision. • AMD can also lead to the loss of the ability to see color and detail. • AMD is caused by a combination of genes and environmental factors. AMD runs in families, and certain genetic variations can increase a person’s risk. There are also lifestyle and non-genetic factors that can increase AMD risks, like age, diet and smoking. • AMD currently affects more than 10 million people in the United States and is the leading cause of blindness in people over the age of 55. • AMD is a growing public health concern. As the “baby boomer” population ages, these numbers will reach epidemic proportions. Basic types of AMD Dry Form: Small yellow-white deposits called drusen accumulate in the cell layer under the retina and clutter in the macular region of the eye. Dry AMD accounts for about 90 percent of all AMD cases, but it can progress to wet AMD, which is more likely to cause severe vision loss. Wet Form: Abnormal, leaky blood vessels form under the retina and cause severe vision loss. Currently, there is not a cure for AMD, but treatments are available for wet AMD, the most severe form. With continued research, even more are on the horizon. Vision with AMD: Normal Vision: Photos from National Eye Institute Foundation Fighting Blindness Students for Sight 6 Retinal Degenerative Diseases Retinitis Pigmentosa (RP) • RP is a retinal disease that causes severe loss of peripheral (side) vision. • The early symptoms of RP include night blindness followed by gradual loss of peripheral and eventually central vision. • Patients are usually diagnosed during childhood or adolescence and typically experience severe vision loss or complete blindness during mid-life. • Approximately 1 in 4,000 individuals worldwide are affected by RP. • At this time, there are no effective treatments to reverse or halt the disease. Basic types of RP Autosomal Dominant: Affected person inherits a mutated gene from one parent, and a normal gene from the other parent. Autosomal Recessive: Affected person inherits two copies of the affected gene – one from each parent. X-linked: Typically, an affected male inherits the affected gene from his mother. In rare cases, a female can be affected. Vision with RP: Normal Vision: Usher Syndrome • Usher syndrome is a form of RP that includes hearing loss and balance problems. • Patients are born with varying degrees of deafness and develop retinitis pigmentosa during mid-life. • Usher syndrome affects approximately 20,000 Americans and is the main cause of deaf-blindness in the world. Foundation Fighting Blindness Students for Sight 7 Common Eye Problems There are many other less serious eye conditions and problems that may cause low vision. Some Eye Problems of Childhood Strabismus is also called “crossed eyes” or “wall eyes.” One eye is turned too far in one direction. Sometimes, a baby’s eyes may cross occasionally in the first few months of life. Infants whose eyes constantly turn should be examined by an eye care professional. The problem usually can be helped. Amblyophia is also called “lazy eye.” It happens when normal vision does not develop in one eye because the “lazy eye” sends a poor message to the brain. This problem usually can be addressed with glasses, eye drops or a patch. The patch is usually put over the stronger eye, but can sometimes be put over the weaker eye. Refractive Errors Like any other part of the body, the eye grows, works, gets tired, and ages. It can also be injured or become diseased. However, most vision problems are not diseases, but refractive errors. These are minor flaws in the way the eye is built that causes it to focus incorrectly. Myopia, also called nearsighted, means that a person sees nearby objects more clearly than objects that are far away. It occurs when the eyeball is too long or the cornea is too rounded and light is focused in front of the retina instead of directly on it. Eyeglasses or contact lenses can correct the problem. Presbyopia literally means “old man’s eyes.” It happens when the lens of the eye becomes hard and less flexible with age. It then becomes even harder to bring objects into focus. Everyone becomes presbyopic, usually between 40 and 50 years of age. Foundation Fighting Blindness Students for Sight 8 Common Eye Problems In addition to retinal degenerative diseases, millions of people in the United States are blind or have vision problems that cannot be fixed or corrected with eyeglasses. Many eye diseases are detected during an eye exam through dilated pupils. Drops are put into the eyes during the exam to enlarge the pupils. This allows the eye care professional to see more of the inside of the eye. Cataracts Cataracts form when the lens of the eye grows cloudy. In a commonly performed operation, the cloudy lens is often replaced with a plastic lens. It is a very safe and successful type of surgery. In fact, it is the most common surgery for people over the age of 60. Diabetic Retinopathy Diabetic retinopathy is a disease that affects some people with diabetes. This disease damages the blood vessels in the eye. It is a leading cause of blindness in adults, but treatment using lasers or surgery can help prevent serious vision loss. People with diabetes should have an eye exam through dilated pupils at least once a year. Glaucoma Glaucoma is an eye disease that causes increased pressure in the eye. It is sometimes called the “sneak thief of sight,” because it does not give any warning signs. This blinding disease damages the optic nerve. Glaucoma is treated with medication, lasers and surgery. African-Americans over the age of 40 and everyone over the age of 60 are at high risk for glaucoma. Those at risk should have an eye exam through dilated pupils at least once every two years. What is Low Vision? Low vision is a vision problem that can not be corrected with contact lenses or glasses. While some vision remains, everyday tasks such as reading the newspaper or driving may be difficult or impossible. Visual aids, such as magnifying glasses, talking watches, computers that read out loud and special video devices assist people with low vision. What is Legal Blindness? Legal Blindness means that a person has either a visual acuity of 20/200 or worse in their better eye while wearing glasses or contact lenses. 20/200 means that a person that is 20 feet away from an eye chart sees what a person with normal vision can see at 200 feet. If you are legally blind, your vision will never be corrected past 20/200, even with glasses or contact lenses. Legal Blindness can also mean that their visual field is limited to 20 degrees or less in the good eye. This is also called tunnel vision. Foundation Fighting Blindness Students for Sight 9 Blindness Sensitivity For Discussion: • What is blindness sensitivity? • Why is blindness sensitivity important? A sighted guide is a person who can see and is acting as a guide for a blind or visually impaired person. When acting as a sighted guide, you should… • Offer your arm rather than taking their arm. The person will gently hold your arm just above the elbow. • Walk about half a step in front of the person you are assisting and walk at the same rate you always would, unless the person has another disability or has difficulty walking. • Describe steps, curbs, right or left turns, or any unusual barriers you may encounter. It isn’t necessary to describe insignificant details such as slight terrain changes. • If encountering a narrow passage, bring the arm you are assisting with directly behind you. Keep that arm behind you until the area widens out again and it is safe to travel side by side. • Verbalize the way a door opens, such as “towards you on your left” or “away from you on your right.” This way, the person can catch the door and hold it open. • If the person has a cane, ask them which side they would prefer. The person will probably transfer the cane to their free hand and will not use it simultaneously with a sighted guide. • If you’re helping a person to his/her chair, don’t push them into the seat. Simply place your hand on the back of the chair and let them follow your arm down to the back of the seat. He/she will find the rest of the way. Foundation Fighting Blindness Students for Sight 10 Blindness Sensitivity The purpose of a guide dog is to help a blind person by leading them around obstacles. Remember… • Never pet, speak to, or feed a dog that is working. The harness that is worn on the dog’s back is what indicates to the dog and to the community that he is working. Whenthe dog is out of the harness, petting is permissible with the handler’s permission. • The dog will not be “working” while someone is receiving sighted guide assistance. The dog should be on the left side of the person and should follow along at a close distance. • Never call the dog in an attempt to get them to follow you. The handler will issue the “follow” command and will follow along somewhat behind you. When interacting with someone who is visually impaired… • Never speak louder to someone who is visually impaired. • Do not try to count stairs. Stopping at the bottom step will indicate stairs and the person will walk accordingly. • Do not change your tone of voice as it can be viewed as patronizing. • Do not push, pull, or grab them in the attempts of showing them a chair or where to go. • Try to avoid pointing or using terms such as “over there” or “here”. Be verbal and specific, i.e., “the chair is about 3 feet to your right.” • Do not be afraid to use visual terminology such as “look”, “see”, or “watch.” People who are blind or visually impaired will use terms like “It’s good to see you,” or “I watched TV last night.” It is part of every day language and should not be avoided. • Address the person who is visually impaired and do not rely on a sighted person who may be with him/her. People who are blind are capable of speaking on their own behalf. • When giving something to a person who is visually impaired, verbalize what you are doing, “Here is your change,” or “My hand is out.” • When in doubt, if your assistance is needed, always ask; never assume. The person will let you know if you can assist in any way and if your assistance is too much or not enough. Foundation Fighting Blindness Students for Sight 11 From Vision Research to Eye Care Gene Therapy Saves Vision in Dogs Children born with a devastating retinal condition called Leber congenital amaurosis (LCA) may soon be able to see thanks to an innovative gene replacement therapy that has just moved into clinical trials. The studies, funded in part by the Foundation Fighting Blindness, are being conducted at Children’s Hospital of Philadelphia, the University of Pennsylvania and Moorfields Eye Hospital at the University College of London. Over the past 15 years, the Foundation funded the preclinical investigations that are making these studies possible. One world-renowned research project gave sight to a Briard dog named Lancelot and 50 of his relatives. Lancelot has become a symbol for many people with LCA and RP—he even visited Congress in Washington, DC to propose new legislation to help the blind! Foundation Fighting Blindness Students for Sight 12 Classroom Activities Wearing your blindness simulation masks, try to: 1. 2. 3. 4. 5. 6. 7. 8. Complete the exercises on the following pages. Sign your name. Read the chalkboard. Pick up paperclips off of the floor. Pour water from a bottle into a cup. Open your locker. Kick a ball outside or in gym class. Make a paper airplane. True or False? 1. The majority of people who are legally blind are totally blind. 2. It is possible to be “legally blind” without glasses, but have 20/20 vision with glasses. 3. More than half of the people who are legally blind are over age 65. 4. People who are blind can hear better than people who are sighted. 5. People who are blind are not offended by words like see, look and watch. Essay Question: How did you feel when you were wearing the masks? What activities were the most challenging? What do you think would be the hardest thing to do if you were visually impaired? Write a short essay reflecting on what you learned through the program. Foundation Fighting Blindness Students for Sight 13 The Anatomy of the Eye Choroid (KOR-oyd) A layer of blood vessels that feeds the retina. Cornea (KOR-nee-uh) The clear outer part of the eye’s focusing system located at the front of the eye. Eyelid The skin-covered structure that protects the front of the eye; limits light entering the eye; spreads tears over cornea. Fovea (FOH-vee-uh) The center of the macula; gives the sharpest vision. Iris The colored part of the eye; regulates the amount of light entering the eye. Lens The clear part of the eye behind the iris that helps to focus light on the retina. Allows the eye to focus on both far and near objects. Foundation Fighting Blindness Students for Sight Macula (MAK-yoo-lah) The small sensitive area of the retina that gives central vision; contains the fovea. Optic nerve The bundle of over one million nerve fibers that carries visual messages from the retina to the brain. Pupil The opening at the center of the iris. The iris adjusts the size of the pupil and controls the amount of light that can enter the eye. Retina (RET-in-nuh) The light-sensitive tissue lining the back of the eyeball; sends electrical impulses to the brain. Sclera (SKLEH-ruh) The tough, white outer coat of the eye. Vitreous Humor (VIT-ree-us) The clear gel filling the inside of the eye. 14 Word Search Foundation Fighting Blindness Students for Sight 15 Imagine Performing Everyday Tasks with a Visual Impairment The urgent mission of the Foundation Fighting Blindness is to drive the research that will provide preventions, treatments and cures for people affected by retinitis pigmentosa, macular degeneration, Usher syndrome and the entire spectrum of retinal degenerative diseases. Foundation Fighting Blindness Students for Sight 16 How to Get Involved How can you get involved with the Foundation Fighting Blindness? • Participate in a VisionWalk with your family and friends • Host a mini-walk at your school around the time of your local VisionWalk • Host a fundraiser at your school, like a bake sale or candy sale and donate the proceeds to FFB • Volunteer at your local FFB regional office for community service hours • Get involved with your local chapter • For more information on these and other ways to get involved, visit www.FightBlindness.org SM 11435 Cronhill Drive Owings Mills, MD 21117 800-683-5555 www.FightBlindness.org