special subjects
Rehabilitation for Other Disorders
Blindness
Patients who are blind are taught to rely more on the other senses, to develop specific skills, and to use specific devices (eg, Braille, cane, reading machine). Therapy aims to help patients function to their maximum and become independent, to restore psychologic security, and to help patients deal with and influence the attitudes of other people. Therapy varies depending on the way vision was lost (suddenly or slowly and progressively), extent of vision loss, the patient’s functional needs, and coexisting deficits. For example, patients with peripheral neuropathy and diminished tactile sensation in the fingers may have difficulty reading Braille. Many people who are blind need psychologic counseling (usually cognitive-behavioral therapy) to help them better cope with their condition. For ambulation, therapy may involve learning to use a cane; canes used by people who are blind are usually white and longer and thinner than ordinary canes. People who use a wheelchair are taught to use one arm to operate the wheelchair and the other to use a cane. People who prefer to use a trained dog instead of a cane are taught to handle and care for the dog. When walking with a person with sight, a person who is blind can hold onto the bent elbow of that person, rather than use an ambulation aid. A person who is blind should not be led by the hand because this action could be perceived as dominant and controlling. 