Influence of Physical Activity and Sport on the Inclusion of People with Visual Impairment: A Systematic Review

People with visual impairment have greater difficulty in accessing physical activity and sport, and a lack of social interaction is also associated with a risk of exclusion. Work is currently being done to include people with visual impairment through physical activity and sport. However, there is a lack of studies examining the status and overall effectiveness of interventions in the pre- and post-COVID stage. This study aimed to provide solid evidence on the characteristics and effectiveness of interventions for the inclusion of people with visual impairment through physical activity and sport in order to address the need for dissemination on this topic. The bibliographic search was carried out with the words “Physical activity”, “Physical exercise”, “Sport”, “Physical training”, “visual disability”, “visual impairment” and “inclusion” in the databases PubMed, Scopus, Web of Science and Google Scholar from 2018 to 2021.The article selection process was according to the PRISMA protocol with a final selection of nine articles. The main results highlighted that the programmes improve the perception of people with disabilities, increase social skills and health and increase the social importance of people with disabilities in the social environment. Among the most generalised conclusions were the need for specialised training, the need for social inclusion and participation of people with visual impairment in their environments and increased physical activity.

Pavimentos Táteis em Paragens de Autocarro

O Projeto de Investigação ACCES4ALL focaliza-se em interfaces modais projetadas de acordo com o conceito de “Design Universal”. Tem como objetivo principal desenvolver um estudo piloto de uma paragem de autocarros acessível, inteligente e sustentável, a localizar numa interface multimodal. Num contexto de sustentabilidade social, os ambientes construídos inclusivos têm de garantir acessibilidade universal. Assim, as pessoas com deficiência visual necessitam de pavimentos táteis e/ou com diferenciação cromática que forneçam orientação e informação sobre os espaços e os meios de transporte. Com esta comunicação pretende-se apresentar exemplos internacionais de sistemas de encaminhamento, através de pavimentos táteis, em paragens de autocarro, tendo-se recorrido a pesquisa bibliográfica e realizado desenhos técnicos. Os resultados indicam que existe uma grande diversidade de soluções técnicas de encaminhamento tátil no ambiente construído, recomendando-se a necessidade de harmonização de soluções podotáteis no mundo, considerando um contexto de Turismo Acessível.Palavras-chave: Turismo Acessível. Acessibilidade universal. Ambiente construído. Paragens de autocarro. Pavimentos táteis. Pessoas com deficiência visual. Tactile Floors at Bus StopsABSTRACTThe ACCES4ALL research project focuses on modal interfaces designed according to the concept of "Universal Design". Its main objective is to develop a pilot study of an accessible, smart and sustainable bus stop to be located at a multimodal interface. In a context of social sustainability, inclusive built environments must guarantee universal accessibility. Thus, people with visual disability need tactile and/or chromatically differentiated pavements that provide orientation and information about spaces and means of transport. This paper intends to present international examples of guiding systems, through tactile surfaces, at bus stops, having resorted to bibliographic research and technical drawings. The results indicate that there is a great diversity of technical solutions for tactile routing in the built environment, recommending the need for harmonization of podotactile solutions in the world, considering an Accessible Tourism context. Keywords: Accessible Tourism. Universal accessibility. Built environment. Bus stops. Tactile surfaces. People with visual disability.

Temporal trends in the epidemiology of childhood severe visual impairment and blindness in the UK

Background/aimsUnderstanding temporal trends in childhood visual disability is necessary for planning and evaluating clinical services and health policies. We investigate the changing epidemiology of severe visual impairment (SVI) and blindness (BL) in children in the UK in the 21st century.MethodsComparative analysis of two national population-based epidemiological studies of incident childhood SVI/BL (ICD-10 definition; visual acuity worse than 1.0 LogMAR in the better eye). We carry out comparative analysis of studies conducted in 2000 and 2015 using identical methods.ResultsOverall annual and cumulative incidence rates remained broadly stable in 2015 at 0.38 per 10 000 (95% CI 0.34 to 0.41) for 0–15 years old and 5.65 per 10 000 (5.16 to 6.18) by 16 years, respectively, and with annual incidence in infancy (3.52 per 10 000, 3.13 to 3.97) remaining considerably higher than any other age. Mortality among children diagnosed in infancy declined (from 61.4 to 25.6 per 1000), despite an increase (from 77% to 84%, p=0.037) in the overall proportion with significant non-ophthalmic impairments/disorders. The relative contribution of all the main groups of disorders increased over time, most notably cerebral visual impairment (from 50% to 61%). Aetiological factors operating prenatally continued to predominate, with an increased relative contribution of hereditary conditions in all children (from 35% to 57%, p<0.001). The substantially elevated rates for any ethnic minority group and those born preterm were unchanged, with amplification of increased rates associated with low birth weight.ConclusionThe changing landscape of healthcare and increased survival of affected children, is reflected in increasing clinical complexity and heterogeneity of all-cause SVI/BL alongside declining mortality.

Fireworks Ocular Injury in Saudi Children; Profile and Management Outcomes

Background: To explore the demographic profiling, causes, types, complications, management outcomes, and severity of fireworks- inflicted ocular injuries and traumas in children in KSA.Methods: This is a retrospective study of 115 cases with eye injuries managed at the Emergency Department, of our institution between 2003 and 2019. Demography, clinical features at presentation, mode of management and the Best Corrected Visual Acuity (BCVA) were evaluated at the last follow up. Results: The study included 117 eyes of 115 children [median age: 9 years; 96 (83.5%) boys; 19(16.5%) girls]. Fifty-six (48.7%) participants were bystanders. The injuries were caused mainly due to bangers (n=47; 40.9%), rockets in bottle (n=28; 24.3%), firecrackers (n=27; 23.5%), and nonspecific reasons (n=13; 11.3%). The children had presented with various severity levels: corneal abrasion (n=52; 44.4%); cataract (n=47;40.2%); penetrating injury (n=40; 34.2%); secondary glaucoma (n=22;18.8%); subluxated lens (n=19;16.2%); limbal stem cell deficiency (n=14;12.0%); Iridodialysis (n=12;10.3%), and vitreous hemorrhage (n=11;9.4%). Management interventions of the eyes under study included: penetrating injury repair (n=40; 34.2%), lens removal plus intraocular lens implantation (n=26; 22.2%), removal of foreign body (n=9; 7.7%). The BCVA after six months was 20/20- 20/60 in 49(41%) cases; 20/70 - 20/200 in 27 (23.1%) cases; <20/200-20/400 in 7 (6%) cases, and <20/400 in 34(29.1%) of the cases. Out of 51.3% eyes with <20/200 before management, only 35% recorded severe visual impairment.Conclusion: Fireworks-related eye injuries were mainly observed in boys primarily due to the use of bangers . Visual disability remained in one-third of the managed cases.

Issues in specifying contrast in building elements for people with a visual disability

BACKGROUND: Standards writers, national and international, have used different contrast calculations to set requirements in building elements for people with visual impairments. On the other hand, they have typically set a single requirement (30%) for specifying the minimum contrast. The systems are not linearly related and 30%means something rather different in each system. OBJECTIVE: To provide a comparison of the various scales in order to illustrate the differences caused by multiple scales with a single compliance value, recommend a single scale for universal adoption and, if a new measure is problematic for implementation, to recommend the most perceptually uniform of the present methods. METHODS: We use the contrast between combinations of 205 paint colours to illustrate the relationships between the measures. We use an internationally accepted scale, with equal perceptual steps, as a “gold standard” to identify the most perceptually uniform measurement scale in the existing methods. RESULTS: We show that Michelson contrast is the most perceptually uniform of the existing measurement scales. We show the contrasts in the proposed method that equate to the various current requirements. CONCLUSIONS: We propose that CIE Metric Lightness could be used as the contrast measure. Alternatively, Michelson contrast is the most perceptually linear of the current measurement scales.

Examining the Psychological Health Quality of Life of Older People with Disability in Selected Districts in Ghana

Older people in Ghana suffer from a wide range of disabilities including visual, physical, and hearing with serious ramifications on their quality of life. Therefore, this paper examines the psychological health quality of life (PHQOL) of older people with disability in selected Districts in the Upper West Region of Ghana. Through a census survey, questionnaires were used to obtain data from 810 respondents.Independent-samples t-test and one-way Analysis of Variance (ANOVA) were used to examine their PHQOL. The results showed that mean scores in PHQOL were highest among those aged 60-69 and lowest for those aged 80 years and older with a significant difference [F (807) = 23.872 value, p = 0.000] in PHQOL of their ages. Those who were married had the highest PHQOL mean score compared with those who were separated / divorced and widowed with significant difference [F (807) = 42.690 value, p = 0.000] noticed in PHQOL across marital statuses. Also, those with physical disability had a higher mean score in PHQOL than those with visual disability. The study concludes that any geriatric policy interventions aimed at improving the PHQOL of older people with disability ought not to downplay their background characteristics as they underpin their PHQOL.

Students with disability perspectives towards inclusive education at the College of Basic Education in Kuwait: Barriers and challenges: اتجاهات الطلبة ذوي الإعاقة تجاه الدمج التعليمي في كلية التربية الأساسية في دولة الكويت: العوائق والتحديات

This research is a qualitative interpretive case study focuses on the perspectives of (6) students with physical and visual disability who study at college of basic education in Kuwait. It sought to elicit the “voice” of students with disabilities, seeking to identify their experiences of inclusive practice and any barriers to participation. The researchers conducted semi structured interviews. It was processed and analysed through data coding, categorising and emergence of themes. Participants of the current study showed a willingness towards the concept of inclusion with some concerns, which include the cultural, structural, and social barriers of implementing inclusive education. The results of this study emphasise the importance of increasing the knowledge of inclusion and how to deal with students with disability. Overall, recommendations include a need for training courses for the faculty members at the College of Basic Education in the field of disability and inclusion.

Assessment of Clinical Outcome Following Therapeutic Penetrating Keratoplasty in Non-Healing Infective and Perforated Corneal Ulcer

BACKGROUND Corneal blindness has been a significant visual disability in developing countries like India. Corneal ulcer contributes mainly as the leading cause for monocular blindness. Considering the common condition, the studies and literature have been surprisingly less when it comes to corneal ulcer and their management. But with the advent of therapeutic penetrating keratoplasty (TPK), the scenario and prevalence of corneal blindness can be reduced. Hence this study was done to know the importance of therapeutic penetrating keratoplasty in case of non-healing infective and perforated corneal ulcers. The objectives were to assess the clinical outcome in a non-healing and perforated corneal ulcer, reduction in symptoms and signs of infection, anatomical or structural integrity of the globe and also evaluate the visual outcome following therapeutic penetrating keratoplasty. METHODS Data were obtained from 30 patients operated at our institute for therapeutic penetrating keratoplasty. Patients with less than one year of follow up, paediatric cases, PL negative cases were excluded. The outcome was assessed based on maintenance of structural integrity, reduction in infective load, improvement in visual acuity and graft survival and its correlation with corneal vascularisation, previously failed grafts, donor tissue quality, graft size and type of surgery. RESULTS Structural integrity was maintained in 93.3 % of the cases, reduction of infective load in 90 % of cases and optically clear grafts in 46.7 % of cases and vision was better than 6/60 in 30 % of cases. CONCLUSIONS The study proved that in the case of non-healing and perforated corneal ulcers, therapeutic penetrating keratoplasty had a good prognosis in reducing infective load, maintaining structural integrity without which eye could have been lost. KEYWORDS Therapeutic Penetrating keratoplasty, Perforated corneal ulcer, non-healing corneal ulcer, corneal blindness, TPK

Anti-VEGF therapies for age-related macular degeneration: a powerful tactical gear or a blunt weapon? The choice is ours

Purpose Blindness and vision loss are still frequent disabilities associated with a relevant impact on health care and quality of life, and a high economic burden. Supranational programs established by the World Health Organization (WHO), International Agency for the Prevention of Blindness (IAPB), and World Health Assembly (WHA) aim at reducing avoidable visual impairment. Age-related macular degeneration (AMD), diabetic retinopathy (DR), and other retinal diseases are well known causes of visual disability. Since more than a decade, intravitreal agents are available for the treatment of these diseases. The aim of this study is to review whether pharmacotherapy with anti-vascular endothelial growth factor (VEGF) drugs has led to a decrease in the prevalence of blindness with emphasis on AMD and different countries. A brief analysis of other factors correlated to changes in the rate of blindness is also presented. Methods PubMed and Scopus web platforms were used to identify relevant studies on epidemiology of blindness and vision impairment, the influence of intravitreal therapies, and the existence of different vision care models. Additional data and material was searched in web internet accessed by the web browser Firefox. Results Age-standardized prevalence of blindness secondary to AMD has started to decline as testified by a number of studies in different countries. This is due to the adoption of anti-VEGF therapy and its adequate management. The frequency of treatment and regimens applied are indirect signs of successful treatment. Local rules and regulations may represent an obstacle. Conclusions This review shows that by implementing existing health care systems and dispensing adequate therapies in the field of retinal diseases, the prevalence of blindness due to these conditions can decline.

Comparative Study between Generic versus Brand Latanoprost in treatment of Open Angle Glaucoma Patients

Background Glaucomas are a group of optic neuropathies characterized by progressive degeneration of retinal ganglion cells. Degeneration of these nerves results in cupping, a characteristic appearance of the optic disc and visual loss. Glaucoma can remain asymptomatic until it is severe, resulting in a high likelihood that the number of affected individuals is much higher than the number known to have it. Without adequate treatment glaucoma can progress to visual disability and eventual blindness which is irreversible. Many types of glaucoma are usually controlled with daily medical treatment consisting of eye drops lowering IOP. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping aqueous fluid flow better through the drainage angle. A generic medicine is defined as a product having the same qualitative and quantitative composition in active ingredients, as well as the same pharmaceutical form, as the reference medicine and whose bioequivalence has been shown by adequate bioavailability studies, also its low price makes it more affordable. Aim of the Work To evaluate intra ocular pressure control and compliance of the patient using a generic prostaglandins eye drops in comparison to a brand one in the management of glaucoma patients and its safety profile, to determine the value of the generic drug in glaucoma management. Patients and Methods This is a prospective interventional cross over study was done on 30 patients recruited from Glaucoma Clinic of National Eye Center, Rod El Farag from January 2019 to July 2019. Results The mean baseline IOP of both main groups on day 0 was 23.9 ± 3.3 mmHg at 9 AM, 23.6 ± 2.7 mmHg at 1 PM, 23.6 ± 2.3 mmHg at 6 PM before treatment with original or generic latanoprost (P = 1). Both treatments reduced the IOP from baseline (day 0 of each drug) at each time-point, and for the three diurnal IOP measurements at 3 months. Original latanoprost had a greater efficacy than generic latanoprost after 3 months, Original Latanoprost reduced the IOP after 3 months of treatment by -8.6 ± 0.84 mmHg at 9.00 AM, 7.4 ± 1.2 mmHg at 1.00 PM hours and -6.4 ± 1.8 mmHg at 6.00 PM, While Generic latanoprost reduced IOP after 3 months by -7.03 ± 0.95, -5.8 ± 1.1 and -4.9 ± 1.8 mmHg, respectively. Conclusion Original latanoprost has a tendency of better efficacy and tolerability with low incidence of conjunctival hyperaemia and ocular irritation compared with the generic latanoprost in management of open angle glaucoma patient.