Moderate Low Vision Research Articles

ORIENTATION AND MOBILITY OF VISUALLY IMPAIRED CHILDREN IN RELATION TO THE CATEGORY OF LOW VISION AND TYPE OF VISUAL IMPAIRMENT

he aim of this research was to examine the orientation and mobility of children with visual impairment in relation to the category of low vision and the type of visual impairment. The research included a sample of 35 respondents with visual impairment, aged between 7 and 15 years. The research was conducted in Sarajevo at the Center for Blind and Visually Impaired Children and Youth "Nedţarići". The results of the research showed that in relation to the category of low vision, there were no statistically significant differences between arithmetic means, nor statistically significant correlations between respondents with severe low vision and respondents with moderate low vision. In relation to the type of visual impairment, there were also no statistically significant differences in orientation and mobility between visually impaired children. Keywords: Orientation and mobility, visually impaired children, low vision.

Managing Chronic Health Needs in Child Care and Schools—Visual Impairments

Patient Education| 2021 Managing Chronic Health Needs in Child Care and Schools—Visual Impairments Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Managing Chronic Health Needs in Child Care and Schools—Visual Impairments. Pediatric Patient Education 2021; 10.1542/ppe_document038 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Managing Chronic Health Needs in Child Care Visual impairment is present when a child cannot see well enough to interact with others and participate in daily child care or school activities (at the child’s developmental level).Low vision involves a decrease in sight (usually permanent) that interferes with a child’s ability to develop fine- and gross-motor skills and language and cognitive functions. It is an impairment in vision that, even with glasses and maximal medical treatment, adversely affects a child’s development.Partially sighted, legally blind, and low vision are terms used to describe the different levels of visual impairment related to a child’s needs in child care or another educational setting.A child who is partially sighted (also called moderate low vision, with typically 20/60–20/100 best-corrected at-a-distance visual acuity) has a visual problem that requires some special accommodations in child care and school. These children may also... © 2019 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.

Ophthalmological evaluation in children referred to a low-vision rehabilitation project of a social assistance agency

A low-vision (LV) rehabilitated child can receive comprehensive education. Objec tive: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Study on the status of low vision among students of Beijing in 2017

Objective: The purpose of this study was to describe the status quo and related factors on low vision (LV) among students of Beijing. Methods: All the students in Beijing were included as the subjects of interest, based on the reference of the Chinese National Survey on Students' Constitution and Health. Results: The overall rate of LV among students in Beijing was 58.6% in 2017, with 61.6% in females, higher than 55.9% in males. LV also appeared higher in urban than in rural areas. The rates of LV appeared as 46.8%, 78.0%, 89.0%, 71.0%, in students from primary, middle, high or vocational high schools, respectively. Rates on light, moderate or severe LV were 8.4%, 17.8% and 32.5%, respectively. Conclusions: The overall rate of LV among students in Beijing was considered high. Students in preschool, in 4-6 grades and the 2(nd) grade of middle schools, were at the key stages of developing vision-related problems. Factors as heavy load on homework, lack of outdoor activities and 'limit of vision space' as well as incorrect reading behavior during puberty, need to be of concern.

Visual Performance and Perception as a Target of Saccadic Strategies in Patients With Unilateral Vestibular Loss.

To evaluate the ability of saccadic strategies developed during vestibular compensation to reduce the effect of an impaired vestibulo-ocular reflex (VOR) on a retinal smear and image motion sensation. Twenty patients with unilateral vestibular loss were examined with a video head impulse test before and after vestibular rehabilitation (VR) with the use of gaze stabilization and refixation saccades training. Head and eye velocity functions were processed to infer the retinal eccentricity, and through its correlation with visual acuity (VA), several measurements are proposed to evaluate the influence of VR on saccades behavior and visual performance. To isolate the effect of saccades on the findings and avoid bias because of gain differences, only patients whose VOR gain values remained unchanged after VR were included. Improved contribution of covert saccades and reduction of overt saccades latency were measured after VR. We found significant differences when assessing both the interval less than 70% VA (50.25 ms), which is considered the limit of a moderate low vision, and less than 50% VA (39.515 ms), which is the limit for severe low vision. Time to recover a VA of 75% (near normal) was reduced in all the patients (median: 56.472 ms). Despite the absence of VOR gain improvement, patients with unilateral vestibular loss are able to develop saccadic strategies that allow the shortening of the interval of retinal smear and image motion. The proposed measurements might be of use to evaluate VR outcomes and visually induced impairment.

The impact of delay in diabetic patient's referral for diabetic retinopathy screening on the level of retinopathy detected in adult Sudanese diabetic Sudanese patients

Background: Diabetic retinopathy (DR) is the most common complications of diabetes mellitus (DM) which needs early detection. Delay in referral of patients with significant DR by physicians to the concerned ophthalmologist may compromise visual outcome since early treatment is associated with a 50% reduction in the risk of visual loss. Objective: The aim of this study is to assess the relationship between delays in diabetic patient's referral for DR screening after diagnosis of DM and the level of the DR detected at Sudan. Materials and Methods: A 2-year prospective cross-sectional study was conducted on 240 patients with type I and II, newly referred patients in the period from January 2013 to February 2015. The estimated time lapse between this first DR screening and the onset of DM was recorded as “delay period” in diabetic patient's referral for DR screening, which was compared with the level of DR and the level of visual loss at the time of the first visits. Results: In a 2-year study (2013–2015), 240 were newly referred diabetic patients, 225 type 2 DM (93.75%), and 15 (6.25%) type I DM. DM duration was 17.6 years (2–40 years); 202 with poor control. Eighty-nine were hypertensive with a mean duration of 3.7 years. About 83.3% were referred by general ophthalmologists, 10.4% by physicians, 4.2% by optometrists, and 2.1% by their own will. Nearly 85% referred for their visual disturbances and 15% for self-referral. Two hundred and eleven patients (87.09%) had one form of DR; while only 29 patients did not apparent DR. Low-risk DR recorded in 174 (72.5%), high risk in 66 (27.5), and diabetic macular edema (DME) in 94 (39.2%). The average delay was 14.8 years; 15.5 years for men and 14.04 years for women. The average percentage of visual loss in the low-risk group was 16.7% (visual score of 83.3%). While the visual loss in the high risk was 69.3% (visual score of 30.7%). DME reported 36.6% visual loss and 63.4% visual score. The mean visual loss in all diabetic study population was 40.9% with the total visual score of 59% which equivalent to 6/40 at the moderate low vision range of the World Health Organization. Conclusion: There was a strong correlation between the levels of DR detected and the percentage of visual loss. The “no apparent DR group” recorded the minimal detection of visual loss.

Clinical and Microperimetric Predictors of Reading Speed in Low Vision Patients: A Structural Equation Modeling Approach

To investigate the simultaneous association of several psychophysical measures with reading ability in patients with mild and moderate low vision attending rehabilitation services. Standard measurements of reading ability (Minnesota Reading [MNREAD] charts), visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] charts), contrast sensitivity (Pelli-Robson charts), reading contrast threshold (Reading Explorer [REX] charts), retinal sensitivity, and fixation stability and localization (Micro Perimeter 1 [MP1] fundus perimetry) were obtained in 160 low vision patients with better eye visual acuity ranging from 0.3 to 1.0 logarithm of the minimum angle of resolution and affected by either age-related macular degeneration or diabetic retinopathy. All variables were moderately associated with reading performance measures (MNREAD reading speed and reading acuity and REX reading contrast threshold), as well as among each other. In a structural equation model, REX reading contrast threshold was highly associated with MNREAD reading speed (standardized coefficient, 0.63) and moderately associated with reading acuity (standardized coefficient, -0.30). REX test also mediated the effects of Pelli-Robson contrast sensitivity (standardized coefficient, 0.44), MP1 fixation eccentricity (standardized coefficient, -0.19), and the mean retinal sensitivity (standardized coefficient, 0.23) on reading performance. The MP1 fixation stability was associated with both MNREAD reading acuity (standardized coefficient, -0.24) and MNREAD reading speed (standardized coefficient, 0.23), while ETDRS visual acuity only affected reading acuity (standardized coefficient, 0.44). Fixation instability and contrast sensitivity loss are key factors limiting reading performance of patients with mild or moderate low vision. REX charts directly assess the impact of text contrast on letter recognition and text navigation and may be a useful aid in reading rehabilitation.

Low vision in children and adolesents: Hospital based study

One thousand five hundred clinical recordswere chosen from the Medical Records Department of the eye clinic, Central Hospital, Benin, Edo State between 2000 and 2004 by cluster random sampling method. Data was classified according to the different etiologies of low vision, gender, congenital and acquired causes, anterior and posterior anomalies and according to World Health Organization's classification. Of the 246 found aged below 20yrs, 37 (15.04%) had low vision. The prevalence of low visionwas thus 15.04%.The leading cause of lowvision was cataract (23.32%).Myopia and optic atrophy contributed 16.22% respectively, aphakia/dislocated lens, 13.51%. retinitis pigmentosa 10.81%, macula degeneration 5.41%, glaucoma and nystagmus 2.70% respectively and the unknown cause 8.11%. 64.86% had moderate low vision, 10.81% was in the profound low vision group, 13.51% was in the near total blindness group, while 7.92% had unilateral loss of vision. 15.76% males were involved while females were 43.24%. Acquired anomaly was 1(2.70%) and posterior segment anomalies were 22(59.46%) respectively.Asignificant difference was found between the congenital causes of low vision and the acquired (P>0.05), congenital causes lead to more low vision cases. There was no significant difference in the sexes (P

Use of Eye Care Services and Need for Assistance in the Visually Impaired

To assess the use of eye care services and unmet need for assistance in visually impaired people. Cross-sectional population-based survey on a sample representing the Finnish population aged 30 years and older. Of the 7979 eligible people, 6645 (83.3%) were both interviewed and had their distance visual acuity (VA) assessed. One hundred forty-seven people were classified as visually impaired (VA < or = 0.25). A home interview included an assessment of the use of eye care services, need for assistance, sociodemographic variables, cognitive functioning, and mobility. Binocular VA for distance was measured with the participants' current spectacles, if any, as a part of a comprehensive health examination. One-half (58%) of visually impaired people had had a recent vision examination and 79% had received some vision rehabilitation services, mainly in form of spectacles (70%). Only one third (31%) had received formal low vision rehabilitation. People with moderate visual impairment (VA 0.1 to 0.25) were less likely to have received low vision rehabilitation, magnifying glasses, or other low vision aids compared with people with severe low vision (VA < 0.1). Furthermore, low cognitive capacity and living in an institution were associated with limited use of vision rehabilitation services. Of the visually impaired people living in the community, 71% reported need for assistance and 24% of them had unmet need for assistance in everyday activities. Although need for assistance was more common in people with severe low vision (83% vs. 67%, p = 0.09), unmet need for assistance seemed to be more common in people with moderate low vision (20% vs. 9%, p = 0.23). Many visually impaired people, older persons in particular, have not had a recent vision examination and lack adequate low vision rehabilitation. This highlights the need for regular evaluation of vision function in elderly people and for actively supplying information about rehabilitation services.

Low vision and blindness in children with multiple handicaps

ObjectiveTo identify causes of visual impairment in children with multiple disabilities (handicaps) evaluated at Laramara, Brazilian Association for Assistance to the Visually Impaired People from March 1998 to November 2003. Method1562 children were evaluated; mean age was 5 years, 49% were females and 51% males; 78% came from the city of São Paulo, Brazil and 20.7% had moderate low vision, 19.2% severe and 9.7% profound low vision. 46.7% were in the near blindness range and 3.7% presented blindness. Data concerning diagnosis, site of the ocular lesion and causes of optic atrophy and cortical visual impairment were analyzed. ResultsThe main causes of visual impairment were: optic atrophy (37%), cortical visual impairment (22%), toxoplasmic macular retinochoroiditis (8.4%), retinopathy of prematurity (7.3%), ocular development abnormalities (6.7%) and congenital cataracts (6%). Optic nerve was the most frequently compromised ocular structure (38.4%). Concerning etiology of the optic atrophy, 47.6% were related to hipoxic–ishemic perinatal episodes and 13.9% to development abnormalities of the central nervous system. Cortical visual impairment was related to perinatal hipoxic–ischemic episodes in 46.9%. ConclusionsNecessity of primary intervention for infectious diseases and better prenatal care is stressed. Secondary prevention measures for detection and treatment of ocular and other problems as well as tertiary intervention and need of rehabilitation units for the multiple impaired are emphasized.

The Motor Development of Sighted Children and Children with Moderate Low Vision Aged 8–13

A study of the motor skills of 60 children aged 8–13—30 who were sighted and 30 who had moderate low vision—found that the children with low vision had poorer motor skills than did the children who were sighted. Furthermore, the children with low vision had weaker gross motor skills, especially balance, than fine motor skills. Implications for intervention are discussed.

Prescribing near magnification for low vision patients

Most patients with low vision request help with reading. Despite improvements in the assessment of visual functions, determining the appropriate magnification for reading still often involves a trial and error approach. Recent research has shown that with accurate and systematic assessments of vision, the required magnification can be predicted but this magnification needs to be much higher than has been previously recommended. This paper presents a systematic approach to enable practitioners to determine the power of a near addition or simple magnifier needed to assist patients with mild or moderate low vision who may present seeking help for reading. Guidelines for appropriate referral to low vision services are also provided.

Visual impairment and cancer: a population-based cohort study in Finland.

To describe the cancer risk pattern of Finnish persons with visual impairment. A cohort of 17,557 persons identified from the Finnish Register of Visual Impairment was followed-up for cancer through the Finnish Cancer Registry from 1983-95. The degree of visual impairment ranged from moderate low vision with visual acuity less than 0.3, to total blindness with no perception of light. The standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated by primary site; the expected rates were based on national cancer incidence rates. The SIR for overall cancer among totally blind men was 2.2 (CI = 1.3-3.5) while in the entire cohort the incidence was increased by only 15% (1,255 cancers observed cf 1,093 expected). Excesses were observed in both genders in cancers of the liver (SIR = 1.8, CI = 1.2-2.5) and lung (SIR = 1.5, CI = 1.3-1.7); in females in cancers of the stomach (SIR = 1.5, CI = 1.2-1.9) and the colorectum (SIR = 1.3, CI = 1.1-1.6); and in males in cancers of the kidney (SIR = 1.8, CI = 1.1-2.6) and the eye (5.8, CI = 1.9-13). The excess in lung cancer was entirely attributable to age-related macular degeneration (which is most common among smokers). Cancer incidence among the visually impaired tended to be increased for most cancer types. Attention should be paid to lifestyle factors underlying the observed risk increases, such as unbalanced diet.

Referral to low vision services by ophthalmologists

People in need of low vision rehabilitation services often experience delays in referral to services. This study investigates referral criteria of Australian ophthalmologists, the frequency of referral of their patients with low vision and their perceptions of low vision services. A survey was sent to a representative, random sample of 200 ophthalmologists. They were asked about criteria used for the referral of their patients with low vision. The survey included questions on the frequency with which they prescribed low vision devices (LVD) and referral of their patients to low vision and rehabilitation services and peer support groups. Perceptions of the quality and availability of low vision services were also investigated. The response rate was 82%. Approximately 11% of ophthalmologists' patients have low vision. It is uncommon for ophthalmologists to prescribe LVD but 67% refer most of their patients with low vision. It is less common for them to refer to rehabilitation services (29%) or peer support services (18%). The perceived local availability of services influences the rate of referral. Ophthalmologists who used the criteria of moderate low vision (< 6/21 to < 6/60) are more likely to refer more of their patients than those who use the criteria of severe low vision. Australian ophthalmologists refer most of their visually impaired patients to low vision services, but infrequently to rehabilitation services or peer support groups. Differences in perceived need for low vision services indicated by the criteria used for referral, and the perceived availability, influence the rate at which ophthalmologists refer their patients for services. Ophthalmologists are encouraged to refer patients with permanent visual loss to low vision services earlier.