Glaucoma fact sheet
Definition and description of the disability
* Glaucoma is not curable, and vision lost cannot be recovered. Through medication and/or surgery, it is possible to stop the progress of further loss of vision. Because glaucoma is a chronic condition, it must be monitored for life. Glaucoma is actually a group of eye diseases that lead to damage of the optic nerve (the bundle of nerve fibers that carries information from the eye to the brain), which can then lead to vision loss and the possibility of blindness. Optic nerve damage usually occurs in the presence of high intraocular pressure; however, it can occur with normal or even below-normal eye pressure.
* Diagnosis is the first step to preserving vision.
Causes
* An increased IOP reading point toward a problem with the amount of aqueous humor (fluid) in the eye: either the eye is generating too much, or it’s not draining properly. The drainage area is the angle formed between the cornea and the iris, which is why you see the word “angle” in the different glaucoma names. Optic nerve damage usually occurs in the presence of high intraocular pressure; however, it can occur with normal or even below-normal eye pressure.
Incidence and Prevalence of the disability
* Glaucoma affects an estimated 3 million Americans, with 120,000 blind due to the condition. Elsewhere in the world, glaucoma treatment is less available, and glaucoma ranks as a leading cause of blindness just about everywhere. Even if people with glaucoma do not become blind, vision can be severely impaired. Worldwide, it is estimated that about 66.8 million people have visual impairment from glaucoma, with 6.7 million suffering from blindness.
Educational Ramifications (How will this disability impact learning?) Considerations/Teaching strategies and techniques (early childhood, elementary through high school and transition)
* If you are the parent of a child with glaucoma, it is important to work closely with your school staff and the educational system to insure that the needs of your child are met. Explore what resources are available in your area. In many communities throughout the country, special education funding and services are provided to meet the needs of visually impaired children.
Five Possible Educational Adaptations (e.g., Instructional, Environmental, and Curriculum)
* Special education services for eligible children are available from birth to adulthood, beginning with Early Intervention. Early Intervention is a program designed to assess the needs of children and to implement services to help the child and support the family. Consulting with a teacher of the visually impaired to better assess your child’s needs and help the family develop a program that best fits the individual child is critical. Early Intervention can also help the child make the transition to an integrated preschool program.
* If the child qualifies, an Individual Education Plan (IEP) can be developed—contact the special education director of your school district for further information. When developing an IEP, think about your child and what works with them at home. These adaptations and ideas may also work in a school environment. Implement these adaptations and ideas into the IEP plan. All the modifications that your child requires must be put into writing. Include whether prescription glasses are worn, if medications need to be taken, and if vision fluctuates under different conditions. The IEP ensures that your child’s school knows and understands your child’s special needs. While it may seem like an exhaustive list, the more information you offer, the more prepared the school system will be in providing support for your child.
Tips for Your Child in the Classroom
* To avoid glare, teach your child to sit with his or her back to the windows or other bright light.
* Educational materials should be presented against a simple background. Keep the work area uncluttered.
* Talk with the teacher about flexible seating, especially if visual props are used. For your child, that may mean moving closer to the front of the classroom.
* Encourage the use of materials with high contrast and bold writing.
* During outdoor playtime, teach your child to use sunglasses and hats. Even overcast days can cause glare in the eyes.
* Have your child wear protective goggles during activities.
* Include ideas that enhance your child’s learning style and ability. If needed, use a Closed Circuit Television (CCTV) for enlarging print.
* If you have any areas of concern, consult with an educator, occupational therapist or low vision specialist to evaluate your child’s home and school environment. These evaluations can give you essential information about your child’s areas of strength as well as areas that need support services.
* Develop a support system with your family and friends. Also, look into community groups and agencies that provide support groups and other resources.
Impact on Families
* Having glaucoma certainly does not mean the end of your productive work life. Advances in treatment, technology, and general understanding of the disease have enabled people to maintain their normal, daily lives despite their glaucoma.
* Good communication with one’s employer or supervisor is a must. Clearly explaining your situation and any adaptive needs are critical steps to ensure that the proper accommodations are made for you. The Americans with Disabilities Act of 1990 (ADA) was created to protect your rights in the workplace. There are exceptions to the ADA, however. If you need guidance determining whether or not it applies to your situation, and what your legal rights are, help is available. For assistance in dealing with the provisions of the Americans with Disabilities Act, the following resources can help you.
References-Four good references from at least two different sources (book, movies, articles, websites, etc…)
Bojic L, Racic G, Gosovic S, Kovacevic H: The effect of hyperbaric oxygen breathing on the visual field in glaucoma. Acta Ophthalmol (Copenh). Jun;71(3):315-9. 1993. (HBO expanded peripheral vision, which lasted for 3 months.)
Bojic L, Kovacevic H, Andric D, Romanovic D, Petri NM: Hyperbaric oxygen dose of choice in the treatment of glaucoma. Arh Hig Rada Toksikol. 1993 Sep;44(3):239-47.
Popova ZS, Kuz’minov OD: Treatment of primary open-angle glaucoma by the method of combined use of hyperbaric oxygenation and antioxidants. Vestn Oftalmol. 1996 Jan-Mar;112(1):4-6. [Article in Russian] (Stabilization of the visual function was attained in 80% patients)
BIPOLAR DISORDER FACT SHEET
Definition and description of the disability
* Bipolar disorder, also known as manic depression, is a recurrent disorder of mood involving episodes of serious mania and depression. Moods can swing from overly “high” and/or irritable to sad and hopeless, and then back again, with periods of normal mood in between. Untreated, bipolar disorder can have devastating effects on individuals with the disorder and their families, including serious behavioral problems (such as wild spending sprees) and their consequences, social and occupational dysfunction, alcohol and drug abuse, and suicide
Causes
* We do not know the precise cause of bipolar disorder. However, research shows that genes play a strong role. Stress or difficult family relationships do not cause the illness. However, these factors may “trigger” an episode in someone who already has the illness.
Incidence and Prevalence of the disability
* It is believed highly likely that bipolar disorder often has a genetic cause, although a specific genetic defect has not yet been identified, as 80 to 90 percent of affected individuals have a relative with bipolar disorder or depression. At least two million Americans suffer from Bipolar Disorder, and it will affect nearly one in one hundred people at some point in their lives.
Educational Ramifications (How will this disability impact learning?)
* A new study may explain why children with bipolar disorder tend to be more aggressive and irritable and also have poorer social skills than healthy children.
The study, conducted at the U.S. National Institute of Mental Health, shows that bipolar youths misinterpret facial expressions to be hostile more often than their healthy counterparts. This misinterpretation could explain difficulties that many children with bipolar disorder, experience and which cause problems with friendships, school and family.
Considerations/Teaching strategies and techniques (early childhood, elementary through high school and transition)
* Children with bipolar disorder usually alternate rapidly between extremely high moods (mania) and low moods (depression). These rapid mood shifts can produce irritability with periods of wellness between episodes, or the young person may feel both extremes at the same time. Parents who have children with the disorder often describe them as unpredictable, alternating between aggressive or silly and withdrawn. Children with bipolar disorder are at a greater risk for anxiety disorders and Attention-Deficit Hyperactivity Disorder (ADHD). These “co-occurring” disorders complicate diagnosis of bipolar disorder and contribute to the lack of recognition of the illness in children (Papolos, 2000).
Five Possible Educational Adaptations (e.g., Instructional, Environmental, and Curriculum)
* Early identification, diagnosis, and treatment help children reach their full potential. Bipolar disorder is treatable. Children who exhibit signs of bipolar disorder should be referred to and evaluated by a mental health professional who specializes in treating children. The evaluation may include consultation with a child psychiatrist, psychological testing, and medical tests to rule out an underlying physical condition that might explain the child’s symptoms. A comprehensive treatment plan should include psychotherapy and, in most cases, medication. This plan should be developed with the family, and, whenever possible, the child should be involved in making treatment decisions.
Impact on Families
* More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a heritable component. Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. Scientists are continuing their search for these genes using advanced genetic analytic methods and large samples of families affected by the illness. The researchers are hopeful that identification of susceptibility genes for bipolar disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying illness process. When caregivers of patients with bipolar illness experience a high burden, patient outcome is adversely affected. This relationship is mediated through families’ affective response and patients’ medication adherence
* (Source: excerpt from Going to Extremes Bipolar Disorder: NIMH)
References
1.National Mental Health Association 2000 N. Beauregard Street, 6th Floor
Alexandria, VA 22311 Phone 703/684-7722 Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA TTY Line 800/433-5959
2.Depression and Bipolar Support Alliance Phone: 800-826-3632
www.ndmda.org
3.National Institute of Mental Health Public Inquiries Phone- 301-443-4513
www.nimh.nih.gov
4.National Foundation for Depressive Illness Phone: 800-239-1265
www.depression.org
5.NMHA offers additional pamphlets on a variety of mental health topics. For more information or to order multiple copies of pamphlets, please call 1-800-969-NMHA
SOURCES:
1. “Bipolar Disorder” NIMH, U.S. Department of Health and Human Services.
2. “Facts About: Manic Depression,” American Psychiatric Association.
3. “Overview of Bipolar Disorder and its Symptoms,” National Depressive and Manic Depressive Association.
4. “Childhood-onset Bipolar Disorder: Under-diagnosed, Under-treated and Under Discussion” by Demitri F. Papolos, M.D. in NARSAD Research Newsletter, Vol.12, Issue 4, Winter 2000/2001, pages 11-13. Published by the National Alliance for Research on Schizophrenia and Depression, www.narsad.org.