Vision Concerns in Children who are Blind or Visually Impaired

By Carmen Willings
teachingvisuallyimpaired.com
Updated October 4, 2017

The process of referring a student with a suspected visual impairment for school based vision services begins when there are concerns about a child's vision or the lack thereof. If you have a concern about a child's vision, the first step is to take the student to an optometrist or ophthalmologist.

For younger children in particular, it is important to find a doctor who specializes in working with children. If the child has additional disabilities, it is particularly important to locate a doctor who specializes or is experienced in working with students with multiple disabilities. The ophthalmologist or optometrist will need to determine the cause, receive a visual diagnosis, approximated visual acuity, and determine if the student needs to be referred for school based vision services (or early intervention for children birth through age 2). The following is a list of the ABC'S of vision problems. Some of these concerns may be related to other medical conditions or medications. It is always best to address any concerns with the student's pediatrician as well.

Appearance

One or both eyes turn inward or outward, or one is slightly higher or lower than the other eye.
Crusty or red eyelids or red eyes.
Eyes that are in constant, rapid motion.
Drooping eyelids(s)
Pupils of different sizes, or different reactions to light and accommodations.

Glands that are enlarged, inflamed, or otherwise infected.
Excessive tearing, light sensitivity, lid spasms.

Behavior

Lack of or reduced eye contact.
Shows poor eye muscle coordination.
Covers or closes one eye for critical seeing.
Thrusts head forward to see distant objects.
Tilts head to one side for critical seeing.
Tries to "brush away" a blur.

Rubs eyes often or blinks often while reading or looking at books.
Frowns or squints when looking at or trying to see distant objects.
Stumbles often over objects, is awkward
Holds book, toy, or picture too close or too far away.

Complaints

Sensitivity to light.
Burning or itching of eyes or eyelids.
Seeing double, or blurred vision.
Headaches, usually after a critical visual task.
Nausea or dizziness.
Eyestrain, fatigue.

School Related

Difficulty copying from the board.
Difficulty with handwriting.
Confuses similar words.
Needs more light to read than expected.
Reading comprehension deteriorates with time.
Doesn't read to the end of a sentence before going to the next.
Head moves instead of eyes when reading or looking at pictures.
Loses place when reading and skips lines.
Needs to use finger as a line marker.
Difficulty solving maze puzzles and word searches.
Math errors due to misalignment of numbers.

Vision Concerns Checklist

This checklist, available free for download on the Printables page, can be used to help those outside the vision field identify vision concerns and know when to make a referral for vision services.

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TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired (a 346 page pdf download)
Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements (a 210 page pdf download)
Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement (a 338 page pdf download)
Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement (a 446 page pdf download)
NEW!Interactive Sensory Stories page access and booklet of activities!

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Lotto Cards

The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC.

On My Way File Folder Cards

Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.

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