Conference Vision 99, 12-16 July 1999, New York

During diagnosis we determine how the child uses his/her vision in the play situation, in spatial orientation and in communication. For this purpose paddles with high contrast and cards with low contrast "Heidi" faces are used.
The visual therapy program helps the child to use his/her impaired vision by choosing colors, contrast level, time of exposure of an object, light, distance, adjusting the childs enviroment.
Visual therapy is performed in play situations. It is adjusted to the level of the child's visual functioning and development.
RESULTS


Infants and children with hypoxic/ischaemic brain lesions have generally poor oculomotor skills. The majority of them have cerebral palsy, partial optic nerve atrophy and lesions of visual pathways. Therefore improvement after visual training is very slow and insignificant. However, we can expect functional improvement in many cases because, as recent findings indicate " the visual system of children who had a perinatal hypoxic-ischaemic encephalopathy can retain some plasticity".
In case of our children, visual improvement manifests itself in longer time of fixation, smoother following of movements, saccades across the midline. When visual functioning is better, the child starts to pay attention to his/her limbs. Because of his/her tetra- or hemiplegia he/she needs help in presenting hands in his/her visual field and finally he/she starts to realize that his/her limbs exist. Eye contact and communication are also of great importance.