Cerebral visual impairment (CVI) is the most common cause of visual impairment in children in the United Kingdom. The mainstay of management is providing strategies and environment adaptations to ...allow the child to use their vision for learning and independence. It is therefore important to understand educational access policies to facilitate timely and appropriate referral to qualified teachers for learners with visual impairment (QTVI) by ophthalmologists. QTVIs were recruited from VIEW (Visual Impairment England and Wales) and the Scottish Sensory Centre (QTVI organisations) via email, newsletter and social media. Respondents were directed to an online electronic questionnaire. 116 responses were received; this represents around 18% response rate. All services accepted referrals for children with cerebral visual impairment (CVI). The majority of services (97%) did not have a strict visual acuity threshold for children with CVI. There is an inconsistent approach in the diagnosis of CVI across the United Kingdom, with some QTVI expressing concern that this had prevented children with visual dysfunction from accessing help. QTVI indicated they would welcome more referrals for Cerebral VI, at an earlier age, and that a formalised referral pathway would be beneficial. Children with CVI are accepted for support by QTVI/sensory services regardless of visual acuity. Some services welcomed referrals for children undergoing assessment where CVI had yet to be confirmed. However, the formal diagnosis of CVI by an ophthalmologist as a pre-requisite to access services in other areas emphasises the need to improve clinicians’ confidence in the diagnosis of CVI. Ophthalmologists are encouraged to engage with local QTVI/sensory teams to facilitate exchange of information and appropriate and timely referral of children in need.
Purpose: To evaluate the causes, associated neurological and ocular findings in children with cerebral visual impairment (CVI), and to identify risk factors for severe vision impairment. Methods: A ...multicenter, retrospective, cross-sectional analysis was carried out from January 2017 to December 2019 on patients less than 16 years of age with a diagnosis of CVI. Results: A total of 405 patients were included of which 61.2% were male and 38.8% were female. The median age at presentation was 4 years (range 3 months to 16 years). Antenatal risk factors were present in 14% of the cases. The most common cause of CVI was hypoxic-ischemic encephalopathy (35.1%), followed by seizure associated with brain damage (31.3%). The most common neurological finding was seizure (50.4%), followed by cerebral palsy (13.6%). Associated ophthalmological findings were significant refractive error (63.2%), esotropia (22.2%), exotropia, (38%), nystagmus (33.3%), and optic nerve atrophy (25.9%). Severe visual impairment (<20/200) was associated with optic atrophy (odds ratio: 2.9, 95% confidence interval: 1.4-6.0; P = 0.003) and seizure disorder (odds ratio: 1.9, 95% confidence interval: 1.2-3.3; P = 0.012). Conclusion: The various ophthalmic, neurological manifestations and etiologies could guide the multidisciplinary team treating the child with CVI in understanding the visual impairment that affects the neuro development of the child and in planning rehabilitation strategies.
Purpose: The purpose of the study investigates the teaching experiences of science teachers teaching students with visual impairment at elementary school level by focusing on challenges in ...teaching-learning science concepts and availability of human and material resources. Design/Methodology/Approach: Descriptive study under quantitative approach followed a survey method to collect data from 50 teachers working in government special education schools for these students. Findings: The findings indicate number of challenges faced by teachers in teaching science subjects particularly abstract concepts to students with visual impairment, lack of enthusiasm among students, limited access to material resources, and a lack of support personnel. Implications/Originality/Value: These findings underscore the need for teacher training programs, enhanced resource provisions, and tailored instructional strategies to fulfill the unique needs of students with visual impairment in science education.
With the rapid development of Internet media, people have a variety of ways to obtain information. Special children are coming into the public’s vision, and the life and learning of many visually ...impaired children and autistic children are also attracting more and more people’s attention, which also enables more people to truly understand these special worlds. Whether these visually impaired children and autistic children are included in ordinary teachers has also become a hot topic. Based on real cases in reality, some blind people receive general education, which is more conducive to their future development. Some celebrity writers, etc., also realize their life value. By collecting the academic performance and psychological emotions of visually impaired and autistic children, this paper analyses prior studies which conduct surveys and test questionnaire data. The present study also makes a comparative analysis of the data, to explore whether visually impaired children and autistic children should receive general education. The result reveals that blind and autistic children need to receive formal education to develop social and learning skills.
Cerebral/Cortical Visual Impairment (CVI) is the leading cause of visual impairment in children and can negatively impact participation in daily activities.
This qualitative study used virtual focus ...groups and an online questionnaire to understand the perspectives of families with children who have CVI. Constant comparison analysis was used to analyze focus group transcripts and extract themes. The PEDI-CAT and an online questionnaire were administered to characterize the study population.
Four themes were identified: (1) Awareness of CVI and its effect on the child and family, (2) Parent experiences, (3) Child factors and functional implications, and (4) Supports that enhance child development/vision.
Findings from this study highlight the substantial impact that lack of CVI awareness had on parent experiences. Lack of awareness led to late diagnosis, missed intervention opportunities, and caregiver burden. Due to insufficient resources, parents had to educate themselves and service providers about CVI and advocate for their child’s needs. Healthcare and educational providers who work with pediatric neurodevelopmental populations must be knowledgeable about clinical features of CVI, task and environmental adaptations to support vision and implementation of family-centered care.
•Parents perceived lack of awareness of CVI among healthcare and education providers.•Lack of awareness led to delays in receiving diagnosis and intervention.•Parents educated themselves and providers about CVI.•Children with CVI encountered challenges with daily activities per parent report.•Children with CVI benefitted from vision-specific adaptations and interventions.
Paediatric low-grade gliomas (also known as pLGG) are the most common type of CNS tumours in children. In general, paediatric low-grade gliomas show clinical and biological features that are distinct ...from adult low-grade gliomas, and the developing paediatric brain is more susceptible to toxic late effects of the tumour and its treatment. Therefore, response assessment in children requires additional considerations compared with the adult Response Assessment in Neuro-Oncology criteria. There are no standardised response criteria in paediatric clinical trials, which makes it more difficult to compare responses across studies. The Response Assessment in Pediatric Neuro-Oncology working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop consensus recommendations for response assessment in paediatric low-grade gliomas. Final recommendations were based on literature review, current practice, and expert opinion of working group members. Consensus recommendations include imaging response assessments, with additional guidelines for visual functional outcomes in patients with optic pathway tumours. As with previous consensus recommendations, these recommendations will need to be validated in prospective clinical trials.
Çalışmak, gelir, sosyal statü, sosyal ilişkiler ve topluma aidiyet duygusu gibi pek çok önemli bireysel, ekonomik ve psiko-sosyal işlevleri yerine getirmektedir. Bütün bu işlevleri ile çalışmak, ...(görme) engellilerin de toplumla bağının kopmaması, toplumsal yaşama katılmasında merkezi rol oynamaktadır. Çalışma, nitel araştırma yöntemi ile çalışma yaşamına aktif katılan görme engelli bireylerin çalışmayı nasıl anlamlandırdıkları, çalışmanın onlar için işlevleri incelemekte ve ortaya koymaktadır. Bulgular, görme engelli bireyler için “çalışma”nın anlamlı ve önemli olduğunu göstermektedir. Çalışmak, para kazanmanın ötesinde, gör(e)memenin yol açtığı olumsuz psikolojik, sosyal, duyusal sonuçları bertaraf etmede ve yaşadıkları topluma dahil olma duygusunu pekiştirmede değerli bir işlev görmektedir. Görme engellilere yönelik önyargılı işveren/iş arkadaşı tutumlarının ve işyeri düzenlemelerinin (görme) engeline göre yapılmaması gibi olumsuzlukların varlığı ise, çalışmanın görme engelli çalışanlar açısından psiko-sosyal, bireysel faydalarını azalttığı çalışmada ulaşılan diğer bulgulardır.
To capture the key features patterning the transition from unaffected mutation carriers to clinically affected Leber hereditary optic neuropathy (LHON), as investigated by optical coherence ...tomography.
Observational case series.
Four unaffected eyes of 4 patients with LHON with the first eye affected were followed across conversion to affected, from 60 days before to 170 days after conversion. The primary outcome measures were multiple timepoints measurements of peripapillary retinal nerve fiber layer (RNFL) thickness for temporal emi-side of the optic nerve (6 sectors from 6-11, clockwise for the right eye and counterclockwise for the left eye) in all patients and nasal emi-macular RNFL and ganglion cell layer (GCL) thickness in 2 patients.
While the presymptomatic stage was characterized by a dynamic thickening of sector 8, the beginning of the conversion coincided with an increase in the thickness of the sectors bordering the papillo-acular bundle (6 and 7 for the inferior sectors, 10 and 11 for the superior sectors) synchronous with the thinning of sectors 8 and then 9. Conversely, the GCL did not undergo significant changes until the onset of visual loss when a significant reduction of thickness became evident.
In this study we demonstrated that the thinning of sector 8 can be considered the structural hallmark of the conversion from the presymptomatic to the affected state in LHON. It is preceded by its own progressive thickening extending from the optic nerve head toward the macula and occurs regardless of the amount of swelling of the rest of the peripapillary fibers.
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