Functional Vision In Children Research Articles

Survey of health- and vision-related quality of life and functional vision in children and young people with childhood glaucoma and cataract

Impaired vision, repeated surgical interventions, topical eye medications and frequent hospital appointments affect daily life of children with childhood glaucoma, cataract, aphakia and pseudophakia and their families. We aim to explore the health- and vision-related quality of life (QoL) and functional vision (FV) of these children and families.

Optical reading aids for children and young people with low vision.

Low vision in childhood is a significant barrier to learning and development, particularly for reading and education. Optical low vision aids may be used to maximise the child's functional vision. The World Health Organization (WHO) has previously highlighted the importance of the use of low vision aids in managing children with visual impairment across the world. To assess the effect of optical low vision aids on reading in children and young people with low vision. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2015), EMBASE (January 1980 to January 2015), the Health Technology Assessment Programme (HTA) (www.hta.ac.uk/), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 8 January 2015.We also used manual searching to check the references listed in retrieved articles. Manufacturers of low vision aids were contacted to request any information about studies or research regarding their products. We planned to include randomised controlled trials (RCTs) and quasi-RCTs where any optical low vision aid was compared to standard refractive correction in children and young people aged between 5 and 16 years of age with low vision as defined by the WHO. We planned to include within-person design studies where the order of presentation of devices was randomised. Two authors independently reviewed the search results for eligibility . No studies met the inclusion criteria for this review. There is a lack of good quality evidence regarding the use of optical low vision aids in children and young people. As such, no implications for practice can be drawn. We believe future research should include functional outcome measures such as reading speed, accuracy and comprehension, as well as the effect of low vision aids on quality of life, in order to truly assess and compare the effect of these devices on a child's life and development.

Functional vision in children with perinatal brain damage

Many authors have discussed the effects of visual stimulations on visual functions, but there is no research about the effects on using vision in everyday activities (i.e. functional vision). Children with perinatal brain damage can develop cerebral visual impairment with preserved visual functions (e.g. visual acuity, contrast sensitivity) but poor functional vision.Objective: Our aim was to discuss the importance of assessing and stimulating functional vision in children with perinatal brain damage.Methods: We assessed visual functions (grating visual acuity, contrast sensitivity) and functional vision (the ability of maintaining visual attention and using vision in communication) in 99 children with perinatal brain damage and visual impairment. All children were assessed before and after the visual stimulation program.Results: Our first assessment results showed that children with perinatal brain damage had significantly more problems in functional vision than in basic visual functions. During the visual stimulation program both variables of functional vision and contrast sensitivity improved significantly, while grating acuity improved only in 2.7% of children. We also found that improvement of visual attention significantly correlated to improvement on all other functions describing vision.Conclusions: Therefore, functional vision assessment, especially assessment of visual attention is indispensable in early monitoring of child with perinatal brain damage.

Impact of low vision rehabilitation on functional vision performance of children with visual impairment

Purpose:To evaluate the impact of low vision rehabilitation on functional vision of children with visual impairment.Materials and Methods:The LV Prasad–Functional Vision Questionnaire, designed specifically to measure functional performance of visually impaired children of developing countries, was used to assess the level of difficulty in performing various tasks pre and post visual rehabilitation in children with documented visual impairment. Chi-square test was used to assess the impact of rehabilitation intervention on functional vision performance; a P < 0.05 was considered significant.Results:LogMAR visual acuity prior to the introduction of low vision devices (LVDs) was 0.90 ± 0.05 for distance and for near it was 0.61 ± 0.05. After the intervention, the acuities improved significantly for distance (0.2 ± 0.27; P < 0.0001) and near (0.42 ± 0.17; P = 0.001). The most common reported difficulties were related to their academic activities like copying from the blackboard (80%), reading textbook at arm's length (77.2%), and writing along a straight line (77.2%). Absolute raw score of disability pre-LVD was 15.05 which improved to 7.58 post-LVD. An improvement in functional vision post visual rehabilitation was especially found in those activities related to their studying lifestyle like copying from the blackboard (P < 0.0001), reading textbook at arm's length (P < 0.0001), and writing along a straight line (P = 0.003).Conclusions:In our study group, there was a significant improvement in functional vision post visual rehabilitation, especially with those activities which are related to their academic output. It is important for these children to have an early visual rehabilitation to decrease the impairment associated with these decreased visual output and to enhance their learning abilities.

A comparative study of the functional vision in children with low vision from 2 to 6 years old

Introduction: The psychometrics properties of the Functional Vision Assessment (AVIF-2 to 6 years) and the test capacity to differentiate visual ability levels in children with low vision were analyzed.

Outcomes and Opportunities: A Study of Children with Cortical Visual Impairment

Pediatric View is an evaluation project that began in 1999 and is located at Western Pennsylvania Hospital in Pittsburgh. It is affiliated with the hospital's Department of Pediatrics and Neonatology and was initiated as an adjunct to the neonatal developmental follow-up clinic. The purpose of Pediatric View is to provide developmental and functional vision evaluations to children who have ocular or cortical visual impairments. A team that includes a neonatologist and an individual who has expertise in child development and visual impairment conduct the evaluations. The evaluations are generally two hours in length, and a detailed report that provides specific follow-up intervention strategies is provided for each infant, child, or adolescent. Since 1999, more than 300 individuals with cortical visual impairment (CVI) have been evaluated at Pediatric View. In 2003, systematic data collection was initiated to monitor the progress of infants, children, and adolescents who have CVI. The data collection and analysis are based on two specific research questions: Are there commonalities in the medical histories of infants, children, and adolescents who have CVI? and Is there measurable improvement in the functional vision of children who have CVI? REVIEW OF THE LITERATURE The medical causes of CVI have been described by Huo, Burden, Hoyt, and Good (1999); Teplin (1995); and Jan and Groenveld (1993). Researchers have also reported on the coexisting ocular conditions of children with CVI (Good et al., 1994: Jan & Wong, 1991; Lowery, Atkinson, & Lambert, 2006). However, there have been no reviews of the birth history, length of medical intensive care, preterm or full-term birth, neonatal seizures or ongoing seizures, and treatment with medications in a diverse cohort of infants, children, and adolescents. It has been recognized that there are improvements in acuity in children with CVI (Good, 2001; Hoyt, 2007; Huo et al., 1999; Jan, Sykanda, & Groenveld, 1990). However, little is known about the functional vision status of individuals who have CVI. According to Topor (2009, p. 1), Vision is functional if a child is able to utilize visual information to plan and carry out a task.... A functional vision assessment measures how well a child uses vision to perform tasks in different places and with different materials throughout the day. The functional vision assessment paints a picture of how a child uses vision and what visual skills the child needs to develop further. The CVI Range (Roman-Lantzy, 2007) is a functional vision assessment that is designed for the specific visual and behavioral needs of individuals who have CVI. It has been shown to be a reliable evaluation instrument (Newcomb, 2010). Newcomb found that the CVI Range has a high degree of interrater, test-retest, and internal consistency reliability. These data indicate that scores that are obtained on the CVI Range measure the intended underlying construct: the degree of affect of CVI. The CVI Range is used with infants, children, and adolescents, and can be used with those who have mild, moderate, significant, or no additional disabilities. METHODS, QUESTION 1 The subset of individuals in this study was selected only if a complete data set was available. Of all the records that we reviewed, a cohort of 77 individuals met the criteria. The mandatory information included the following: medical etiologies, maternal pregnancy and perinatal history, an eye examination by an ophthalmologist, visual diagnoses of ocular or cortical visual impairment, the presence and type of seizures, and medications. The cohort included 77 individuals from 17 U.S. states and two countries outside the United States. Although the individuals traveled from all regions of the United States, they are not considered a random sample. All 77 families voluntarily sought the services offered at Pediatric View and scheduled their own appointments. …

Unilateral lens extraction for high anisometropic myopia in children and adolescents

A subpopulation of children with anisometropic myopia, amblyopia, and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated using lensectomy alone (clear lens extraction) or lensectomy with simultaneous implantation of an intraocular lens (refractive lens exchange). Clinical course and outcome data were collated retrospectively in a group of 7 children and adolescents (mean age, 9.1 years; range, 4-20 years) with neurobehavioral disorders and noncompliance with spectacle wear for anisometropic myopia. Myopia in the 7 eyes ranged -11.9 to -24.5 D (mean, -16.7 D). Goal refraction was 0 to + 4 D. Correction was achieved by lensectomy in 5 eyes and lensectomy with intraocular lens implantation in 2 eyes. Primary posterior capsulectomy/subtotal vitrectomy was performed during the primary procedure in 5 eyes (71%). Mean follow-up was 3.8 years (range, 0.5-5.4 years). Myopia correction averaged 17.3 D. A total of 86% (6 eyes) were corrected within +/- 3 D of the goal refraction and the remaining 14% to within +/- 4 D. Uncorrected visual acuity improved postoperatively in all 7 eyes, albeit modestly (average gain 0.14 Snellen fraction; gain from a mean 20/2550 to a mean 20/130). Myopic regression averaged approximately 0.43 D/year. Capsular opacification necessitated YAG-laser membranectomy in the 2 eyes that had preservation of the posterior capsule at the primary procedure. Retinal detachment has not occurred in any of the eyes during the follow-up period. Refractive myopic lensectomy reduced high anisometropia and improved functional vision in children who have high myopia beyond the range of excimer laser correction and who will not wear glasses. Further study is indicated to determine the long-term safety of this procedure in similar pediatric populations.

An educational assessment of functional vision for children ages 3–5

During 20 years at ELIYA (Israel Association for the Advancement of Blind and Visually Impaired Children), a multidisciplinary team (vision teacher, social worker, representative of the social service department and an optometrist) has evaluated over 600 children from birth to 5 years of age. About 60% of the VI children evaluated were multihandicapped. The remaining percentages were children functioning close to their chronological age. Most of the children we evaluated had undergone extensive medical procedures (US, CT, MRI, VEP and ERG), and had a medical diagnosis. All the children had an Ophthalmologic and Optometric examination. In most situations the children did not cooperate in Low Vision evaluations, or they did not have the required skills to make use of these evaluations (BUST, LH cards). All these reports did not provide enough information about the child's use of vision in real life situations, and these “real life situations” are the environments which promote growth and development. This particular assessment is meant to demonstrate the tools to evaluate the child's functional vision through the use of common objects in real life situations. The information gathered in this assessment enables the low vision teacher and the parent to develop an educational program which will further the development of functional vision. The skills evaluated in this assessment include:–distance used for near and far vision,–scanning skills,–skills used in identifying pictures,–skills used in identifying objects in space,–graphic skills,–distinguishing figure from background.

The impact of visual impairment on functional vision of children in rural South India: the Kariapatti Pediatric Eye Evaluation Project.

To determine the impact of visual impairment on functional vision of children in a rural population of south India. A visual function questionnaire (LVP-VFQ) was administered to 1194 children aged 7 to 15 years identified through a systematic random sampling technique from 144 hamlets of Kariapatti in rural south India as part of a larger population-based project. Visual acuity estimations and clinical examinations for morbidity were performed in these 1194 children. A Rasch analysis was performed to validate the use of the instrument in this population. Bootstrap estimates (95% confidence intervals) of the regression coefficients were used to compare visual function scores between children with normal sight and children with uncorrected monocular and binocular visual impairment. The mean age of children was 10.3 +/- 2.1 years. The reliability estimates were 0.82 for person ability and 0.88 for item difficulty parameters, according to the Rasch analysis. A separation index of 2.15 was obtained for person measures and 2.74 for item measures, and the mean square infit and outfit statistics were 1.03 (Z(STD) 0.1) and 0.99 (Z(STD) -0.1), respectively. Children with monocular visual impairment (bootstrap estimate [95%CI] -0.05 [-0.08 to -0.01]) and binocular visual impairment (bootstrap estimate [95%CI] -0.09 [-0.11 to -0.07]) were more likely to have functional visual deficits than were normally sighted peers. Monocular or binocular visual impairment impacts on the functional vision of children in this rural population. Further studies are needed to determine the impact of treatment of visual impairment on functional vision in children of this population.

Functional Vision Screening for Severely Handicapped Children

Ophthalmologists traditionally have been unable to provide teachers and parents with useful information about a severely handicapped child's functional vision. Literature concerning the assessment of vision in handicapped children is reviewed and a guide is proposed for use by teachers in evaluating the severely handicapped child's functional vision.