Near Visual Acuities

By: Carmen Willings   
teachingvisuallyimpaired.com

As part of the Functional Vision Evaluation, it is necessary to assess the students near visual acuities. The technique used will vary depending on the students cognitive abilities.

Near Visual Acuity

Assess the student's near vision using a combination of informal and formal devices. Near acuity allows the student to perform visual tasks needed to succeed in academics such as reading, writing and fine motor activities. Take note of the students working distance. Include reading, sewing, stamp collecting, artwork, electronics or other preferred near vision hobbies. Observe the student reading not only typical school materials, both silently and aloud, but materials that vary in contrast and format.
A notebook can be assembled that includes samples of these items; in addition the evaluator can use a selection of age-appropriate books that include various typographic and picture formats. Observe the student's ability to read environmental print including: telephone books, maps, menus, price tags, clothing labels, comic books, medicine bottles, comic books, classified advertisements, game tickets, bus schedules, magazines, TV guide, catalogs, food labels, recipe, coupons, music and newspaper articles. Measure the student's reading speed under various conditions because many students with low vision use large or standard print for years without any comparison being made of their efficiency in various print styles. It is also important to observe the student after sustained silent reading. Some students can read efficiently for short periods, but their speed and efficiency decrease after five or ten minutes. Also observe the student performing math problems and reading diagrams, charts, maps and graphics. The student who fatigues easily when reading silently will need alternative approaches for longer tasks: audio taped materials, readers, and Braille in combination with print.
The formal assessment of near vision can be made using a standard near point card that includes a variety of sizes of print. This assessment is typically administered at 14 or 16 inches, and the teacher records the smallest line of print that can be read at that distance. When the student is unable to read a line of print, the evaluator can ask the student to move the card closer until the line becomes visible. Any changes in the administration of the test should be clearly indicated in the written report. Although the formal testing of near point visual acuity can provide information about the smallest-size letter a student can see, measured visual acuity should be considered in conjunction with informal methods, since eye charts consist of individual, separate letters that are easier to distinguish than are words or various print styles.
A variety of charts are available for pre-readers. I have used the LEA symbols, Sloan letter chart and Sloan number chart based on the students abilities. Not all students will be able to participate in this type of a formal assessment. I have included a page on print comparisons when assessing students who are pre-readers. 

Depending on the results of the Near Visual Acuity, the following strategies, recommendations, and accommodations may be necessary to meet the students unique visual needs:
  • Teach systematic search patterns
  • Teach tactile discrimination of materials and coins
  • Provide extra time to locate materials and assignments in class
  • Omit picture dependent test items
  • Teach the student object/picture discrimination and recognition
  • Teach the student to use low vision devices if prescribed.
  • May need large print or braille standardized tests.
  • Extra storage space if large print or braille textbooks are used.
  • May require larger work space to accommodate large print/braille books or assistive technology devices. 
  • Use computer shortcuts and accessibility
  • May need to have breaks during periods of extended reading/viewing.
  • Teach student to increase their reading speed and accuracy.
  • May need screen magnification or screen reading software for computer.
  • May need shortened assignments.
  • May need a book stand.
  • May need extended time for tests and to complete assignments.
  • May need braille instruction.
  • May need bold line or raised line paper.
  • May need 20/20 pen or other black marker
  • May need keyboarding instruction to provide a more efficient means of writing.
  • May need shorter written assignments.
  • May need to adapt written work (type, tape, or provide oral response or write answers directly on test)
  • May need extra space to write math problems or written response.
Near Acuity Equivalents
This Near Acuity Equivalent chart, available on the Printables page, can be used to help show a comparison between a student's near acuity, font size and print examples.
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