Spectrum of Visual Dysfunction Detected by a Novel Testing Protocol Within a Special School Eye Care Service

Area of Science:

• Ophthalmology
• Developmental Pediatrics
• Special Education

Background:

• Children with special educational needs (SEN) exhibit higher rates of vision problems compared to typically developing peers.
• Existing vision assessments often prioritize visual acuity and refraction, potentially overlooking crucial visuoperceptual deficits like cerebral visual impairment (CVI).

Purpose of the Study:

• To evaluate the feasibility and outcomes of in-school visual function testing for children with SEN.
• To identify the prevalence of visual function difficulties beyond acuity in this population.

Main Methods:

• A retrospective chart review of 78 children in a special school vision program.
• Utilized a testing strategy including acuity, fields, contrast sensitivity, eye movements, accommodation, stereopsis, visual attention, and refraction, adapted to each child's engagement level.

Main Results:

• 31% of children had low vision (worse than 6/19).
• 49% exhibited at least one atypical visual function response, most commonly in visual attention (35%) and eye movements (25%).
• Only 20% of children showed normal responses across all completed tests.

Conclusions:

• Standard acuity testing is insufficient for identifying the visual challenges faced by children with SEN.
• In-school visual function testing, using methods requiring minimal cognitive, speech, or motor skills, can reveal critical visual (dys)functions impacting learning.
• This approach provides immediate, actionable feedback for educators and caregivers to support student learning.