Transcript 10 - Dr Lea & Children`s Vision

Assessment of visual functioning
with special reference to infants
Lea Hyvärinen, MD, PhD, FAAP
Professor h.c., Rehabilitation Sciences, University of Dortmund
Senior Lecturer, Developmental Neuropsychology, Univ. of Helsinki
www.lea-test.fi
Tampa USF October 2011
Visual communication
Social smile, active interaction
at the age of 12 weeks.
Eye contact, copying of expressions
At 6 weeks, 8 weeks at the latest
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Communication – at 8 weeks
Eye contact and social smile
Normal eye contact at 6 weeks, social smile at 12 weeks.
Insufficient accommodation
Mirror neuron system
Eye contact and social smile
Near correction
Insufficient accommodation
Recommended assessments
• Following functions should be assessed in all
infants:
• eye contact and social smile (accommodation )
• grating acuity as detection acuity
• contrast sensitivity for communication
Grating Acuity & Heidi Face
as detection acuity
& communcation distance
Preferential looking
Detection tests
2.5%
Hiding Heidi
low contrast pictures for assessment of communication distance
Nordic faces and shadows of facial expressions are at low contrast.
Recommended assessments
• Following functions should be assessed in all
infants:
• eye contact and social smile
• grating acuity as detection acuity
• contrast sensitivity for communication
• refractive errors, confrontation visual fields
• ocular motor functions, including accommodation
• observation of hand functions and copying them
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At the Art Museum
Pori, Finland
Infant artists’
Mirror neuron functions
Photo: Päivi Setälä
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Recommended assessments
• Following functions should be assessed in all
infants :
• eye contact and social smile
• grating acuity as detection acuity
• contrast sensitivity for communication
• refractive errors, confrontation visual fields
• ocular motor functions, including accommodation
• observation of hand functions and copying them
• face recognition of family members
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Infants at risk
Accommodation in
Hypotonic infants
Compensating accommodation
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Watching simple pictures
two years later
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Infants at risk
Delayed motor development in premaurely born infants
Combined effect of visual and motor disorder delays the
development of an infant in all functional areas.
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Constricted visual field
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Large illuminated ball used by child’s own therapist.
Fixation
Brief fixation on the middle
size picture of face
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Accommodation
difficult to measure when the infant does not look at
Mother’s face and voice
used as the target.
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Eye contact
when reading lenses give a clear image on the retina
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Reaction during assessment of her brother
noises and body language show disapproval
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Visually active
ten weeks later: improved visual and motor functions
RE: GrA less than in LE > training
as a part of physiotherapy
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Infants at risk
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•
•
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Infants with delays/difficulties in communcation
All hypotonic infants: brain damage, Down
All infants with Down syndrome, refraction
Infants with strabismus
All deaf and hard of hearing infants
All infants with syndrome based risk of VI
Early Intervention
should start EARLY
It should start during the assessment.
Assessment of visual functioning
with special reference to infants
Lea Hyvärinen, MD, PhD, FAAP
Professor h.c., Rehabilitation Sciences, University of Dortmund
Senior Lecturer, Developmental Neuropsychology, Univ. of Helsinki
www.lea-test.fi
Tampa USF October 2011
Accommodation
eye contact and social smile
Weak accommodation can be compensated with ”reading glasses.”