Pediatric Visual Impairments

What is visual acuity?

is a measure of how clearly a person can see, or the ability of the eye to distinguish fine details and shapes at a specific distance.

what can cause visual impairments?

structure of the eye, the focus of light on the retina, photoreceptors of the retina, transmitting a signal from optic nerve to brain, interpretation of visual information in cortex, integration information, providing appropriate feedback to the eye

what step is challengeing for people who suffer from visual impairments

integration of information

patients are unable to take the information that was brought in from the eye and figure out what to do with it in the cortex.

myopia

near sighted --> can see up close

eye is too long from cornea to retina

cornea is curved

vision goes blurry in distance

converges in front of retina

hyperopia

far sightedness

eye is too short from cornea to retina

cornea is flat

converges behind the retina

close up blurry

can see far objects

the person has blurred vision with all distances and the cornea is oblonged this is called

astigmatism

prevents light from focusing properly on retina

what is strabismus

eyes do not line up

you notice a child with eyes moved inwards

estropia

extropia

eyes move outward in relation to person

hypertropia

eyes move upward in relation to person

hypotropia

eyes move downward in relation to person

Often happens in premature infants not past 30 weeks gestation this is seen due to immature eyes and blood vessels to retina

retinopathy of prematurity if it receives too much light the blood vessels die

26 weeks no light exposure till past 30

a patient has a lazy eye this is called

amblyopia

the ventral stream allows for

recognition

damage of this causes inability to recognize faces (propoasgnosia) and objects

the left visual field is processed on the

right hemisphere

the right visual field is processed on the

left hemisphere

when someone has damage to the dorsal stream this presents as

damage in spatial awareness processes

the dorsal stream guides movement

what are the overall impacts of visual impairments in kids

motor

cognitive

social / emotional

speech langauge

what is an occular disorder

problems with the structure and function in the eye like near sightedness or strabismus

what domain is most important for developing normal IQ in kids birth to a year?

motor development

what signs would alert us to think there is a visual problem?

- reading facial expressions

- decreased hand eye coordination

- stares at bright light

- photophobia

- non directed eye movement

- does not reach for bottle or responding to face

- not watching TV or interest in books/toys

- respond to certain areas of the field

when 2 or more present contact MD

what are the causes of corticovisual impairments at birth

lack of O2 to brain or blood supply

prematurity

hydrocephalus

head injury

genetic conditions

infections

later in life what is a cause of corticovisual impairments

head trauma

stroke

what is a cortical visual impairement

damage to the posterior visual pathways and or the occpital lobes of brain

not cognitive impairment and not stable it changes what they can process, dependent on regulatory and nonregulatory things

what are common visual functions in CVI

vision is variable

peripheral sparing - lateral visual field

compulsive light gazing > photophobic

color vision is perserved

poor depth perception

moving target > stationary target

what can we modify when testing children with CVI

lighting

reduce background clutter

increase contract

positioning of child --> very supportive to reduce energy towards posture

positioning of equipment

bright colors or auditory stimulus

be energy efficient for child

use their visual field to their advantage

what test is similar to the GMFM used for kids with visual impairments

Organ Project

a criterion referenced test

for children with visual impairments

how can we make interventions successful

energy conversation

positioning of supports

separate fine motor from visual motor tasks

simplify and make familiar

allow increased time for processing

contrast colors - make bright

mobile / visual targets

combine other sensations

what interventions should we use?

highly stimulating

textured objects

sounds are encouraged to associate different tasks and complete interventions and to show success

vibrating toys

3D toys

structured play environment

what are orientation and mobility experts

Not us!

teaches people how to navigate in society and how to get around

use different modes of transportation

allow them to understand different objects/concepts and what they are

introduce cane early

multiple impairments and cognitive abilities are not justification for preventing a child from being considered for adaptive instruction

is exercise in the lifespan of a child with visual impairments the same as a neurotypical child?

- children with visual impairments do not participate in the same levels of physical activity as sighted peers

- provide motivation to exercise to increase sleep and self esteem as a child