University of Edinburgh

"Meaningful Participation": facilitating learning for pupils with visual impairment and additional difficulties

Presented on Tuesday 18 January 2011


Janis Sugden

Paediatric Visual Impairment

3 main causes of visual impairment

  • Problems of the eye
  • The optic nerve
  • The brain

Notes: See Prof A J Jackson PhD, MCOptom, FAAO, FBCLA
In contrast to sight loss in adults, which is predominantly a consequence of problems of the eye, the majority of children suffer visual impairment because of damage to the optic nerve or the brain

When do sight problems occur?

  • Almost all sight problems occur before or at birth or on the first 28 days of life.
  • It is estimated that 70% of visually impaired children have an additional disability (VIS 2003).

Prevalence in Scotland

  • In Sweden 13.1 per 10,000 births
  • In Denmark 12.9 per 10,000 births
  • In Scotland 12 per 10,000 births


However a one year capture of birth suggests

  • 6 of every 10,000 children born in the UK each year become severely visually impaired or blind by their 16th birthday and probably a further 12 becoming visually impaired (worse than 6/18 or 0.5 to 1.0 Log MAR).
  • Thus there are at least 4 newly visually impaired children each day in the UK and 2 per 1000 children in a given population at any time are visually impaired or blind.

Rahi J, Cable N Severe visual impairment and blindness in children in the UK. Lancet 2003;362(9393):1359-1365.



Division of Notifications by Additional Disability

additional disability

Types of additional disabilities

additional disability



Site of visual impairment

site of visual impairment


Aetiological classification

This study categorised the time of acquiring the cause of childhood visual impairment into three major periods:

  • Prenatal, before birth including both genetic and intrauterine (in the womb) causes;
  • Perinatal & neonatal, at the time of birth and within the first 28 days of life;
  • Postnatal, during childhood, after the first 28 days of life.
  • Disorders acquired in the prenatal period were the most common.
  • The second most common is at and around the time of birth).
  • Prematurity and hypoxic/ischaemic damage are the two main causes of acquired visual impairment at this time.
  • It was uncommon to acquire a visually impairing condition during childhood.

What do we use vision for?

  • Access information
  • To interact socially and to communicate
  • To move around safely

Childhood VI has far reaching effects throughout life

  • Impairment in childhood can effect many aspects of development;
  • Can lead to long term education and social disadvantages unless appropriate provision is made at an early age.

Where are these needs met?

  • Primarily in education.
  • Care needs to be taken to ensure that appropriate planning and delivery of services is available.
  • Care needs to be taken to the needs of those with additional disabilities.

Notes: The needs of are met in education with input from hospital, optometric, and social services when required.