Vision Disorders Explained By Parents and Queries Answered By Experts On the field.
Dated 27/8/18
Asdparents and Therapists Group was highly privileged to have two eminent optometrists on board to answer queries from parents on vision disorders and Visual perception disorders. Our sincere gratitude to
*Diwakar Rao, working in Sankara Eye Hospital, HOD of Vision Therapy Department, Specialized in Vision Therapy & Behavioural Optometry & Neuro Optometric Rehabilitation.
*Nikhita Jacob , optometrist from sankara vision clinic , Bangalore
*Zahi-r-Ibrahim Opthalmologist
Vision disorder is basically vision impairment where the vision is affected due to various reasons like refractive error.
Visual perception disorder is related impairment of perceptual skills like discrimination between things, matching the shapes, colors and similar actions in day-to-day life.
Q.What are the possible symptoms of vision disorder?
A.Blurring of vision, going closer to objects, rubbing eyes, squeezing eyes.
Q.My child usually fidgets fingers or objects in front of the eyes.Could you explain the same?
A.Referring to your queries with regard to fidget with fingers or staring at hands is due to visual stimulus.
Most of the special kids have very sensitive visual stimulus, to avoid this over stimulation they adopt eye poking, flapping of hands or even staring at objects.
Their is no written evidence on this.
Q.My daughter have the habit of eye-poking ,sometimes eyeball comes outside. what can i do for this?
A.Eye poking is due to very sensitive visual stimulus. Not to worry about.Eye poking symptoms reduce over a period of time with Vision therapy.
Initially we can help them like using a sticker on the child’s shoes so they know which foot to put them on.
Four line papers to help with word spacing and sizing and correct line alignment.
Use a marker to outline the boundaries for coloring.
Break visual activities into small steps.
Later slowly stop helping them in such routine duties and let them to do it on their own.
Q.My son does cornergaze , mostly when he focus more on TV ,when objects move ,can you explain why is it happening ?
A.Most of the kids have corner gazing, fond of seeing moving objects and rotating objects is due to visual stimulus.
https://www.autism.com/vison
https://www.covd.org/page/Autism
http://www.newimageeyecenter.com/vision-perception.html
Chitra Chandran explained how to ready a child in the spectrum for Vision examination in the hospital.
Preparation is always needed,the only difference is that, compared to preparing a day before as applicable for some kids, deliberately tell the child while on the way to the hospital nowadays ( a step ahead towards dealing with emergency)
Give instructions in advance on how to listen to the doctor and nurse,and explain that they r trying to help the child.
Also let them understand how to ask them or parent for any help
She pointed out some issues faced by asd kids for eye examinations such as sensory issues towards touching the chin and forehead , keeping eyes open for a long time and so on. She also suggested that for touch sensitivity, we should try giving that kind of rough feel with some object at forehead and chin beforehand itself n try keep them desensitized
https://lynnhellerstein.com/succeed-in-school/
https://lynnhellerstein.com/casestudies/
https://link.springer.com/article/10.1007%2Fs10803-012-1475-2
Mrs Akila Vaidyanathan explained that Vision is affected by dysfunction of the organ or it's parts the nerve etc. Perception is affected by how we process the sensory data collected by the organ (same goes for hearing)... both are related but the latter is also affected by attention or the lack of it.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327555/
https://www.greatplainslaboratory.com/articles-1/2015/11/13/rickets-and-eye-poking-in-autism-associated-with-calcium-deficiency
Q.Could someone explain more on convergence insufficiency.Is it the reason why children lack the ability to focus on fast moving objects and catch it?
A.Convergence insufficiency actually causes inability to focus but that is not the only reason when it comes to moving objects. Eye movements required to focus on moving objects are called saccades and pursuits, which is mostly affected in ASD kids. That could also be the reason that the child is not able to fixate at moving objects.
Q.How heritable are refractive disorders?
A.If the parents are having a moderate to high power, then most likely the child will have refractive power.
Q.Are vision disorders (not visual perception disorder) more in asd population than general population?
A.Not really required. Indeed most ASD kids have good vision and affected perceptual skills.
Zahi-r-Ibrahim explained that Refractive errors are independent of issues caused by visual processing.Sometimes individuals struggle to see ,not because they have a refractive error, but due to visual stress.
Glare be it from the surrounding, or glare from a reading surface affects the individual.
Scotopic sensitivity - (visual stress) , arises from the glare from the surrounding, which impacts on visual processing of information.
In scotopic sensitivity,( visual stress ) individuals affected by it , often cannot read or write very well and are sensitive to light n sound
Individuals who have refractive errors and have been wearing glasses to correct refractive errors , still affected by visual stress ,affecting their reading and writing ,hence affirms
Refractive error independent of
Refractive error.
Q.My daughter mostly likes to squint her eyes every now and then.what could be the reason?
A.Possible reason can be refractive error.We can correct refractive error by glasses.I will recommend comprehensive eye examination
Q.I have squint ( I wear glasses ).when I wear my glasses u won’t see my squint but when I am physically exhausted ,my squint is obvious .What’s wrong with the eyes?
A.Your symptoms look like intermetant Divergent squint, which get obvious towards end of day, or when you are tired.
Possible cause is poor eye muscle control.
I will suggest eye examination.
Vision therapy will help in your case.
Q.Why does my son constantly rub the eyes?
A.It can be because of foreign body sensation in eye.
It can be because of poor focusing ability (Accommodation insufficiency)
In this case distance vision will be normal.
Problem will be seen for near vision.
Q.Is there any test to find out ,the issues from glare from the surrounding and from flash cards .How I can help him for this problm?
A .If struggling with glare from flash cards - change the background colour.
Sky blue , pink and yellow.
The colour flash card to which his response is quickest is the colour that is helping to reduce the glare best.
Use that colour flash card.
Perhaps low light switch to black white flash cards - better contrast .
Daylight - colour paper.
Its a case of trial and error ,if it works use that.
https://www.autismspeaks.org/blog/2015/04/10/%E2%80%98how-can-we-tell-if-our-nonverbal-teen-needs-glasses%E2%80%99
Thank you all
#Asd Parents and Therapists Group,Kerala
Dated 27/8/18
Asdparents and Therapists Group was highly privileged to have two eminent optometrists on board to answer queries from parents on vision disorders and Visual perception disorders. Our sincere gratitude to
*Diwakar Rao, working in Sankara Eye Hospital, HOD of Vision Therapy Department, Specialized in Vision Therapy & Behavioural Optometry & Neuro Optometric Rehabilitation.
*Nikhita Jacob , optometrist from sankara vision clinic , Bangalore
*Zahi-r-Ibrahim Opthalmologist
Vision disorder is basically vision impairment where the vision is affected due to various reasons like refractive error.
Visual perception disorder is related impairment of perceptual skills like discrimination between things, matching the shapes, colors and similar actions in day-to-day life.
Q.What are the possible symptoms of vision disorder?
A.Blurring of vision, going closer to objects, rubbing eyes, squeezing eyes.
Q.My child usually fidgets fingers or objects in front of the eyes.Could you explain the same?
A.Referring to your queries with regard to fidget with fingers or staring at hands is due to visual stimulus.
Most of the special kids have very sensitive visual stimulus, to avoid this over stimulation they adopt eye poking, flapping of hands or even staring at objects.
Their is no written evidence on this.
Q.My daughter have the habit of eye-poking ,sometimes eyeball comes outside. what can i do for this?
A.Eye poking is due to very sensitive visual stimulus. Not to worry about.Eye poking symptoms reduce over a period of time with Vision therapy.
Initially we can help them like using a sticker on the child’s shoes so they know which foot to put them on.
Four line papers to help with word spacing and sizing and correct line alignment.
Use a marker to outline the boundaries for coloring.
Break visual activities into small steps.
Later slowly stop helping them in such routine duties and let them to do it on their own.
Q.My son does cornergaze , mostly when he focus more on TV ,when objects move ,can you explain why is it happening ?
A.Most of the kids have corner gazing, fond of seeing moving objects and rotating objects is due to visual stimulus.
https://www.autism.com/vison
https://www.covd.org/page/Autism
http://www.newimageeyecenter.com/vision-perception.html
Chitra Chandran explained how to ready a child in the spectrum for Vision examination in the hospital.
Preparation is always needed,the only difference is that, compared to preparing a day before as applicable for some kids, deliberately tell the child while on the way to the hospital nowadays ( a step ahead towards dealing with emergency)
Give instructions in advance on how to listen to the doctor and nurse,and explain that they r trying to help the child.
Also let them understand how to ask them or parent for any help
She pointed out some issues faced by asd kids for eye examinations such as sensory issues towards touching the chin and forehead , keeping eyes open for a long time and so on. She also suggested that for touch sensitivity, we should try giving that kind of rough feel with some object at forehead and chin beforehand itself n try keep them desensitized
https://lynnhellerstein.com/succeed-in-school/
https://lynnhellerstein.com/casestudies/
https://link.springer.com/article/10.1007%2Fs10803-012-1475-2
Mrs Akila Vaidyanathan explained that Vision is affected by dysfunction of the organ or it's parts the nerve etc. Perception is affected by how we process the sensory data collected by the organ (same goes for hearing)... both are related but the latter is also affected by attention or the lack of it.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327555/
https://www.greatplainslaboratory.com/articles-1/2015/11/13/rickets-and-eye-poking-in-autism-associated-with-calcium-deficiency
Q.Could someone explain more on convergence insufficiency.Is it the reason why children lack the ability to focus on fast moving objects and catch it?
A.Convergence insufficiency actually causes inability to focus but that is not the only reason when it comes to moving objects. Eye movements required to focus on moving objects are called saccades and pursuits, which is mostly affected in ASD kids. That could also be the reason that the child is not able to fixate at moving objects.
Q.How heritable are refractive disorders?
A.If the parents are having a moderate to high power, then most likely the child will have refractive power.
Q.Are vision disorders (not visual perception disorder) more in asd population than general population?
A.Not really required. Indeed most ASD kids have good vision and affected perceptual skills.
Zahi-r-Ibrahim explained that Refractive errors are independent of issues caused by visual processing.Sometimes individuals struggle to see ,not because they have a refractive error, but due to visual stress.
Glare be it from the surrounding, or glare from a reading surface affects the individual.
Scotopic sensitivity - (visual stress) , arises from the glare from the surrounding, which impacts on visual processing of information.
In scotopic sensitivity,( visual stress ) individuals affected by it , often cannot read or write very well and are sensitive to light n sound
Individuals who have refractive errors and have been wearing glasses to correct refractive errors , still affected by visual stress ,affecting their reading and writing ,hence affirms
Refractive error independent of
Refractive error.
Q.My daughter mostly likes to squint her eyes every now and then.what could be the reason?
A.Possible reason can be refractive error.We can correct refractive error by glasses.I will recommend comprehensive eye examination
Q.I have squint ( I wear glasses ).when I wear my glasses u won’t see my squint but when I am physically exhausted ,my squint is obvious .What’s wrong with the eyes?
A.Your symptoms look like intermetant Divergent squint, which get obvious towards end of day, or when you are tired.
Possible cause is poor eye muscle control.
I will suggest eye examination.
Vision therapy will help in your case.
Q.Why does my son constantly rub the eyes?
A.It can be because of foreign body sensation in eye.
It can be because of poor focusing ability (Accommodation insufficiency)
In this case distance vision will be normal.
Problem will be seen for near vision.
Q.Is there any test to find out ,the issues from glare from the surrounding and from flash cards .How I can help him for this problm?
A .If struggling with glare from flash cards - change the background colour.
Sky blue , pink and yellow.
The colour flash card to which his response is quickest is the colour that is helping to reduce the glare best.
Use that colour flash card.
Perhaps low light switch to black white flash cards - better contrast .
Daylight - colour paper.
Its a case of trial and error ,if it works use that.
https://www.autismspeaks.org/blog/2015/04/10/%E2%80%98how-can-we-tell-if-our-nonverbal-teen-needs-glasses%E2%80%99
Thank you all
#Asd Parents and Therapists Group,Kerala
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