A brief experience of blindness.
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ABSTRACT: This review article provides an overview of some of the key issues and challenges surrounding the management of visual impairment in older people. It also discusses the role of the nurse in the treatment and management of three common ocular conditions, including cataract, age-related macular degeneration and chronic open-angle glaucoma.Aging Health 12/2009; 5(6):821-831.
any eye procedure:
Wash your hands
(and afterwards too)
Position the patient comfortably with
his/her head supported
Avoid distraction for yourself and
Ensure good lighting
Always explain to the patient what you
are going to do.
To remove ingrowing eyelashes
To prevent corneal abrasion
You will need
Magnification (magnifying loupe)
Torch or flashlight
Local anaesthetic eye drops
Explain the procedure and advise the
patient that it will cause some very
The patient, helper, and examiner
should be positioned appropriately.
The helper can hold the torch (Figure 1).
Instil the local anaesthetic eye drops
Using magnification, identify the
eyelashes which need epilating
For lower eyelashes:
ask the patient to look up,
fix his/her gaze, and keep still
with an index finger, gently hold
down the lower eyelid
For upper eyelashes:
ask the patient to look down,
fix his/her gaze, and keep still
with a thumb, gently ease the
upper eyelid up against the
With the epilation forceps in the other
hand, hold the ingrowing eyelash
close to its base and pull gently
forward to pluck it out (Figure 3)
Repeat until all ingrowing lashes are
Between each epilation, wipe the
eyelash off the forceps with a clean
swab (Figure 4)
Reassure the patient when all
ingrowing lashes have been removed
and advise him/her not to rub
A brief experience of blindness
Senior House Officer in Ophthalmology,
London House, Mecklenburgh Square,
London WC1N 2AB, UK.
Some months ago, I observed a blind pedestrian
negotiating a busy London street with remarkable
speed and confidence. “Just how does he do it?”,
I thought to myself. I decided that I, as an eye health
professional, could benefit from a brief experience of
what it was like to be ‘blind’. This became the inspi-
ration for a fundraising event, which involved me having
my eyes covered for 24 hours, and being effectively
‘blind’, under close supervision from a sighted guide.
Living with sudden and complete visual loss is a
high-risk endeavour, and ‘pretending’ to lose one’s
sight is no less risky. For this reason, prior to the
event, my sighted guide, Puneet Sayal, and I
underwent intensive visual awareness training.
This involved learning a range of safe coping
techniques, both indoors and out, such as opening
doors, climbing stairs, and pouring hot drinks.
Even the simplest activity could be challenging.
On the day of the event, with close guidance from
my guide, I went about my normal daily routine:
getting dressed, preparing and eating breakfast,
walking to university, attending classes, etc.
I quickly noticed that some people treated me
differently now that my eyes were covered: they
were either more or less attentive than usual, and
they sometimes addressed me indirectly by
talking to my guide. Some seemed disturbed by
my condition, others overeager to help.
I found I was less confident, found it more
difficult to concentrate in class, and was not able
to contribute as much as usual. I was completely
dependent on my guide and experienced a severe
loss of freedom. As the day progressed, I began to
feel stressed and became anxious to remove my eye
coverings. When they finally came off after 24 hours,
the light was actually painful. I also felt quite
emotional and remained unsettled for a few hours.
Reflections after the event
The experience was deeply unsettling, but very
valuable to me. Thanks to my guide, I never felt
unsafe. I was more disturbed by my diminished
confidence, independence, and ability to contribute.
I cannot suggest that I now ‘understand’ what it is
like to be blind, but I did learn the following lessons:
Blind people must be treated normally –
inclusion and dignity are paramount
Efforts to help blind people can both help and
Ask first before offering help and be precise with
Look at blind people and speak to them directly,
using normal language
Leaving a blind person without announcing it
is unkind and embarrassing
Ask how and at what pace a blind person would
like to be guided
Make sure the person you are guiding is safe,
but stay relaxed, and remember not to pull, but
to walk with him/her holding your arm
Being blind is a constant challenge
Rehabilitation training is crucial.
Epilation of eyelashes
Centre for Eye Health,
London School of
Hygiene and Tropical
Medicine, Keppel Street,
London WC1E 7HT, UK.
Figure 3Figure 2
Copyright © 2008 Sue Stevens. This is an open access article distributed under the
Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Copyright © 2008 Hessom Razavi,. This is an open
access article distributed under the Creative Commons
Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided
the original work is properly cited.