Effectiveness of Bates Therapy on Visual Problems Among Elderly People

Prof. Mrs. N. Sheelavathi¹ , Prof. Dr. N. Ganapathy², Prof. P. Padmavathi^3*

¹Ph. D Scholar, Principal, Community Health Nursing Specialty, PGP College of Nursing and Research, Namakkal District – 637 207.

²Chairman, Dhanvantri College of Nursing , Pallakkapalyam, Namakkal District -637 303.

³Principal, Dhanvantri College of Nursing, Pallakkapalyam, Namakkal District -637 303.

*Corresponding Author’s Email: padmasekar2009@gmail.com

ABSTRACT:

The eye is the window of the human body through which it feels its way and enjoys the beauty of the world, but as age rises elderly people develop visual problems by showing the symptoms like blurred vision, visual defect, fore sight and short sight, etc, which blocks the beauty of eye sight. Objectives: To determine the effectiveness of Bates therapy on visual problems among elderly residents. Design: Pre-experimental design where one group pre and post test. Setting: K.K Illam home for aged, Erode. Participants: Elderly residents who fulfilled the inclusion criteria. Selection criteria: The inclusion criteria of the elderly residents Who can read three lines on snenell’s chart without spectacles at a distance of 6 meters with both eyes, see superiorly 30⁰, laterally 50⁰, inferiorly 50⁰and medially 40⁰ with both eyes and their Pupillary size to light 2mm for both eyes.. Methods: 38 elderly residents were selected by using consecutive sampling technique. Pre and post test assessment done by using visual acuity assessment scale and visual functioning scale to assess the visual problems. Results: The study findings showed that 7(47%) were in the age group 60 -65 and 66 -70 years respectively. However 67 % them were females, 60% of them had diabetes Mellitus, all (100%) had less than 20 years of visual problems, 60% of them using spectacles below 10 years and 67 % of them had twice in a year eye check up. Paired ‘t’ test value was 12.24 in visual acuity and 11.23 in visual functioning when compared to the level of significant (p<0.05) it was high. It seems that Bates therapy on visual problems among elderly people was effective. There is no significant association between post test scores on visual problems among elderly people and their demographic variables (age, gender, associated disease conditions, duration of visual problems and duration of using spectacles). Conclusion: Eye exercise is given to any kind of eye problems to improve vision. Therefore Bates therapy was very beneficial for elderly people to regain their eyesight back. Clinical practice: To prove Bates therapy, they need supportive research to be warranted. As a part of nursing care service, Bates therapy can be implemented to the clients in the hospital and community settings.

KEYWORDS: Effectiveness, Bates therapy, Elderly people, visual problems.

INTRODUCTION:

“The light of the body is the eye”

Ageing is a journey or maturation or odyssey the process of ageing classically depicted as one of the constant and inexorable decline often reaching a peak of bodily function efficiency around the end of second decade of life. Moreover the later years of life are conventionally seen until very recently as one of withdrawal from the main stream of life due to infirmity, (Linda, 2005) In India it is reported that at present there are 77 million elderly persons and the number is expected to be 177 million in the next two decades, (Soneja, 2002).

India is home to over to 76.6 million people over the age of 60. According to data available with the health ministry the country has 76,622,321 persons aged 60 and above. With nearly 14 percent of the elderly population Uttar Pradesh tops the chart with 11.6 million elderly. Maharashtra follows with 8.45 million senior citizens. West Bengal has 5.7 million, Bihar and Tamilnadu have 5.5 million senior citizens each. Delhi is home to 719,650 citizens above the age of 60. At the other end of the spectrum are places like Lakshadweep (3,729), Daman and Diu, Pondicherry and Dadra and Nagar Haveli with about 8,000 elderly each, (Indian Health News, 2007).

According to the census 2001, life expectancy of India has risen. According to it, India’s total population was 1,02,87,37,436 which has 21.3 percent increase since 1991. Population of people falling under the age group of 60 years and above was 7,66,22,381 which was 7.5 percent of the total population, ‘aged females’ were 7.1 percent. The projected population of senior citizens of India in 2008 was 8,60,75,775. According to the United National Child Fund (UNICEF), life expectancy in India 1970 was 49, in 1990, it was 58 and in 2005, it was 64 years. According to the world life expectancy.com as on 2008, global life expectancy for some countries will be: India – 68.6, United States of America – 78, Australia – 80.6, South Africa – 42.5, China – 72.9, Russia – 65.9, Saudi Arabia – 75.9, United Kingdom – 78.8 and France – 80.6, (Seilesh, C.J, 2008).

In India ¾ of geriatric population is young old and rest old old. In 1000 life expectancy was 18 years. In early 1900, the average life expectancy was around 47 years but will be around 85 years or more by 2010. The total number of elderly people globally anticipated to be doubled during 1996 – 2016 from 62.3 million to 11.29 million, (Dr. Basarkar. S, 2007).

According to the World Health Organization (2009), Everyone is at risk for glaucoma from babies to senior citizens. Older people are at a higher risk for glaucoma. Young adults can get glaucoma, too. Glaucoma is the second leading cause of blindness in the world.

Adler (2002), conducted a study and concluded that Bates Therapy is an effective treatment for convergence insufficiency. The restoration of near point of convergence values to normal accompanied by a reduction in symptoms was concluded as successful treatment. Routine eye exercises were shown to have a highly significant (t = 14.61, p < 0.001) effect. Although treatment times were longer, the rate of success was greater than that reported by previous studies.

STATEMENT OF THE PROBLEM:

Effectiveness of Bates therapy on visual problems among elderly people in selected area at Namakkal District

OBJECTIVES:

· To assess the level of visual problems among elderly people before and after Bates therapy.

· To determine the effectiveness of Bates therapy on visual problems among elderly people.

· To find out the association between post test scores on visual problems among elderly people and their demographic variables.

OPERATIONAL DEFINITIONS:

Bates Therapy:

It is a series of steps which includes stretching, Blinking, Swinging, Palming or Cupping and Sunning is given to the elderly residents with visual problems for the duration of 60 minutes 2 times a day for 30 days.

1. Stretching:

Close both the eyes very tightly by shutting the lids firmly. Open them suddenly which allows you to feel the stretch. Once open arch your brows and stretch your face. Repeat this several times for 10 minutes.

2. Blinking:

Look as far as possible and inhale then look down as far as possible and exhale. Blink your eyes more than dozen times. Do the same procedure by turning to your left and right then diagonally up to left, down to right, up to right and down to left followed by rapid blinking for 10 minutes.

3. Swinging:

Rotate your eyes in all the directions. Slowly and steadily concentrate one eye at a time. Do this exercise more than dozen times and try doing this with your eyes shut for 10 minutes.

4. Palming or cupping:

1. Sit with both feet squarely on the ground

2. Rub the palms of your hands together vigorously

3. Gently close your eyes

4. Cover eyes with cupped palms. Have the base of your palms gently resting on the base of the eye socket. Keep fingers relaxed

5. Imagine a piece of black velvet; notice the depth of the colour black and the texture of the fabric

6. Ensure that your shoulders are relaxed on a table or chair back to release the tension for 15 minutes.

5. Sunning:

Sunning means to use sun's light for your eyes. Move your head from side to side for the heat to benefit the eyes. After a while try stretching the eyes to allow more sunlight to your eyes for 15 minutes.

RESEARCH HYPOTHESIS:

H₁: There is a significant level of visual problems among elderly people before and after Bates therapy.

H₂: There is a significant effectiveness of Bates therapy on visual problems among elderly people.

H₃: There is a significant association between post test scores on visual problems among elderly people and their demographic variables.

METHODOLOGY:

Pre experimental research design pre and post test only design. The study was conducted with permission of Managing Director from KK illam, Erode. The sample consisted of 30 elderly people who fulfil the inclusion criteria were chosen for the study by using purposive sampling technique. The tools used to collect the data were demographic variables, Visual Acuity assessment scale and Visual functioning scale. Elderly people received Bates Therapy two times a day for 30 days. Both the groups’ data were collected after 30 days of intervention. Descriptive and inferential statistical methods were used to analyse the data.

RESULTS AND DISCUSSIONS:

The study findings showed that 7(47%) were in the age group 60 -65 and 66 -70 years respectively. However 67 % them were females, 60% of them had diabetes Mellitus, all (100%) had less than 20 years of visual problems, 60% of them using spectacles below 10 years and 67 % of them had twice in a year eye check up

Frequency and percentage distribution of pre and post test scores of visual acuity among elderly people. (N₁= 15)

Level of visual acuity	Pre test score				Post test score
	Right eye		Left eye		Right eye		Left eye
	F	%	F	%	F	%	F	%
Sever	2	13	1	7	-	-	-	-
Moderate	13	87	14	93	1	7	-	-
Mild	-	-	-	-	14	93	15	100
Normal	-	-	-	-		-	-	-

Frequency and percentage distribution of pre test and post test scores of visual acuity among elderly people depicts that, 87% and 93% of them had moderate visual acuity in both eyes whereas in post test 93% in right eye and all (100%) in left eye in mild visual acuity. It showed that Bates therapy was effective in reducing visual problems among elderly people.

1. Comparison of Mean, SD and percentage of pre and post test scores of visual acuity

Elderly people	Max Scores	Pre test			Post test			Difference in mean %
Elderly people	Max Scores	Mean	SD	Mean %	Mean	SD	Mean%	Difference in mean %
Right eye	6	2.3	0.8	38	4.5	0.72	75	37
Left eye	6	2.4	0.71	40	4.5	0.19	75	35

2. Comparison of Mean, SD and percentage of pre and post test scores of visual functioning

Elderly people	Max Scores	Pre test			Post test			Difference in mean %
Elderly people	Max Scores	Mean	SD	Mean%	Mean	SD	Mean%	Difference in mean %
General health and Vision	24	17.7	0.18	74	9.9	0.25	41	33
Difficulty with activities	72	59.6	0.25	83	29.6	0.42	41	42
Response to visual problems	45	10.9	028	24	32.8	0.81	72	48

3. Determine the effectiveness of Bates therapy on visual problems among elderly people.

Significance of Pre and Post test scores of experimental group I

Sl. No.	Areas	‘t’ Value	Level of Significant
1	Visual acuity	12.24	P< 0.05 Significant
2	Visual functioning	11.23	P< 0.05 Significant

The paired ‘t’ test value was 12.24 in Visual acuity and 11.23 in Visual functioning 6.82 which was statistically highly significant at p< 0.05 level. It seems that Bates therapy was more effective for reducing visual problems in elderly people.

4. There is no statistical significant association was found in post test scores of level of visual acuity and Visual functioning among elderly people with demographic variables such as age, gender, associated conditions, visual problems, use of spectacles and duration of eye check up.

CONCLUSION:

The present study assessed the effectiveness of bates therapy on visual problems among elderly people The study findings revealed that bates therapy was effective in improvement of visual acuity and visual functioning among elderly people. It is simple, effective and safe method. This method practiced during any age group with visual problems, it is more helpful for the elderly to enhance the early life during aged period. The study suggests that long term Bates therapy use will not cause any problems in the visions

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Received on 04.02.2016 Modified on 08.02.2016

Int. J. Adv. Nur. Management. 2016; 4(2): 135-138.

DOI: 10.5958/2454-2652.2016.00030.5