Functional vision assessment: What to consider

Nusrat ZerinAssistant Professor

Proyash Institute of Special Education and ResearchBangladesh University of Professionals (BUP)

Dhaka CantonmentDhaka, Bangladesh

What is a functional vision assessment? Functional vision assessments is to make people use their residual vision.

They are normally done in school /home.

Why do a functional vision assessment? We cannot tell how much a child sees from looking at their eyes: some children's vision is also affected by cerebral vision impairment (CVI), attention, epilepsy & other factors. An assessment can help to ensure that a child makes most of sight they have. By observing the child in daily routine, adjustments can be made as per need.

FVA will influence: –• teaching approaches • choice of learning materials.

Assessment of children with CVI is a lengthy process, more easily carried out at home or school than in a clinical setting. Aim of FVA:The aim of a functional vision assessment should be to supplement clinical findings, and identify appropriate learning conditions to effectively address the child's needs.

What does an assessment investigate? • ability to recognise objects, pictures, shapes,

colours etc. • perception of movement • figure-ground discrimination • depth perception • how visual attention is affected • capacity to "look and listen", or "look and do".

FVA:4 major areas to assess:

1. Communication (eye contact, expression, object’s size/distance/color, gesture, visual signs, auditory, vocal language, tactile information)

2. Near vision related activities3. Activities of daily living 4. Orientation and mobility

Steps of FVA:• Visual acuity and visual field • Observe the use of visual task• Imitation • Tracking• Identify color contrast or which color • Shape of different objects• Walking by avoiding barriers on way• Identify pictures• Identify differences in picture• Identify incomplete pictures and complete• Eye hand coordination

Before starting FVA:1. Length of time: several visits2. Routine : Children with complex needs tend to have a busy routine -

various therapies, medical procedures, personal care, assisted feeding.3. Variations

a) Epilepsy and medication can affect wakefulness and cause significant fluctuations in vision.

b) Cerebral palsy often causes acute discomfort , reduced motor control.

Visual responses will vary according to positioning in terms of comfort, head control and other visual access. It should be possible to see the impact of these factors on the child's visual attention during classroom observation.

c) Environmental factors - assessment report on how a child sees in his

normal living environment.