Often times individuals with special needs may have a more difficult time expressing their visual difficulties. They may also have impaired vision secondary to their birth and developmental history - such as cortical vision impairment (CVI). CVI is a decrease in vision secondary to an event that damages the visual pathway within the brain. Keep in mind CVI is not a physical problem with the eye but instead damage to the brain that affects vision. CVI is much more than decreased vision - it can affect an individual's perception of their environment through visual stimuli. It is important to recognize that CVI does not mean the individual is blind, their visual skills are altered but they may have residual vision. Also, CVI does not have the same effect on each person. There is a spectrum of visual strengths and weaknesses that need to be evaluated.
CVI is unique in the fact that it can occur during different times of life. It can occur in-utero, during birth, or after birth. Most commonly it is caused from an ischemic event (lack of oxygen for a period of time). Generally this event is from asphyxia or a cerebral vascular accident. It can be caused from trauma, hemorrhaging, or even complications with pre-maturity. Of course there are other causes of CVI. To determine if an individual does in fact have CVI it is important they have a comprehensive eye examination to determine that a refractive error or an ocular disease are not the causes of the decreased vision. The individual's health history should also be significant for a specific event that could have neurological implications.
Because each person with special needs (including autism, cerebral palsy, Trisomy 21 and other chromosomal anomalies) or CVI have unique goals for daily activities and education, it is important to determine their individual strengths and weaknesses. This is where a Specialized Vision Assessment is essential. A Specialized Vision Assessment (also known as a functional vision assessment) is an evaluation that takes into consideration those goals as well as visual strengths. During this assessment a residency trained pediatric optometrist determines appropriate environmental modifications. Environment modifications and visual modifications can play a major role in functional skills as well as independence. These modifications can also be very helpful when advocating for an IEP or planning interventions by the various members of the care team.
Modifications that are implemented can relate to mobility, visual clarity, education, communication devices, or enhancements to assist in other therapies. A Specialized Vision Assessment is not a one-time assessment. As the child or individual matures and makes progress during their various therapies, abilities and goals change. As these changes occur, you will work with your Residency-Trained Pediatric Optometrist to maintain a vision plan that allows the individual to achieve their potential in all areas of life.
A Specialized Vision Assessment is also nice for families because in certain situations a family may not know what their family member is able to see (or if they can use their vision at all). During a Specialized Vision Assessment the residency-trained pediatric optometrist should determine, behaviorally, what the individual can see and where in their vision they can see their best. For some parents, a Specialized Vision Assessment is the the first time when they find out whether or not their child can see them. Knowing how your child sees is not only helpful but also relieving.
Keep in mind that a Specialized Vision Assessment does not replace a comprehensive eye examination with a residency-trained pediatric optometrist. A comprehensive eye examination with a residency-trained pediatric optometrist evaluates ocular health and determines if glasses would be beneficial. A functional vision assessment helps determine an individual's functional vision. Following a specialized vision assessment a complete summary is provided to the family with findings and recommendations. Many families also have the report sent to other members of the care team as well as educators so everyone is aware of things to improve the individual's visual environment.
For individuals who may have special needs, cortical visual impairment, or require modifications in the classroom or home - a Specialized Vision Assessment will help evaluate and determine appropriate modifications that can enhance their quality of life. For any child, but especially those with special needs, be sure to seek care from a residency-trained pediatric optometrist - because everyone deserves individualized care.
For more information about pediatric vison care, check out our blogs about Pediatric Vision Care, Cerebral Palsy, Autism, Kids Eyeglasses and Your Child's First Eye Exam.