Factsheets Recognising Eye Problems in People with Learning Disabilities 2

Looking at a person’s eye and their behaviour.

The Appearance of a person eyes 

We can look at the a person’s eyes to check whether they are healthy, free from infection and soreness. Looking at the shape and characteristics of a person’s eye might help us recognise if there is an eye condition being present or developing.

You might observe:

• The white of the eyes appearing red, bloodshot or sore
• The white of the eye appearing yellow
• In-growing eyelashes
• Pupils (the round black part of the eye) seem mis-shapen or incomplete
• Eyes which look 'milky', you may not be able to  see the iris (the colour of the eye) or the pupils clearly
• Eyes which appear to 'rove' or constantly flicker, move side to side or up and down and that this seems to be happening beyond the person’s control
• Eyes which appear bulge, with the cornea (clear front part of the eye) seeming to be  ‘pointed’ or having an unusual shape
• Eyes which seem scarred or damaged
• Frequent eye infections or sticky eyes with discharge
• Frequent cysts or styes on the eye-lids, dry skin on eye lids
• Partially closed or droopy eyes
• One eye turning in or out - squinting
• Watery eyes  - weepy eyes / dry eyes.

Observing the behaviour and actions of the person

We can look at the behaviour of person to try and find out whether the person might have an eye problem or a visual impairment.  The behaviours might help people make the best use of their sight.  Some of the behaviours may provide stimulation for the person. We should not think of these behaviours as being ‘odd’ or ‘unusual’.  The behaviours serve a purpose for the person.   

You might observe some or more of the following:      

• Frequent touching of eyes – the person may poke or  rub their eyes, or ‘lifts’ their eye lids
• 'Light gazing' – the person may appear fascinated or interested by light and will stare into light sources (lamps, sun etc)
• 'Finger or hand flapping' – the person enjoys flapping hand in front of eyes
• 'Unusual' head positions
• Unusual head movements - for example, frequent head shaking or in a circular movement of head
• Covering one eye. Constant blinking
• Avoiding bright lights or sunlight - appears uncomfortable or unhappy  in bright light or sun light (turns head away, flinches,  closes eyes, covers eyes)
• Preferring or seeing see some colours better than others
• Problems in focusing – moving head backwards and forwards to see objects, words, photos. Closely examines objects
• Person seems tense and rigid, startled by noises or people or becomes suddenly anxious or upset
• Does not seem to recognise people
• Does not make eye contact with other people or looks closely at people
• Seems uninterested in other people or the environment around them.
• Problems judging how far away things are, difficulty reaching out for things
• Knocks things over - for example, a cup on a table
• Prefers objects to be placed in a particular position - for example, on one side or the other
• Sees bright objects on colour-contrasting backgrounds better - for example, a red plate on a white tableclot
• Bumps, knocks into objects - such as doors, furniture, objects on the floor
• Is anxious or unwilling to walk alone
• Finds it difficult to judge distances
• Seems clumsy and uncoordinated - for example, problems with balance
• Copes better in well-lit areas
• Copes better in twilight-type lighting
• Finds it difficult to cope with changes in the environment - walks confidently indoors but reluctant to walk out of doors
• Constant looking down as if looking for kerbs, steps, stairs
• Feels way around, not obviously using sight - for example, sliding feet to find steps
• Becomes confused/disorientated
• Increased falls

We highly recommend recording your findings and observations.  Share your observations with others and work with the person to make sure information is recorded in their Health Action Plan or personal information.

If you suspect the person you support has an eye  problem or a visual impairment then you must contact an optician or GP.

June 2009 

For More Information on this topic please read:

Recognising Eye Problems in People with Learning Disabilities 1

Related Information:

Adapting Accomodation for people with Learning Disabilities

Consent to Medical Treatments

The Need for an Eye Examination

Eye Poking and Touching in People with Learning Disabilities

Eye Poking and Touching - Strategies and Supporting People 

Glaucoma

Keratoconus

Recognising Eye Problems in People with Learning Disabilities 1

Recognising Eye Problems in People with Learning Disabilities 2 

Supporting People to use their Sight Effectively

Taking Action on Eye Problems

Treatments and Interventions for Keratoconus Part 2

Treatments and Interventions for Keratoconus Part 3