Vision rehabilitation inJapan

Nippon Lighthouse
Welfare Center for the Blind
Tadaaki Tanabe
Vision 2017, Hague Netherland
25th – 29th June, 2017

In connection with this presentation, there is noconflict of interest to be disclosed with anycompanies.

Ontleedkundige Tafelen

Japanese translation “Kaitai Shinsho”
Copyright Sugita Genpaku Memorial Municipal Hopital

Outleedkundige Tafelen
Copyright Tokyo Medical Dental University Library

Dr. Sugita Genpaku in 18th Century
Copyright Sugita Genpaku Memorial Municipal HospitalProfile of Japan••••Population (2016):126,918,000
Handicapped people (2013):
3,937,000
Certified Visually Impaired people:
310,000
Visually impaired student (segregated specialeducation)(2015)
Total:
5,716
Kindergarten section:
215
Elementary section:
1,767
Junior high section:
1,229
Senior high section:
2,505• Administrative districts are composed of 47 prefectures.

Vision Rehabilitation• Vision rehabilitation is not a commonly used
word in Japan yet.
• Visually impaired Japanese people can berehabilitated in four different areas of need;– Vocational– Educational– General Welfare– And clinical.

Vocational Training• The vocational training available for the vision impaired
is composed of acupuncture, massage, computer
training and telephone operators in national
rehabilitation centers and other facilities owned byprivate sector.
• Massage has long been a source of employment for
the visually impaired, which has also been protected by
the government. However many massage shops ownedby the regular sighted people, both certified anduncertified are increasing in numbers due torecent deregulation within the massage industry.

Vocational training center for the visually impaired-Acupuncture, massage-

The training program is athree year course which
upon graduation, thestudent in certificate ofmassage and acupuncture.
• 5 national or public
rehabilitation
centers:▲• 2 rehabilitation centersowned by private
sector : ★

Massage shop for visually impaired
Facility to practice massage, acupuncture
Those visually impaired persons who have the certificate of masseur andacupuncturist practice here and get higher techniques under the guidance ofthe expert instructor, and prepare to become independence in the days tocome.

Massage shop for visually impaired
There are currently 9 massage shops across Japan that employ low
vision / vision impaired employees.

Vocational Training Center-Computer training, telephone operator• National vocational rehabilitation center for person with disability ： ▲• Nippon Lighthouse rehabilitation center for the visually impaired : ★

Computer Training
Making excel sheet withvoice

A year course
・Business accountant
・Financial planner programTelephone operator

Using braille pin display to memorize telephone number

Education• Compulsory and vocational special education areoffered to the visually impaired students permitted bythe school with free of charge.
• Compulsory educations are served as segregated orinclusive elementary and junior high school.
• Vocational education serves acupuncture and massage
trainings as same as vocational training which is also
served in national rehabilitation centers.
• Since schools for special education are located in every
prefectural capital city all over Japan, most people
living in Japan can have a chance to access it.

Special education schools for visually impaired• Small prefecture has one school in capital city.
• Large prefecture or city have several schools depending upon population.

Welfare• Service in welfare area is offered to the only
certified visually impaired people. It contains
social adjustment trainings such as orientationand mobility, braille and ADL training.
• Trainings are supplied by facilities managed by
the government or private sectors which aresubsidized by the government.

Orientation and Mobility
Walking with long
cane on the street

Along with guide line of safety
equipment for the blind inunderground shopping area

Communication tool
Reading vocal news
paper online

Japanese vocal word
processor

Daisy (Digital Accessible Information System)
Visually impaired people who registered online library can listen to the weekly
magazines, many books which were recorded by reading volunteers.

Welfare Service Facilities for Vision Rehabilitation
There are 70 facilities all over Japan, which is mainly located in the big cities.

Case report
Age: 70 (Female)
Eye disease: retinitis pigmentosa
Visual acuity : R: Hand movement L: Finger Counting
Vision rehabilitation
Vocational training : when age 52-54
Massage, acupuncturestudied and certificated at special education school
Welfare service: when age 55
Social adjustment training: O&M, Braille, Voice computer
Practice program of massageOutreach program (Advice about computer): when age 59-70

After practicing she runs her own
acupuncture clinic

She can write clinical record withvoice computer

Instructor Course for Vision Rehabilitation••

Nippon Lighthouse, Instructor Course
6 months O&M course for the staffs working in the facilities.
2 years course for the graduates who do not affiliate to anyfacilities.
National Rehabilitation Center for Persons with disabilities, College
2 years course for the graduates.

Low vision care in hospital-Low vision clinic• Low vision care is conducted in low visionclinic by ophthalmologist and orthoptist.
• Low vision clinic can supply low vision carewhich does not include orientation andmobility training, supported by health careinsurance.

Common services in low vision clinic• Optical low vision aids
Magnifier, Telescope,
Absorptive glasses• Non-optical low vision aids
Typoscope, CCTV.

Low vision clinics
There are 166 low vision clinics all over Japan. Service providers concentrate inurban area.

RIKEN CenteriPS