Low Vision, Visual Impairments and Metropolitan Urban Planning Open Access to Scientific and Medical Research DOI: 174006
Total Page：16
File Type：pdf, Size：1020Kb
Journal name: Clinical Ophthalmology Article Designation: Original Research Year: 2018 Volume: 12 Clinical Ophthalmology Dovepress Running head verso: Nuzzi et al Running head recto: Low vision, visual impairments and metropolitan urban planning open access to scientific and medical research DOI: 174006 Open Access Full Text Article ORIGINAL RESEARCH Low vision, visual impairments and metropolitan urban planning: example of a topographic enhancement, need and monitoring in an Italian city Raffaele Nuzzi Significance: The purpose of the study was to analyze all the steps needed to manage partially Eleonora Bottacchi sighted or blind persons. Francesca Monteu Purpose: The aim of the first research was to collect and analyze data and opinions regarding the mobility of visually disabled people in Turin. The aim of the second research was to assess issues, Eye Clinic, University of Turin, Molinette Hospital, Turin, Italy daily needs and expectations regarding the urban reclassification plan for Via Nizza (Turin). Materials and methods: In the first study, we proposed a survey, partially structured and partially unstructured, of 100 patients enrolled in the Visual Rehabilitation Center of the Ophthalmic Hospital of Turin. In the second study, we collected data from a survey of eleven patients enrolled in the Turin section of the Italian Confederation of Blind. For personal use only. Results: It was observed that the visually disabled population was not necessarily elderly (46% of the population was less than 60 years of age); it was observed that the visually disabled people were active frequently. Environmental aids considered more useful were sound traffic lights (30%) and gradient signaling (29%); the first was not widespread in urban areas and was the aid most requested by the patients enrolled (49%); 48% of enrolled patients did not use tactile maps. As regards the reclassification of the urban plan of the area in Turin, important needs and expectations were highlighted. Conclusion: As regards urban planning in Turin as well as in other Italian cities, many changes in public facilities are to be done to ensure an increasing independence and safety of visually impaired people. visually disabled people, blindness, public facilities, environmental aids, sound Clinical Ophthalmology downloaded from https://www.dovepress.com/ by 54.70.40.11 on 23-Dec-2018 Keywords: traffic lights, gradient signaling Introduction The steady increase in life expectancy and improvements in the quality of life over the last several years in developed countries has caused an increase in the frequency of chronic diseases, including those associated with vision. Therefore, an increasing number of people need to address the difficulties related to low vision/visual impair- ment or blindness. The social awareness of this problem has certainly increased in the last several years, but there is still a long way to go incompletely understanding Correspondence: Francesca Monteu this problem. In Italy, until 1942, visually impaired people were considered mentally Clinica Oculistica Universitaria, incapacitated and, therefore, disenfranchised from the Civil Code. In spite of a sig- Ospedale Molinette, Via Cherasco 23, 10126 Torino, Italia nificant delay, the 262/42 legislation abolished this law.1 Tel +39 347 994 9826 In 2017, the WHO estimated that there were 253 million visually impaired people, Fax +39 11 248 5708 Email [email protected] of which, 217 million had low vision and 36 million were blind.2 submit your manuscript | www.dovepress.com Clinical Ophthalmology 2018:12 2107–2119 2107 Dovepress © 2018 Nuzzi et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you http://dx.doi.org/10.2147/OPTH.S174006 hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Powered by TCPDF (www.tcpdf.org) 1 / 1 Nuzzi et al Dovepress It is important to note that international banks such of their daily living, problems, needs, and expectations from as “The World Bank Group” or “The European Bank for the urban renewal project of Nizza street. Reconstruction and Development” use data reports about As this was an ongoing project, only members of the UIC the prevalence of blindness and its causes as an indicator of who were aware of the plan were interviewed. The survey a country’s socio economic development. Until the mid-80s, comprised of ten questions and was administered to eleven epidemiological data on the prevalence and causes of visual subjects. The ethics committee of our institution (Ospedale impairment in Italy were limited and based on case series Oftalmico Sperino, Torino) reviewed the study protocol. and information collected in other countries.1 The protocol did not require any specific formal approval A study carried out in 2009 by the Italian Ophthalmo- because our study involved only a verbal interview, without logical Society3 estimated a prevalence of 0.56% for severely any clinical or surgical intervention. Verbal informed con- low vision among people .40 years, 0.47% for moderate- sent was obtained from all the participants, and the ethics to-severe low vision, and 0.31% for moderately low vision, committee approved the verbal consent process. totaling to 1.34%. With respect to blindness, the National Institute of Materials and methods Statistics4 carried out a survey that revealed the percentage of First survey blind people to be 0.62%, corresponding to 362,000 people. Data collection for the first survey was done in 2014 after With regard to the Piedmont region, data collected by participants gave their verbal consent. Both structured the National Institute for Social Providence5 in 2012 showed and unstructured questionnaires were administered to the figures of 8,885 blind/disabled people in a total population participants. of 4,457,335 people. One hundred subjects were recruited from the Visual Rehabilitation Center of the Ophthalmic Hospital in Turin. Topographic project The survey was submitted orally via direct or telephonic In Turin, the urban renewal project of Nizza Street originated interview. For personal use only. from a previous feasibility study that was planned as part of The inclusion criteria were as follows: 1) participants the National Operative Programme for Metropolitan Areas must be Turin residents and must independently use public (PON-Metro). places at least twice a week or reside in neighboring provinces The basic principle in functional reorganization of an but have the need of independent travel to Turin at least twice area is redistribution of different environmental spaces across a week for employment/personal/academic reasons; 2) those various user categories: 1) the weakest ones; 2) pedestrians having mild, moderate, or severe visual disability or partial or and disabled; and 3) bicycle officers and vehicle mobility. total blindness certified by the criteria of the law number 138, Consequently, there will be an improvement in safety and (Classification and Quantification of Visual Handicap and enhanced architectural development at pedestrian crossings. Ophthalmic Investigations), stipulated the 3rd of April 2001; Clinical Ophthalmology downloaded from https://www.dovepress.com/ by 54.70.40.11 on 23-Dec-2018 All the pedestrian crossings will have safety ramps and vibro- and 3) those who were at least 18 years old. tactile traffic lights as requested by the Blind Italian Union The exclusion criteria were as follows: 1) no psycho- (UIC); thus, lighting in public areas will be increased. logical or psychiatric illnesses, degenerative nervous system diseases, or use of drugs that could compromise cognitive Purpose processes or judgment abilities; and 2) less frequent use of The purpose of the study was to analyze all the steps needed public places (less than twice a week) or use of public places to assist a visually impaired person. only with assistance. The aim of the first part of our research was to collect The survey comprised five sections (Table 1). and analyze data and opinions regarding the mobility of The study was conducted in accordance with the tenets visually disabled people in the metropolitan area of Turin. of the Declaration of Helsinki. The main objectives were to study the following: 1) clinical characteristics of the patients; 2) mobility of visually disabled Second survey persons; 3) determine which environmental aids or signs were With respect to the second part of our research, performed in more frequently used; and 4) satisfaction of visually disabled 2017, data collection was carried out using a partly structured people in the metropolitan area of Turin. and partly unstructured questionnaire after obtaining verbal For the second part of our research, we aimed to create a consent from participants. The eleven included subjects were rapport with visually disabled people to understand aspects recruited from the Turin region of the UIC. The questionnaire 2108 submit your manuscript | www.dovepress.com Clinical Ophthalmology 2018:12 Dovepress Powered by TCPDF (www.tcpdf.org) 1 / 1 Dovepress