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Ophthalmology

 Low Vision Clinic

What is Low Vision?

"Low vision" is a term used to describe visual impairment that cannot be corrected with glasses correction, contact lenses, surgery or medicine.  Low vision can interfere with the ability to function in the classroom and outside of school.  In our clinic we consider children with vision loss that interferes with the ability to perform daily or educational activities (generally occurs at visual acuity of 20/60 or worse) as visually impaired. Children with low vision face special challenges in school, where great emphasis is placed on learning in a visual environment, both with near vision and at a distance.

How Does Our Program Help?

The Vision Enhancement Center provides a comprehensive assessment of visual function, eye health and visual demands of visually impaired children in educational, home, and community settings.  In our clinic we consider children with vision loss that interferes with the ability to perform daily or educational activities (generally occurs at visual acuity of 20/60 or worse) as visually impaired. The clinic is aimed at determining what visual aids can help children best utilize their remaining vision for reading, writing, and even driving.  We can also review and suggest environmental alterations for the home and classroom to support optimal independence and safety.

What Should You Expect?

The low vision exam is an important step in determining how your child uses his or her vision to function and whether visual aids and other environmental modifications can make daily tasks, like reading and writing, comfortable and manageable for your child. So to prepare for your exam, write down questions you may have and bring them to your appointment

The low vision exam usually takes about 60 minutes. The exam begins with a verbal history from patient and family members. Our goal is to address the primary concerns of the child, parent and teacher in regards to the effect vision impairment has on the child's performance. Methods to maximize vision are reviewed. Your child's optometrist will ask questions about how your child is progressing in school, the use of magnifiers or any other visual equipment at home and at school. A review of textbooks and academic papers customarily used in school helps to determine appropriate print size and level of magnification needed.

A portion of the exam will address the appropriate magnification systems and non-optical recommendations keeping in mind the age and developmental abilities of the child.

After the exam, the optometrist will discuss the results of the visual assessment with the patient and family members. The benefits of eyeglasses, appropriate magnification devices and changes in the home and school environment will also be reviewed. These results will be shared with other health professionals, educators, and social workers to support the visual needs of the child.

What Causes Visual Impairment in Children?

The most common causes of visual impairment in children are inherited or congenital eye diseases such as oculocutaneous albinism, retinal dystrophies such as retinitis pigmentosa or Stargardt's disease, retinopathy of prematurity, nystagmus, and optic nerve hypoplasia. Children can also suffer from acquired vision loss secondary to traumatic injury to the eye or brain.

Typically, eye diseases cause one or more of the following symptoms:

  • a loss of ability to see detail (visual acuity)
  • a loss of side or peripheral vision (visual field)
  • constant double vision (diplopia)
  • an inability to navigate steps or the edge of curbs (contrast sensitivity)
  • an inability to distinguish colors

Low vision rehabilitation aims to maximize the patient’s functional vision in efforts to help improve their quality of life. While low vision rehabilitation cannot restore lost sight, it can make the most of the existing sight you do have, and it can equip you with the techniques necessary to maintain an independent lifestyle. Low vision rehabilitation determining what visual aids can help children best utilize their remaining vision for reading, writing, and even driving.  We can also review and suggest environmental alterations for the home and classroom to support optimal independence and safety.

What Tools are Available to Maximize a Child’s Vision?

Glasses

We first must ensure that the child is in the appropriate refractive correction. In people with vision impairment, glasses are often not sufficient. Glasses create an in focus image on the retina, however, in a low vision patient this part of the retina frequently does not function properly. 

Telescopes

Hand-held and spectacle mounted telescopes can be used to improve a patient’s distance vision. Hand-held telescopes can be used for short-term viewing tasks such as traveling, reading street signs or viewing a wall-mounted restaurant menu. For more continuous viewing like sitting in a classroom, these same telescopes can be miniaturized and mounted into a pair of glasses. In very limited cases, a bioptic or spectacle mounted telescope can be used for driving.

Magnifiers

Hand held and stand magnifiers are used to magnify materials at near. The devices available through a doctor will have better optics and lighting than those purchased over-the-counter and more importantly will be correctly prescribed to the patient's acuity and demands of the task or activity being performed.

Electronic magnification

There are a number of electronic magnification systems, self-focusing telescopes and video displays with virtual reality mountings that can be used to improve visual function. These prescribed devices are especially helpful in higher education and maintaining employment. We live in a digital era where the quality, quantity and diversity of electronic magnification systems is continuously changing!

Light & Contrast

It is common for visually impaired people to have difficulty with contrast and glare. There are special filters and sunglasses designed for specifically for the visually impaired. These will allow individuals to function in brightly lit areas or dim areas where it is otherwise difficult for them use their vision. The illumination of the room and the material you are trying to view is also very important for visually impaired people. Specialty lamps and lighting can be used to maximize vision.

How to schedule your appointment?

You may only schedule your child’s visit to the Low Vision Clinic once he or she has received a preliminary evaluation with a Texas Children’s Hospital ophthalmologist. Once your child has completed that initial evaluation, your Texas Children’s Hospital ophthalmologist can refer you to the Low Vision Clinic. To schedule your preliminary evaluation, please call 832-822-3230.

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