本研究旨在探討18歲至49歲青年壯年期間途失明者之致盲原因，及其從失明至職業重建，至重返社會自力更生的適應歷程。本研究以質的研究方法對80名盲成人進行個別面談，研究結果如下： （一） 致盲原因 1. 男性致盲原因依序為眼外傷、視網膜剝離、青光眼、視神經萎縮、視網膜色素變性、黃斑變性、眼內炎或全眼炎。女性依序為青光眼、視網膜剝離、視網膜色素變性、眼內炎或全眼炎、視神經萎縮。男性女最大差異在於男性高比率的眼外傷，俞三成的中途失明男性因眼外傷致盲。 2. 部分視網膜色素變性患者，伴有先天性聽障，符合Usher Syndrome盲聾雙障的特徵。化學性灼傷和熱灼傷致盲者，因伴隨顏面傷殘，形成另一種心理創傷。 （二） 適應歷程 根據受訪者所陳述的適應歷程，可程歸納成六個階段，其間長短及順序，依個人狀況及社會資源而有所差異，部分受訪者所經歷的階段同時發生、重疊或倒回： 1. 喪失視力的階段：視力惡化→到處求醫→宣告眼盲→黑暗煎熬→行動束縛。情緒和心理反應包括震驚、恐懼、痛苦、絕望，易有自殺念頭，最需要專業介入。 2. 失業失學的階段：經濟困難，依賴父母或配偶維持生計，沮喪、無助。 3. 人際疏離的階段：自卑、猜疑、頹廢，人際適應困難，自我封閉，與外界疏離。 4. 尋求資訊的階段：長期坐困家中，鬱悶、自省，開始思索未來的出路。因資訊不足，家人反對按摩職訓，或自己心態未調整，受訪者從失明到走出來職業重建，間隔1至32年不等，其中四成受訪者超過10年以上。 5. 參加職訓的階段：調整心態，學習按摩、定向行動、點字、盲用電腦等課程。 6. 重返社會的階段：職訓結業學員多數從事按摩業。大學學歷及專業人士較有機會從事非按摩的工作，但多數仍在盲界服務，如視障機構的教師、社工員。僅極少數能重返失明前的專門領域，在明眼的工作環境服務，包括一名電腦諮詢員和一名精神科醫師。此階段除職業適應外，尚面臨婚姻、子女養育、獨立生活、人際適應等問題，更需要社會與家庭支持，給予重新出發的機會和信心。

　　　　　The purpose of this research is to study adults' sight-losing causes and their adaptation progressing from vocational rehabilitation to self-reliance in the society. Personal interviews with 80 acquired blind, losing vision between ages 18 and 49, are recorded and analyzed by a qualitative research method. The results are stated as below: I.Sight-losing Causes 1. As for males, the most often cases are ocular injuries, and then retinal detachment, glaucoma, optic atrophy, retinitis pigmentosa, macular degeneration, endophthalmitis, and panophthalmitis in order. For females, the causes in order are glaucoma, retinal detachment, retinitis pigmentosa, endophthalmitis, panophthalmitis, and optic atrophy. The greatest difference between the sexes is the remarkably higher ratio of injuries for the male-over 37% of the male cases is caused by ocular injuries. 2. Some of the retinitis pigmentosa patients have congenital hearing disabilities as well, in conformity with the blind and deaf features of the Usher Syndrome. To the victims of chemical burns and thermal burns, psychological problems may occur due to possible facial injuries. II.Adaptation Process From loss of sight to rehabilitation, most of the acquired blind may go through six stages of adaptation: 1. Losing sight: Usually, the victims will suffer from deterioration of sight, impact of completely losing sight, and torture of endlessly staying in the black. They are often subject to the idea of committing suicide. At this stage, professional assistance is vitally needed. 2. Losing education or work (being hard up): The victims have to depend on their parents, spouse, and/or relatives for living. 3. Separating from others: As usual, it is difficult for the victims to adapt themselves to the society. Gradually, they isolate themselves and thus separate from all social activites. 4. Seeking for information: Due to deficiency of information, opposition coming from their families, or incomplete psychological adjustment, the victims need up to 32 years to walk out and receive vocational rehabilitation-40% of them stayed isolated for at least 10 years. 5. Attending vocational training: Attending massage, orientation & mobility, Braille, and computer courses for the blind. 6. Returning to the society: The majority of the victims who have finished one or several of the above-said courses will do massage as their life career, though. Those university graduates and professionals among the victims may have a greater opportunity to do other work, but sill limited in the blind world, such as teachers or social workers for institutes for the blind. Very few can return to their professional jobs and work in normal working conditions - only two successful cases: one computer counselor and one psychiatrist.