Vision FAQ’s

Q. How does a child qualify for Vision Services? (see request for services)

A: For a child suspected of having vision impairment, the child shall meet one or more of the following minimum criteria:

The child’s residual acuity is 20/70 or less in the better eye with correction;
The child’s visual field is restricted to 20 degrees or less in the better eye;
The child has an eye pathology or a progressive eye disease which in the opinion of the ophthalmologist is expected to reduce either residual acuity or visual field according to the criteria stated in paragraphs; or
The assessment results of a licensed ophthalmologist or optometrist are inconclusive, or the child demonstrates inadequate use of residual vision.

For a child to be eligible for special education services as a child with vision impairment, the eligibility team determines that:

The child’s disability has an adverse impact on the child’s educational performance; and
The child needs special education services as a result of the disability.

Q. What is acuity and how is it measured?

A: Acuity is measured as a fraction of normal vision. 20/20 vision refers to the size print a person with typical vision can see at 20 feet. Someone with 20/60 vision can see at 20 feet what a person with typical vision can see at 60 feet. They have 1/3 the visual acuity of a person with typical vision. Someone that is considered legally blind, 20/200 vision, has 1/10 the visual acuity. What a person with typical vision sees at 200 feet they have to be within 20 feet to see.

Q. Can you define the terms commonly found in eye reports?

Amblyopia – reduced visual acuity which is not correctable by glasses or contacts. This condition is often called “lazy eye” because it is typically the result of disuse. It is usually marked by blurred vision in one eye and favoring one eye over the other.
Anisometropia – different refractive errors in each eye.
Astigmatism – an optical condition in which the refracting power of an eye is not the same in all portions of the eye, preventing light rays from focusing clearly at one point on the retina, resulting in blurred vision.
Cortical Visual Impairment (CVI) – a neurological disorder resulting in bilateral impairment of visual acuity caused by damage to the Central Nervous System, meaning that it is a form of visual impairment that is caused by a brain problem rather than an eye problem. It is a condition that indicates that the visual systems of the brain do not consistently understand or interpret what the eyes see. CVI is sometimes known as Delayed Visual Maturation because vision can sometimes seem to be improving over time. This can be due to the child learning how to make better use of the unusual types of information that their visual system presents to them, and to take into account the context and other clues. Thee degree of vision impairment can range from mild visual impairment to total blindness. The degree of neurological damage and visual impairment depends upon the time of onset, as well as the location and intensity of the insult. The presence of CVI is not an indicator of a child’s cognitive ability.
Exotropia – the eye(s) turns outward.
Esotropia – the eye(s) turn inward.
Hyperopia – farsighted.
Legally Blind – the individual has a distance acuity of 20/200 or less. The student may easily have sufficient “residual” vision for use of print materials.
Nystagmus – involuntary eye movement, with the eyes moving quickly in one direction (quick phase), and then slowly in the other (slow phase). Nystagmus may occur in the vertical or horizontal directions, and also in a semicircular movement.
Ocular Albinism – only the eyes lack pigment. Children with ocular albinism have generally normal skin and hair color, and many even have a normal eye appearance. Reduced acuity is associated with this condition.
Optic Atrophy – damage to the optic nerve resulting in a degeneration or destruction of that nerve. Optic atrophy may also be referred to as optic nerve head pallor because of the pale appearance with fewer than normal vessels on the surface of the optic nerve head. The change in visual function can be a decrease in sharpness and clarity of vision (visual acuity) or decreases in peripheral vision. Color vision and contrast sensitivity can also be affected.
Optic Nerve Hypoplasia – is a medical condition that results in underdevelopment of the optic nerves. Optic nerve hypoplasia can appear in one or both eyes, causing anywhere from a mild to serious visual impairment in the form of decreased visual acuity and visual fields. People with this condition are also more likely to present with light sensitivity and nystagmus. Because optic nerve hypoplasia involves the underdevelopment of structures located within the brain, the condition may also be found in conjunction with a constellation of hormonal imbalances and midline brain defects known as septo-optic dysplasia.
Partially Sighted – means the individual has a distance acuity of 20/70 to 20/200. It indicates a wide range of possible visual capabilities. This student usually is able to use print materials without special modifications.
Ptosis – drooping of the upper eyelid caused by muscle failure.
Retinoblastoma – a malignant tumor of the retina that generally affects children under the age of 5. Retinoblastoma occurs when a cell of the growing retina develops a mutation. This mutation causes the cell to grow out of control and become cancerous. Sometimes this mutation develops in a child whose family has never had eye cancer, but other times the mutation is present in several family members. One or both eyes may be affected. A visible whiteness in the pupil may be present. Blindness can occur in the affected eye, and the eyes may appear crossed. The tumor can spread to the eye socket, and to the brain, through the optic nerve. This is a rare tumor, except in families that carry the gene mutation. Retinopathy of Prematurity – the lack of normal retinal development due to premature birth. Blood vessels growing from the optic disc area outward through the retina abnormally develop. Depending on severity of the condition scarring can result with possible retinal tears.
Strabismus – condition in which the eyes are not simultaneously directed to the same object. The eyes do not focus on the same point. This deviation may or may not include ocular (eye) muscle paralysis.

Q. What is the difference between an ophthalmologist and optometrist?

A: An ophthalmologist is a physician who specializes in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury. They provide a full spectrum of care including routine eye exams, diagnosis and medical treatment of eye disorders and diseases, prescriptions for eyeglasses, surgery, and management of eye problems that are caused by systemic illnesses. Ophthalmologists can be medical doctors (M.D.) or doctors of osteopathy (D.O.).

An optometrist is not a medical doctor, but is a doctor of optometry (O.D.). Optometrists diagnose vision problems and eye disease, they test patients’ visual acuity, depth and color perception, and ability to focus and coordinate the eyes. They prescribe glasses and contact lenses, and prescribe drugs to treat eye disorders. They cannot perform surgery, but they often provide patients with pre- and post-surgical care. Sometimes ophthalmologists and optometrists work in the same practice and co-manage patients.

Q. What services and support does a teacher of the visually impaired provide?

A: Services and supports are provided based on the comprehensive assessment(s) completed by the vision specialist and the educational team. Each student’s needs are different and the appropriate services and support will reflect those needs.

Supports frequently include:

Perform functional vision assessments, including assessment of the educational environment
Interpret eye reports as they relate to the child’s functional use of vision
Perform Learning Media Assessments (ages 3-21)
Participate in eligibility and re-eligibility determination
Participate as a member of a transdisciplinary team in developing the Individualized Education Program (IEP)/Individualized Family Service Plan (IFSP), completing assessments, and providing programming
Recommend other specialized evaluations as needed, such as orientation and mobility
Provide training to educational personnel regarding the needs of the student with a visual impairment and the impact of their vision loss and need for compensatory skill development
Loaning of specialized materials and equipment

Q. When does a child need large print?

A: The functional vision assessment (FVA) and Learning Media Assessment (LMA) aid in the determination of the use of large print. The eye care specialists’ reports are also a component of the decision to utilize large print. The use of large print may only be recommended after low vision aids (e.g., magnifiers) have not been successful.

Q. When does a child use Braille?

A: The functional vision assessment (FVA) and Learning Media Assessment (LMA), addressing reading and writing skills, support the determination to use Braille. The LMA is done annually to ensure the appropriate medium is currently in use. Additional factors such as readiness for a literacy program are assessed.

Children with multiple disabilities learn at varying rates but should receive information for literacy. If tactual learning and auditory learning are needed, activity boxes, communication boards, and other technology may be necessary for supplemental communication. Sometimes Braille is not the child’s best medium, but can be used functionally to help the child identify personal items or places. This type of functional reading provides the child with a degree of independence.

Q. What is Braille?

A: Every character in the Braille code is based on an arrangement of one to six raised dots. Each dot has a numbered position in the Braille cell. These characters make up the letters of the alphabet, punctuation marks, numbers, and everything else you can do in print.

Q. What is Orientation and Mobility (O&M), and who receives it?

A: Orientation and Mobility is that part of a blind and visually impaired child’s education that prepares him/her for more independent travel. Orientation refers to an awareness of one’s self in relation to the physical environment, as well as having an understanding of the many objects one encounters in their environment. It is for this reason that Orientation & Mobility specialists stress the area of concept development, particularly body image concepts, spatial orientation and environmental concepts. Mobility is the ability to travel safely, efficiently, and as independently as possible. Put simply, it is the ability to walk in a safe manner and know where you are going.

Q. How can I find out if my teenager will be able to drive a car?

A: See the Oregon Department of Transporation (OAR 735-062-0050 – Eyesight Check Content and Standards)