Detection vision development in infants and toddlers with congenital vision disorders and profound‐severe visual impairment

Abstract

Aim To investigate detection vision development in infants and toddlers with congenital disorders of the peripheral visual system (CDPVS) and severe to profound visual impairment (SVI/PVI). Method This was a longitudinal observational investigation of a cohort of infants with CDPVS (entry age 8–16mo) followed up 12 months later. Detection vision (Near Detection Scale [NDS]) and resolution acuity (Keeler Acuity Cards [KAC]) were assessed at each time point. Relationships between detection vision, resolution acuity, and age were investigated. Results The study cohort comprised 80 children (39 females, 41 males), mean age 13 months (Time 1) and 26 months (Time 2); 22 (27.5%) with PVI (light perception at best) and 58 (72.5%) with SVI (basic ‘form’ vision) at Time 1. All children achieved a measure with the NDS, however only 35 per cent and 56 per cent at Time 1 and Time 2 respectively did so on KAC. Those with PVI at Time 1 showed no further improvement at Time 2, but 87 per cent of children with SVI showed improvement in vision. The median change in NDS score was 1.0 (range 1–7, SD 1.68). Interpretation Vision development continues after 12 months of age in many toddlers if they have basic ‘form’ vision. A measure of detection vision is feasible in very young children when resolution acuity measurement is not achievable. What this paper adds The Near Detection Scale (NDS) can measure low levels of vision when acuity is not otherwise measurable. Vision can improve in toddlers with severe visual impairment who have some ‘form’ vision. Infants with light perception at best by 12 months are unlikely to show improvement in vision. There is a moderate negative relationship between the NDS and resolution acuity results.

Prognostic value of transient pattern visual evoked potentials in children with cerebral visual impairment

“…PRVEPs by contrast could be recorded in over 50% of children and provided useful prognostic information regarding future acuity levels. It highlights that early signs of significant behavioural visual acuity reduction in the context of other neurodisabilities must be taken seriously by the paediatric ophthalmologist or neurodisability paediatrician, who will need to work closely together to address the long‐term visual and developmental consequences; regular behavioural acuity assessments from infancy across the preschool years (allowing for cognitive limitations) will provide the framework for essential vision and developmental early intervention and rehabilitation in this highly ‘at‐risk’ clinical population 26–28 …”

The associations between vision level and early hand use in children aged 6–36 months with visual impairment: A cross-sectional, historical case note review

“…The children’s vision level was recorded as a numerical score between 0 and 9, according to their classification on the Near Detection Scale (NDS): a 10-point scale ranging from no light perception (point 0) to a 0.1 cm ‘lure’ (point 9) according to visual fixation on incrementally sized lures at 30 cm distance; vision level was divided further into PVI (points 0–1, light perception at best) and SVI (points 2–9) (Dale et al, 2017; Salt et al, 2020).…”

“…lures at 30 cm distance; vision level was divided further into PVI (points 0-1, light perception at best) and SVI (points 2-9) (Dale et al, 2017;Salt et al, 2020).…”

Development and validation of the Visual Function Battery for Children with Special Needs

“…Furthermore, evidence supporting the usefulness of functional assessment as an objective measure is limited. 6 Therefore, a practical, reliable, and validated visual function battery including standardized tests and functional assessment of vision is required to quantify the heterogeneous and complex visual characteristics and abilities of children with special needs. In this study, the Visual Function Battery for Children with Special Needs (VFB-CSN) was developed to measure the various types and severities of visual function.…”