Common Causes of Visual Loss in Children

Presented on Friday 15 May 2009

Visual Challenges and Strategies to help

Dr J Skillen

Hints and tips for all involved in children with visual impairments

Features of VI

Refractive error

Glare (ocular)

Reduced Vision

Enlarged Print

Low tech magnifiers

High Tech LVA's

Distribution of LVA use across age groups in Scotland

Contrast Sensitivity

Conditions with loss of contrast

Communication, Facial expressions Orientation and Mobility, Kerbs Accessing information, Reading Text Activities of daily living, Eating

Increase Contrast Wherever Possible

Colour Issues

Impaired accommodation common in:


Add a reading lens

May 1st 2008 – Science Daily

Control of eye movements


Assessment of fast eye movements

OKN drum

Visual Fields

Testing in Children under 10

Example of a normal Peripheral field in 10 year-old

normal 10 year old

Field Loss

Simultagnosia (B)

Unable to single out information when in crowded and busy environments
- difficulty hunting for a toy in a tightly packed box of toys
- Difficulty finding Mum in a crowd of Mums
- Overloaded with information when trying to read.

Behavioural changes in busy crowded surroundings

Strategies Keep things simple

How to make things easier at home

Other Signs of Dorsal 'WHERE' Pathway deficits

Notes: By understanding where in the brain different types of visual information are processed we can then begin to understand the difficulties that may arise when things go wrong. Problems with the 'what' and 'where' pathway gives rise to specific types of visual difficulties which can be tricky to recognise during normal eye tests. In fact the ability to read letters on a chart can be completely normal and yet a person may be profoundly affected by dorsal or ventral based visual difficulties.


Other Signs of Temporal Lobe/ Ventral 'What' Pathway deficits

Remembering what is seen and visual imagination

Facial expression Six basic emotions

facial expressionsprosopagnosia

The facial expression recognition distance

The BIG Picture

the big picture

Royal College of Ophthalmologists Guidelines