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EDITORIAL

Ashoke Chowdhury

 

2008 is an important significant year for the visually impaired all over the globe. Monsieur Louis Braille was born in France two hundred years ago to deliver the sightless people from the long imprisonment in the dark.

 

Needless to add Braille himself was a sightless, who suffered this tragedy at the age of three only, while playing with a sharp instrument, which pierced into one of his eyes causing bleeding resulting into blindness. He lost another eye due to sympathetic opthalmia.

 

Now his life was sealed with the stamp of darkness. Nevertheless, Braille never lost his indomitable courage to proceed to his cherished target. Braille became an organist at the first school for the blind in Paris. But he never forgot about the pains, he had to undergo in learning thing for want of definite reading and writing system for the blind.

 

“Inscrutable are the ways of God”. French war was over and Charles Barbier, an artillery officer of Nepolean, who developed twelve doted night signals for the soldiers during war, came to the first school for the blind with his developed signal, if it was of any use to the sightless.

 

Monsieur Braille was present on the occasion and took this twelve doted night signals as a challenge for developing and writing script for the sightless. ‘Rome was not built in a day’ so, also Braille script was not develop over a night. It took long time for Louis to make experiment over twelve dots and to reduce the numbers to six dots perceptible within the preview of our tactile sense. We received sixty three characters by combination and permutation of six dots in different position. Thus the tireless endeavour of Monsieur Braille was crowned with success. Initially it was accepted in France and thereafter this remarkable discovery spread all over the globe with unanimous acceptance.

 

Braille is no more alive but his deeds made him alive all over the World. In fact Braille script has unlocked the treasure of wisdom to the sightless with its golden key.

Technology has been introduced to produce Braille in huge quantity to reduce paucity of Braille materials. Needless to say that Webel Mediatronics Ltd. with its multi-faced Braille literacy programme has been doing this commendable services towards education and rehabilitation for the blind.

 

 

Way To Light

WITH REFERENCE TO THE SIGHTLESS

Ashoke Chowdhury

 

Sightless persons are deprived of outer light due to loss of vision. This is in fact an organic defect that obstructs light to enter into the retina that reflects image of the external world through the perceptual interpretation of the optic nerve in the human brain. A blind person seems to imprison himself in the dark world, forever, with no ray of hope to enjoy the colorful beauty of the external world. What a deplorable state of life! Is there no way out to come to light? Yes, there are ways to be released from the dark imprisonment.

 

Education as observed by Swami Vivekananda is the fullest manifestation of man within himself. True educational light gradually unfolds the latent possibilities present in one self. One begins to realize one’s own self and explores the unknown realms inspite of visual impairment. Thus Homer Composes E and Odissi, two great epics, Jhon Milton Composes ‘Paradise Lost’, a great English epic, Nicolous Saunderson, occupied the lucasion chair in the university of Cambridge after Sir Isaac Newton despite his sightlessness. The above noted important figures had seen inner light focused within themselves and enlighted millions of seeing readers all over the globe.

 

In fact what is of paramount importance is to awaken Consciousness to realize and comprehend the ongoing affairs of the world. Needless to add that Dr. Helen Keller, beside her triple impairment would come to the zenith of our success, when her consciousness was awakened. Dr. Keller learnt names of different objects with no co-relation with the same. But one day Miss Sullivan took her to the garden and placed her one palm under the flowing water from the tap and wrote w-a-t-e-r on the other palm. Immediately on this moment her consciousness was awakened and she felt for the first time that this flowing substance is connected with the name of water. That was turning point of her life. She came back to her room and touched every object of her house and felt that every object was quivering with life. Thereafter she proceeded ahead with the triumphant march of life.

 

A sightless person according to me may discover the inner light that is divine light through meditation, the way as shone by the sages of India. In fact to discover the divine self within oneself is the ultimate goal of human life. A sightless person through constant contemplation of God may perceive that illumination of divine light even in the external darkness.

 

The process of meditation is a long way to arrive at the target. True religious teacher or preceptor is the only person to guide the disciple how to proceed and where to stop. The span of attention should be concentrated upon the middle of the forehead between two brows. This portion is the golden gate to begin meditation. In course of time streams of consciousness flow within ourselves with a view to arriving at our cherished goal. As soon as the devote reaches the goal, he discovers illumination of divine light within himself emanating from deep darkness and exalting the self of the sightless to a high spiritual feeling with transcendental bliss and solitude. Tagore has interpreted this state of life as divine light originating from the perennial source of bubbling joy within oneself, emanating from the deep darkness.

 

As soon as a sightless person reaches this state, he no more needs external vision; as inner light has illuminated his inner self with which he may develop all pervasive vision to enter into the cosmos.

 

 

News Highlights on Voice Of World

 

1. Voice Of World observed World Telecom Day on 17th May 2008 at Calcutta Press club. Mr. Samar Chakraborty, Chief General Manager of BSNL was present at the occasion in presence of so many press media and announced some relaxation to the sightless, who are conducting telephone books at different centres. Voice of World conducted a rally of seven hundred sightless persons outside the press club for the awareness of the society.

 

2. Voice of World celebrated Helen Keller’s Birth anniversary at Ganabhaban on 28th June. Many competitions were organized by the said concern like Braille Reading and Writing, News Reading, Dancing, Song of different types of programme through out the day. Many VIP attended the occasion with their nice deliberation to encourage the sightless. The attempt of Voice of World was appreciated by one and all. The winners won the prizes at the end of the occasion and all were financed by Voice of World.

 

3. The members of Voice of World belonging to Rotary Interact Club received Rotary shares award on 29th June 2008 at Bidyamandir Minto Park.

 

4. New committee of Interact Club was launched on 6th July at Behala.

 

5. Bangabir Competition was held at Behala branch where the Voice of World received a donation in kind in the form of electric fan.

 

6. Voice of World set up a very good infrastructure at Rishra in collaboration with Japan Govt. Needless to add that nearly 22 lakhs of rupees were sanctioned for building up this structure.

 

25 sightless ladies are undergoing vocational training on knitting, candle making, chair recanning, paper bag making and home management for future rehabilitation.

Beside this modern technology has been introduced for importing vocational training on adapted computers for undergoing training on medical transcription, computer application and office management and so on. Vocational Rehabilitation centre, Govt. of India has sponsored this scheme or project in favour of Voice of World.

 

In addition to above noted activities the sightless students both male and female are encouraged to do higher studies up to university level and they are properly taken care off by the Voice of World for developing man power in the society in different capacities either as a teacher or as a legal professional or as telephone operators or as railway announcer according to their latent.

 

Thus the emphases of Voice of World is always not only on education but also on development of man power to serve the society with their latent potential varied training programmes.

 

 

Therapeutic Management of Visual Impairment

Dr. Ruma Chatterjee (Vice President)

(Society for the Visually Handicapped)

(Paper presented At All Indian Rehabilitation Professionals Congress 2008)

(At Science City Auditorium)

 

Therapeutic Management of Visual Impairment:

At the outset, I want to clear one point; i.e. I am not a medical practitioner. What I intended to share with you is the submission of my practical experience while working with visually impaired children and weaving of the practical knowledge with theoretical back up in my lectures before the B Ed/Diploma students of Special Education in different institutions in Kolkata. Furthermore, while managing a project with deaf-blind and Multi-sensory impaired children, I have to go through the medical report thoroughly and sometimes consult physician to understand the implications of the impairments. In many cases I have found that visual stimulation gives marvelous results. But the process is a long and arduous one. In the context of mainstreaming of the children/people with disability, the therapy part has become more important as that can include a child with disability in the mainstream successfully.

 

In this brief article, I would discuss some of the common visual impairments which can be treated or handled if the parents are aware of the implications of that particular impairment and the therapy appropriate for rehabilitation.

 

  Amblyopia:

Commonly called lazy eye. It is a vision defect involved lower visual acuity in one eye which cannot be corrected by glasses or contact lenses. Result is often a loss of stereoscopic vision (3D) and depth perception. Visual therapy can improve this condition. Early detection and treatment offers the best outcome.

 

The choice of screening tests depends on the child’s age. During the first year of life, strabismus can be assessed by the cover test and the Hirschberg light reflex text. Newer automated techniques can be used to test children younger than age 3 years. Photo screening can detect amblyogenic risk factors such as strabismus, significant refractive error, and media opacities; however, photo screening cannot detect amblyopia. Screening children younger than age 3 years for visual acuity is more challenging than screening older children and typically requires testing by specially trained personnel.

 

In children older than age 3 years, stereopsis (the ability of both eyes to function together) can be assessed with the Random Dot E test or Titmus Fly Stereotest; visual acuity can be assessed by tests such as the HOTV chart, Lea symbols, or the tumbling E. Traditional vision testing requires a cooperative, verbal child.

 

  Treatments that can improve visual acuity include:

·          Surgery for strabismus and cataracts.

·          Use of glasses, contact lenses, or refractive surgery to correct refractive error.

·          Visual training, patching or atropine therapy of the nonamblyopic eye to treat amblyopia.

 

  Glaucoma:

It is an important cause of blindness all over the world, particularly in old people. Early detection is the only way to prevent blindness from open-angle glaucoma. Sometimes patients do not seek early treatment because they mistake glaucoma for cataract, and come for surgery when the vision is severely reduced. Screening test for glaucoma should be a part of routine eye test after 40. Relatives of glaucoma patients and people over 60 are especially at risk.

 

  Optic Nerve damage:

Most optic nerve damage is irreversible, and so there is very little treatment for patients with advanced optic atrophy. However, in less advanced cases where the cause is known, it may be possible to stop the progress of the disease.

 

  Photophobia:

Photophobia, or light sensitivity, is an intolerance of light. Sunlight, fluorescent light, incandescent light--all can be bothersome. Sometimes light-sensitive people are bothered only by bright light. In extreme cases, any light can be irritating.

 

The best treatment for light sensitivity is to treat the underlying cause. In many cases, once the triggering factor is treated, photophobia disappears. If the person affected with photophobia is taking a medication that causes light sensitivity, talk to the prescribing physician about discontinuing it or replacing it with another drug.

 

If any one is sensitive to light, avoid bright sunlight and other bright lights. Wear wide-brimmed hats and sunglasses with ultraviolet (UV) protection.

 

In an extreme case, the person may consider wearing prosthetic contact lenses that are specially colored to look like his own eyes. Prosthetic contact lenses can reduce the amount of light that enters the eye, so his eyes are more comfortable.

 

  Refractive Errors:

Myopia, Hypermetropia, Presbyopia and Astigmatism: Use of proper spectacles.

 

  Retinopathy of Prematurity (ROP)

The most effective proven treatments for ROP are laser therapy or cryotherapy. Laser therapy “burns away” the periphery of the retina, which has no normal blood vessels. With cryotherapy, physicians use an instrument that generates freezing temperatures to briefly touch sports on the surface of the eye that overlie the periphery of the retina. Both laser treatment and cryotherapy destroy the peripheral areas of the retina, slowing or reversing the abnormal growth of blood vessels. Unfortunately, the treatments also destroy some side vision. This is done to save the most important part of our sight--the sharp, central vision we need for “straight ahead” activities such as reading, sewing, and driving.

 

Both laser treatments and cryotherapy are performed only on infants with advanced ROP, particularly stage III with “plus disease”. Both treatments are considered invasive surgeries on the eye, and doctors don’t know the long-term side effects of each.

 

In the later stages of ROP, other treatment options include:

Scleral buckle--This involves placing a silicone band around the eye and tightening it. This keeps the vitreous gel from pulling on the scar tissue and allows the retina to flatten back down onto the wall of the eye. Infants who have had a sclera buckle onto the wall of the eye. Infants who have had a sclera buckle need to have the band removed months or years later, since the eye continues to grow; otherwise they will become nearsighted. Sclera buckles are usually performed on infants with stage IV or V.

 

Vitrectomy--Vitrectomy involves removing the vitreous and replacing it with a saline solution. After the vitreous has been removed, the scar tissue on the retina can be peeled back or cut away, allowing the retina to relax and lay back down against the eye wall. Vitrectomy is performed only at stage V.

 

  Squint:

The management and treatment of squints is very different in children and in adults.

 

  For children:

(a) Correction of refractive errors with spectacles;

(b) Treatment of Amblyopia--if a child has a constant squint in one eye and no apparent eye disease, the squinting eye is probably amblyopic and the fixating eye should be covered. As soon as the squint starts to alternate, the covering can be stopped.

(c) Surgery.

 

For adults: It may be due to serious neurological or general medical disease. Double vision can be relived temporarily by covering one eye.

 

  Low Vision:

Low Vision is a condition in which the vision loss is severe enough to interfere with the daily life of the patient. After a retina or corneal problem, the vision can only be enhanced with special aids to read or see. One of the main problems of Low-vision rehabilitation is difficulty faced by rehabilitation workers who often do not know how to help a child/person with low vision. Ophthalmologists and Optometrists are in a quandary with regards to the proper treatment for the persons with Low-vision, as their problems can neither be treated with surgery or prescription of spectacles. Generally, a person with Low-vision can have the following problems field loss, cloudy vision, or combination of field loss and cloudy vision. In most of the special schools for the sightless, still there is no provision to facilitate the learning of the children with Low-vision. Although Braille system of reading and writing would be the prescription for a learner with Low Vision when the reading materials increase in volumes, but for the initial years there are so many ways to facilitate the reading and writing skill of the young learner.

 

·          Magnifier and different LV devices are used.

 

·          Proper illumination in the class room may help the child with Low Vision to read his printed text book.

 

·          Large print helps.

 

·          A small aperture cut out from a piece of black card board and put in front of the reading material, can help to cut glare and enhance image.

 

·          Use thicker tip-pens while writing to enhance contrast.

 

·          Enhance contrast by using different colour.

 

·          Stairs having the same colour can cause confusion for a person with low-vision, thus making it difficult for him/her to use them. Instead, stairs with contrasting colours should be put in place.

 

·          Teachers/rehabilitation workers must know that seeing process for the person with Low-vision is so strenuous that their eyes become tired after some work/reading; therefore they require.

 

·          However, these therapies do not relieve the person affected by Low Vision of his pain, as he does not fall in the category of blind, nor does he see clearly. This condition secretion from pituitary and adrenalin glands. This imbalance is reflected in the behavioral problem which has to be addressed medically. Specific drugs are to be used to regulate secretions.

 

  Conclusion:

The recommended therapies for the persons with visual impairment including Low-vision would enhance his/her skills in performing in a mainstream classroom/workplace. However, “work therapy”, as claimed by many successful persons with blindness, is the only answer to proper “inclusion”. This includes body movement and adapted physical activities for proper muscle tone. This physical activity would be taken as therapeutic intervention for the growth of a visually impaired child and his/her mainstreaming in course of life in later years.

 

 

My thrilling experience as a sightless tourist

Written By Soumen Lahiri

(Asst. Music Teacher Voice of World)

 

It is a common idea that touring to different countries is basically made by the sighted person. But idea is completely wrong. As vision impaired, I have traveled a lot and enjoyed every bit of it with the help of my other organ--like sound, touch, smell and or the feelings. While I was in Hong Kong, I traveled to Disney Land and found that all important things are written in Braille in the wall.

 

One day my father told me that we will go to Ladakh. I enquired my father that what would be my attraction to Ladakh. He replied that I could enjoy the nature with the help of sound, smell and weather.

 

Khardungla is the highest motorable road in the world. Altitude is 18400 ft. ‘La’ means pass in Tibatian language. I was very much afraid to go to that high altitude.

On that very morning, the tour operator gave us one medicine, as a protection for high altitude sickness.

 

There were many pot holes in the hilly road. I was told, that the water melted from snow had damage the road.

 

The climate was changing as we were going to high altitude to higher altitude. We put on woolen garments one after another.

 

It took two hours for reaching 18400 ft. from 1200 ft. I had experienced slight breathing problem due to lack of oxygen apprehension proved wrong.

 

There were snow everywhere. White snow looked like a silver with the ray of the sun as I was told by my mother. I touched the snow it was soft like dust. I took some snow in my hand after removing my gloves. I was shivering due to coldness of the snow. I immediately threw away the snow and again put on the gloves.

 

Though it was not snowing at that time, I was told that snow remains through out the year and Militaries were there to help the tourist.

 

When we were coming down, I had felt that my head was reeling and I was feeling diginess and also some loss of breath. This tour was very much different from other tour, because it was my first experience to go such high altitude and feel the snow.

 

In fact nature has prepared her platform everywhere to enjoy her beauty and sounds for every tourists. There is no discrimination on the part of nature between seeing and non-seeing visitors to enjoy her surroundings. The seeing will enjoy beauty and colour with vision and non-seeing will feel her with the help of ear and touch. So far as the beauty is concern, the sightless tourist may enjoy the same with the interpretation of the guide. Thus I have enjoyed the sights and sounds of nature to my heart’s content with the help of my remaining organs and the interpretation of my parents.

 

 

Helen Keller, the miracle worker

Swapan Mukhopadhyay

 

We all know Helen Keller, the miracle girl, Helen Keller the mental prodigy, Helen Keller the genius. But that is not the reason why millions of people throughout the world love Helen Keller. No doubt the personal achievements of this blind-deaf and dumb woman are amazing. But that is not the reason why millions of disabled in this world find her as their companion and guiding spirit to march forward with hope and dignity.

 

There is another story of Helen Keller never written by her and less talked about. This is the story of her relentless struggle for the cause of disabled, disadvantaged and helpless poors of the world. It is a long struggle and sometimes lone struggle till the death of this miracle worker. So we love and respect this crusader for the blind, the fighter for the down-trodden. We admire her personal achievements but we are grateful to her for her immeasurable contributions to the causes of the disabled of the world. The indomitable spirit of this miracle worker is the real springhead of inspiration for all who have lost hope and confidence. Thus the story of this miracle worker is the touch-stone to defeat our disabilities and to march forward to achieve success in life.

 

I shall try to draw a very brief sketch of the story of this part of her life from 1904 when she was twenty four to 1968 when she died.

 Helen’s first contribution is to bring an uniformity in Braille transcription internationally so that sightless people are not confused in different methods of Braille transcriptions.

 In 1907 Helen campaigned rigorously against a social taboo and called upon mothers to demand for the preventive treatment of their new born children so that they were not born blind. She was a lone fighter against a superstition and saved millions of new-born babies from a disease called “Opthalmia neonatorum” that caused their blindness.

 

Helen told that “it is not the blindness but the attitude of the seeing to the blind which is hardest to bear”. She fought for the dignity of the blind in the society. She pointed out that the status of the poor, disabled women in the society is dismal because they suffer from tripple disabilities--because of their poverty gender and disability. In 1935 she compelled President Roosevelt of America to change his economic policy and to include the blind in the social security Bill. It had a cascading effect throughout the world. She forcefully established that blinds are not second class citizen. As a severely disabled person Helen understood better than anybody that during war disabled are worst affected and war leaves millions of people disabled. She never stopped her fight against war and even preparedness for war. After war when she was reported that hundreds of blinded soldiers were psychologically broken and many tried to commit suicide even in army hospitals, she rushed to them and inspired them showing her own disability. Once a young blind soldier was so much inspired that he cried out “The kiss of this lady is the kiss of my mother”. Such was the influence of Helen Keller to the blind.

 

Helen was bold to fulfil her social commitments without any hesitation to speak and protest against any sort of exploitation of the big industrialists and businessmen even if they were her benefactors or patrons of the American Foundation for the blind. Walking on the forefront she led the procession of the striking workers of the industries in the streets of New York.

 

In the journal “Call” of New York she wrote--“Rights are things that we get when we are strong enough to claim them”.

 

While Helen was asked whether she desired to have her eye-sight, she replied promptly--“No, no, I would like to walk in dark with the hands of my friends than to walk alone in light”.

 

Helen’s devotion to the cause of mankind was wonderful and so we all love this miracle worker.

[Swapan Mukhopadhyay is the author of the Bengali book--Helen Keller.]

 

 

Silver Jubilee of

Society for the Visually Handicapped (SVH)

Ashoke Chowdhury

(Former Principal, Calcutta Blind School, Behala)

 

I had a long association with Mr. Shyamal Dutta, founder President of SVH since the decade of 80’s. Being a Rotarian representing the Rotary Club of Behala, he and his wife Mrs. Anuradha Dutta, would often visit our School and extend their support to various empowerment projects involving our students with vision impairment. He was so generous and compassionate that besides organizing financial support for various events and project, both individually and by his Club, he hosted a Rotary District Conference, attended by dignitaries from various parts of the country and abroad, in the premises of the School.

 

In 1983 I along with several other visually impaired citizens attended a small informal meeting in his the then residence at 34 Ritchie Road and learnt that he and some other likeminded individuals have come forward to form a Society to support Equal Opportunity Education. I met Ms. Hena Basu, the Hon. Secretary of the Society and in due course they began conducting small projects where two alumni of my School namely Arup Chakraborty and Ranabir Dutta took an active part.

 

Logo of SVH is Braille A Page--Light A Mind. To make this vision a reality, gradually this Society trained sighted Braillists, developed self-learning material, and volunteers transcribed page after page to serve needs for reading material in Braille format. And all these they served free of charge. They developed a bank for aids and appliances for the Blind and spread out their activities touching lives of Persons with Vision Impairment and total loss of vision, facilitating an improvement in the quality of their lives.

 

The empowerment project for which this Society’s name will remain ever-memorable in the history of developing self-reliance and body-confidence of Blind and visually impaired their mountain adventure training for the Blind. Adult Blind young men and women from all over the country would participate in this annual adventure course, with sighted escorts, conducted by the Himalayan Mountaineering Institute, Darjeeling under the Ministry of Defence, Government of India and organized by SVH from 1989 to 2001. This course generated a spirit of self-confidence, body-confidence and socializing skill among persons with loss of vision and at a national level they learnt the skill of camping, group living and mainstreaming. Back home, the visually impaired trainee became a hero in his/her own locality where hardly any sighted youth had climbed 14000 ft. Dzongri Pass in Western Sikkim, the route of basic course of HMI.

 

I wish this Society managed by dedicated volunteers all success and serve Persons with loss of vision in larger number.

 

 

LADY WITH THE LAMP

(In memory of Late Bandana Chakraborty)

 

“Kind hearts are the garden, kind thoughts are the roots kind wards are the blossoms, kind deeds are the fruits”.

 

All of us must have heard the name of Florence Nightangle, who carried a lamp in hand in the dark to look after the wounded soldiers during crimean War. The author had been entouch with a lady named late Bandana Chakraborty, a dedicated soul to the suffering humanity, who also carried a lamp in hand to focus light to the inner eye of hundreds of sightless persons in the remotest part of villages in the district of Purulia. Needless to add in this connection that Mrs. Chakraborty was the worthy wife of Sri Nandadulal Chakraborty, general Secretary of Netaji Eye Hospital and blessed daughter-in-law of Swami Asimananda Saraswati, who set up this hospital in 1943 with the instruction of Netaji Subhas Chandra Bose, when Sri Annada Shankar Chakraborty was a political co-mate of our beloved leader.

 

Sight Savers International, Royal Common Wealth Society for the Blind, Sanctioned a project on community Based Rehabilitation for the rural blind in favour of Sri Sri Bijoy Krishna Ashram Relief Society, covering a total population of 178766 from 1997 up to March 1999. Smt. Bandana Chakraborty was the project director. Interested Educated villagers attended the training classes taken by trained personnels under the control of the director. Thus man power was developed to prepare the sightless villagers in community Based Rehabilitation programme for the prevention of blindness, training for economic placement of the rural sightless people.

 

The CBR concept has taken a firm ground in India. CBR and integrated Education are creating better acceptance of disability both by the persons affected as well as by the community. The integrated Education programme has also been started since March 1999 by the society, supported by Sight Savers International. Eight (8) blind children under a trained Itinerant teacher are studying well at normal schools.

 

A modified view of this CBR project for the developing countries is that It should be cost effective individual need-based and result oriented, must result in complete integration of the individuals into the community and the outcome should enable the individual to stay within his family fold and the community and he should be able to contribute to the family income with money, kinds or even labour.

 

Activity of the project may be classified into two ways--

Direct Activities:--

Identification

Medical Rehabilitations

Certificate of Blindness

Social Rehabilitation

Economical Rehabilitation

Provision of Support Service

 

The Referral Activities:--

Prevention and cure of blindness

Integrated education

As per the guideline of Sight Savers International within the time bound, two years

 

Project:

Till December 1999 we would definitely cover more than two lack population and two hundred incurable persons. The effectiveness of CBR and the long term development and sustain ability of any CBR initiative will require the co-ordinations involvement and collaborations of the following seven groups.

1. People with disabilities.

2. Families of people with disabilities.

3. Communities.

4. Government (Local, Regional, National).

5. NGO (Local, Regional, National and International).

6. Medical professional, alive Science professionals, educators, social scientist and other professional.

7. The private Sector (Business and Industry).

It is Crystalline clear from the above description what a herculean task, Mrs. Chakraborty accomplished with her patience, perseverance and indomitable spirit. It is easy to do any project in urban area but what a difficult task it is to accomplish the same in the remotest part of this villages where the light of knowledge has not been focused properly or progress of literacy has not been achieved successfully. Smt. Chakraborty had a heart to feel the problems of the disabled people and for this reason she marched forward with a sacred lamp in hand to illumine the hearts of the sufferers overcoming all the obstacles.

 

In fact her pleasant personality had a magnetic attraction. She could move all the people to her cherished goal. Her achievement within two years was crowned with success. Beside this project she was a fountain of inspiration to her husband, Sri Nandadulal Chakraborty, who also dedicated his life to the service of suffering humanity by extending the volume of Netaji Eye Hospital at Ramchandrapur in the district of Purulia and spreading its branch even to Calcutta with a philanthropic mission.

 

Salute to the inspirer, Swami Asimananda Saraswati, who initiated this incantation of social service into the heart of his worthy son. The flame of light that Swamiji lit up is being carried on by his worthy son and daughter-in-law in collaboration with so many devotees. According to Mr. Chakraborty, “we have many miles to go to reach our target”.

Mrs. Chakraborty is no more but her sacred memory is still vivid and living like the constilation of stars in the blue sky. May the almighty retain her soul in Heaven with transcendental bless. To conclude let me remember Swamiji’s blessings on her,

 

“May your desires be fulfilled

Your virtuous soul

Be replete with ecstasy,

May the holy name of my master

Always abide with you

In the path of your life’s journey”.

 

(Materials collected from project report)

Sri Ashoke Chowdhury

Devotee to Swami

Asimananda Saraswati

 

 

Low Vision Management A New Hope

To the Visually Challenged Persons

Dr. S.P. Chakraborty (MS, Ophthalmology)

Netaji Eye Hospital, Ramchandrapur Ashram

Purulia, West Bengal

 

What is low vision:

As defined by WHO (World Health Organisation) the term low vision is used for persons who are having vision 6/18 or less in the best corrected eye or whose visual field is reduced to 10 degree while looking straight ahead. They may be suffering from various ocular diseases, which inspite of best available treatment, have caused permanent incurable impairment in their capacity to see. These visually changllenged groups of people are termed as low vision clients.

 

Who are low vision clients:

The following groups of patients who are having incurable vision impairing conditions, constitute few of the vision category persons--

A. Albinism; B. Degenerative Myopia; C. Advanced Glaucoma; D. Congenital anomalies; E. Age Related Macular degeneration; F. Retinitis Pigmentosa; G. Retinal and Macular dystrophy and denerations; H. Corneal Opacity; I. Diabetic Retinopathy; J. Nystagmus; K. Optic Atrophy etc.

 

Objective of low vision management:

Low vision management focuses on the rehabilitation if the residual vision of the person By various non-optical, optical and training methodology low vision management tries to utilize the left over vision of the visually impaired person to make his or her day to life easier and comfortable. This is simply saying, making better use of whatever vision the patient is left with. This demands lot of understanding on the part of the patient and the guardians as well as lot of counseling on the part of the medical professional to make them understand and expect realistically of the outcome of low vision management. The crux of the matter is that, though the visual acuity is not going to improve, it is the quality of life of the clients, which will be embittered in the long run.

 

Stages in management of low vision:

It is an integrated community approach, which can efficiently manage these conditions. The family members, the teachers of children, health workers, health care professionals all come together and the team approach deals with it in the following manner--

Stage I--Detection of visual disability (Family, teacher, health workers).

Stage II--Identification by visual screening by teacher, CBR (Community Based Rehabilitation) worker or health worker.

Stage III--A: Clinical Assessment of the condition by Ophthalmologist (Examination, Diagnosis, treatment, refraction, prescription, provision of Optical low vision aids etc.)

B: Educational (special education personnel) educational needs, reading material, regular/special schools, provision of non-optical low vision aid.

C: Functional (special services personnel) visual orientation/mobility, visual communication, use of vision in activities of daily life.

Stage IV--Training in maximum use of vision and how to use low vision aids by parents, Teachers, CBR workers.

Stage V--Monitoring of change in the clients visual ability by parents, clinical, educational and CBR personnel.

Devices used in our low vision management clinic:

A. Non-optical Devices:-

1. Typoscope; 2. Sitting habits; 3. Writing Guide; 4. Reading/Writing stands; 5. Large print books; 6. Sunglasses/hats; 7. Bold line exercise books; 8. Black felt pens; 9. Changed Reading techniques; 10. Colour; 11. Contrast; 12. Lighting; 13. Size; 14. Distance.

B. Optical low vision Devices:-

1. Magnifying Glasses; 2. Hand magnifiers; 3. Stand magnifiers; 4. Telescopes.

How to recognize possibility of impaired vision in you child?:

1. By the appearance of eyes:-

A. No eyes at all; B. Very small eyes; C. Closed or partially closed eyes; D. Eyes which look milky; E. Eyes which constantly move; F. Eyes which seem scarred or damaged; G. Frequent eye infections or sticky eyes; H. Constant frowning; I. Presence of Squints or oblique eyes; J. Unusual eye movements; K. Constant Blinking.

2. By Behaviour:-

A. Frequent touching of eyes e.g. poking, rubbing etc.; B. Avoids bright light; C. Avoids close work; D. Obvious problems in focusing for example distance to close objects, large to small objects; E. Short attention span; F. Poor self-care skills; G. Poor communication skills.

3. By responses to other people:-

A. Does not seem to recognize people--unless spoken to; B. Does not make eye contact; C. Peers at people; D. Jumpy when approached without being warned; E. Lack of regard for other people, environment etc.; F. Sees people wearing bright colours better.

4. By response to objects:-

A. Closely looks at objects; B. Peers at objects; C. Moves objects towards light; D. Preference for bright objects; E. Appears to see moving object better than stationery objects.

5. By movements:-

A. Crashes into objects--such as doors, furniture; B. Is anxious or unwilling to walk alone; C. Finds it difficult to judge distances; D. Copes better in well till areas; E. Gets lost when moving about.

 

 

Changing Pattern of Visual Impairment

Prof. I.S. Roy, MBBS, DO, DOMS, FRCS, FRC Ophth (Lond)

Director, Netra Sevasram

Commissioner, St. John Ambulance Brigade

 

This is a changing world and in the last decade we have noticed several new trends in the pattern of blindness due to research progress. There is a distinct shift from infectious blindness condition to non-infectious chronic diseases. For example--

1. Ophthalmia neo-natorum is nil;

2. Trachoma and onchocerciacis are rare;

3. Blindness from small pox is nil;

4. Malnutrition and Vit. Deficiencies causing Keratomalacia are rarely seen.

However the corneal blindness is still rampant from fungus and viral infection.

 

These have been made possible through public awareness created by Govt. and NGO’s with the co-operation of the ophthalmic community. Needless to say several International Organisations are doing commendable work viz. RCSB, Danida, Rotary International, Lions International, Seva Foundation, Cristopher Blindness Mission and many others.

Despite all these the global blindness is increasing--In fact the slogun “HEALTH FOR ALL by the year 2020” has failed a and we foresee that the blindness figure of 12 million will be doubled by the tear 2020. The reason is simple-the population at large is growing older. As a result the Senile Cataract, Age related Mac. Dgn., maculopathy of Diabetes and BP are seen in large number. There is not only a changing pattern in the disease but also a changing trend in the treatment modality. Patients demand foreign IOL and phaco. Same result of visual improvement can be obtained at a cost of Rs. 1000 only from our hospital. The laser therapy is very expensive where Photo Dynamic Therapy is necessary.

Glaucoma is another disease which escapes the attention in many cases and the treatment has also been made expensive with Auto Perimetry, OCT, Laser therapy, Xalatan like drug. Extremely surprising is that the demands are from the economically weaker section of the society. The craze for the very expensive type of treatment has been induced into the patients brain by the media like T.V. and unethical publicity of the medical community. Now a day Ophthalmologists are more keen to copy the very expensive treatment modality available abroad.

 

To cope with the increasing blindness population several measures have been taken. They are as follows. The slogan is “Vision 2020 Right to Sight”.

 

Infrastructure development-Base hospital are now replacing the old camps in school and dharmashalas; Govt. has supplied microsurgical-facilities to sub-divisional hospitals.

 

Manpower development to train Surgeons in Micro-Surgery techniques; more important is to train Mid Level Ophthalmic Personnel (MLOP). Many hospitals like that of Netra Sevasram are active to develop their own ‘in house’ training to meet their requirement. The MLOP are trained in OPD management, Indoor and operation theatre management. All of them are excellent assistants during surgery like IOL implantation, squint and many other intraocular surgeries.

 

Indigenous Ophthalmic equipments, suture, IOL, spectacles at an affordable cost; in this context I am boldly announcing that a cut bifocal could be obtained cheapest at a cost of Rs. 20. Even then the profit was Rs. 2. However one patient of mine paid 26000 for his bifocal, that also did not give him the satisfaction while playing golf and simultaneously fiddling with his cell phone.

 

Country-wide Pediatric Unit to combat neglected childhood blindness. Many cases of ROP and refractive errors and amblyopia are still untreated as there is only a few eye specialist who can either detect these or the interest of the ophthalmologists is least on these cases.

 

Eye bank or eye collection centre to cope with the corneal blindness through keratoplasty.

 

Of late the monomanual phaco is in the process of transition to sleeveless Bimanual micro-phaco emulsification. Only difference is vision is same in both system, but expense is just doubled.

 

Before I conclude, a couple of lines on “Tale Ophthalmology” needs a mention. This is Remote Ophthalmology with the help of a well equipped bus with high tech ophthalmic services at the door step of patients in remote villages. This Tele Bus through satellite establishes connection with Chief Ophthalmologist hundreds of KM away who then advises the treatment. It is wonderful-saves time and travel cost for the rural victims.

However the Tele Bus needs huge money form a “Generous Donor”.

 

 

The Service for the multifaced handicapped children

Smt. Tapasi Nandi, Volunteer to SVH

 

On being acquainted with Ms. Hena Basu, General Secretary of Society for Visually Handicapped, I was gradually interested in serving the visually impaired children under the guidance of Ms. Hena Basu. I started working with her at the State Library in preparing audio cassette from the print materials and used to do library work as and when assigned to me from time to time. I had an opportunity to attend teacher’s training centre at Bahura Village in the district of 24 Parganas (S). This training was intended to the development of manpower for “Sarbasiksha Mission”. I was so much impressed to see this program that I decided I would continue this type of work after my graduation.

 

In course of time my wish was fulfilled, when opportunity came to me to deal with the deaf-blind children. There is a working centre of SVH at Maharashtra Nibas, where incidentally came the father of a deaf-blind child named Sri Souvik Ghosh. Mrs. Ruma Chatterjee, Vice President of the concern made me acquainted with the father and Sense International (India), which was entrusted with serving the deaf-blind children, offered me a chance to make a trip to Delhi for attending a 14 days training program for the deaf-blind children under the deaf-blind section of National Association for the Blind, Delhi. Gradually I came to learn about the requirement of deaf-blind children and had a chance to work with the teachers for deaf-blind at the centre. But 14 days experience is not enough to deal with the multi-category children and I was told that I should go to Mumbai for special training program of deaf-blind children for 1 year; either wise my training would not be officially acknowledge.

 

On my return from the program, I had a chance to go to ‘Nabajiban’ concern an orphanage with Mrs. Ruma Chatterjee, where there were 3 multi-category handicapped childrens. Gandhari was a deaf-blind child who use to run away when anybody touched her, Pratiksha a child with blindness accompanied by Cerebral Pulsy and another child named Prasun who was blind as well as very feeble, which immobilized him. Ruma di taught me how to deal with them and I applied the cue communication to deal with these special childrens. These individual cases provide me an opportunity to apply my training in practice and to enjoy my application when each one responded to me call.

 

Now my ultimate goal is to bring smile on the lips of the multi-category children through application of my training module. This could not have been possible without the active assistance of SVH, Kolkata.

 

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