Eye and Vision Screening Procedures, Part 5

1. Eye and Vision Screening Procedures, Part 5 Department of Blind and Vision Impaired Created by Carmen Valdes & Lisa Shearman

2. Eye and Vision Screening Procedures • Learning Objectives for Part 5: • 1. Methods for testing vision for infants and toddlers. • Testing eyes for near fixation. • Testing eyes for far fixation. • Testing for tracking. • Testing for eye preference.

3. Fixation on Object The Near Fixation (at 8-18 inches) tests the child’s eyes while focusing on an object or light. The examiner notes whether the child alternates, prefers fixation with one eye, or can hold fixation well with either eye.  Type of object to use: 4x5 inch object at 2 months old 1 inch object at 4 months old Cereal at 6 months old The Distance Fixation (at 10 feet) tests the child’s eyes while focusing on an object or light. Type of object to use: 4 inch object at 9 months old Recommendations: Pass: Steady fixation Refer: Fleeting or not able to fixate

4. Tracking (horizontal, vertical) • Tracking is used to test visual efficiency using eye teaming (identification of any eye turns) and eye tracking (large eye tracking ability). • 3 months 50 degrees either side of midline horizontally at 12 inches in front of the child’s eyes 30 degrees above and below midline vertically • 6 months Full 180 degree arc with smooth transition over midline • 10 months Full 180 degree arc without moving the head • Recommendations: • Pass: Smooth Tracking • Refer: Jerky or not present

5. Eye Preference Testing for eye preference can consist of refusal of the child to have the right eye covered while not objecting to having the left eye covered is interpreted as evidence for reduced visual acuity in the left eye. An example of preference is when the child consistently turns head to use one eye to look at objects. There should be no eye preference Recommendations: Pass: No eye preference Refer: Demonstrate a preference

6. Shifts Gaze • By 4 months, the baby should be able to shift gaze between objects • At 4 months • Able to shift gaze between two objects • At 6 months • Smoothly shift gaze across midline • Recommendations: • Pass: Yes • Refer: No

7. References First Look, Vision Evaluation and Assessment for Infants, Toddlers, and Preschoolers, Birth Through Five years of Age, (1998) California Department of Education, Sacramento, California, http://www.cde.ca.gov/spbranch/sed/look.htm Appleby K., M.A., (2002) Vision Assessment of Infants and Children with and without Special Needs, Parts1 & 2, Vision Associates, Lake City, Florida http://www.visionkits.com/images/1026/1026.html Smith Millie, and Levack Nancy, (1996) Teaching Students with Visual and Multiple Impairments, A Resource Guide, Second Edition, Texas School for the Blind and Visually Impaired, Austin, Texas http://www.tsbvi.edu/publications/vmi.htm Essential Elements in Early Intervention, Visual Impairments and Multiple Disabilities, (1999) Chen, Deborah, Ph.D., editor, American Foundation for the Blind, New York, N.Y. www.Afb.org Anthony Tanni, Story Andrea, and PattersonJames Dr., Vision Screening for Young Children Early Intervention Programs, Developed by the Vision Impairment Services for Infants and Toddlers Program, Anchorage, Alaska ) http://www.tsbvi.edu/Education/Vision%20Screening%20Form%202001.rtf Bishop Virginia E. Ph.D., (1998), Infants and Toddlers with Visual Impairments, http://www.tsbvi.edu/Education/infant/ LH MATERIALS , Assessment of Vision in Children By (2001) Lea Hyvärinen, MD http://www.lea-test.sgic.fi/

8. Thank You! This completes the training for Visual Screening.