Evaluation+Summary


 * Educational Low Vision Evaluation (Ana)**

Student: Ana Date of Birth: October 1, 1996 Age: 13 Grade: 7 Date of Evaluation: September 1, 2009 Evaluator: Jane Do Evaluator Title: Teacher of Students with Visual Impairments (TVI) Eye Specialist Diagnosis: Optic Nerve Hypoplasia, Nystagmus, Strabismus, Amblyopia, Astigmatism

Distance Acuity With Correction: 20/200 OD (right), 20/300 OS (left) Near Acuity With Correction: 20/80 OD (right), 20/100 OS (left)

Visual Field: Field restriction, intermittent peripheral blind spots (left side is more restricted than right side).

Other Medical Diagnosis: None

Tests Administered: Distance Test for the Partially Sighted Near Vision Test for Children Pupillary Reflex and Muscle Balance with Penlight Visual Fields Cap PV-16 (Quantitative Colour Vision Test, 16 hues) Visual Skills Appraisal

__**GENERAL INFORMATION**__

Ana is a 13 year-old 7th grade student at Maple Middle School. She is a bright girl and enjoys music, art and hanging out with friends. Ana appears to be adjusting nicely to her new school environment.

According to the eye report dated 9/01/2009, the primary cause of Ana’s visual impairment is Optic Nerve Hypoplasia (ONH). ONH is characterized by small or underdeveloped optic nerve heads. The optic nerves are located at the back of each eye and transmit visual stimuli into the visual channels of the brain allowing images to be perceived and interpreted by the visual cortex. Therefore, ONH may affect visual acuity (clarity of vision) and/or visual fields (perception within our central and peripheral fields). Additionally, Ana presents with eye conditions that typically co-occur with ONH including nystagmus (an involuntary movement of the eyes), strabismus (an eye turn or misalignment of the eyes), amblyopia (also called “lazy eye”) and astigmatism (an irregular curvature of the cornea that may affect visual clarity). These conditions have been present since birth and her prognosis is permanent. Her congenital impairments were detected at 6 weeks old and she received ocular patching at the age of five. She had six surgeries to reduce her strabismus, starting at six months old to 10 years old. The outcome of these surgeries and patching was not indicated in her medical records. Ana’s best corrected distance acuity is 20/300 in her left eye and 20/200 in her right eye. Based on these measurements, Ana meets the criteria for “legally blind.” Legally blind refers to a specific degree of vision impairment; it does not mean a total loss of vision. The criteria for legal blindness is best corrected visual acuity of 20/200 or less and/or a visual field restriction of 20 degrees or less. This term is used primarily to qualify individuals with a vision impairment for state and federal services and financial support but is not required for a student to receive special education services for a vision impairment. Finally, Ana presents with some visual field restriction, more so on her left than her right. Her recent eye report also indicated that Ana’s color vision and contrast sensitivity were normal.

__**RESULTS OF EVALUATIONS**__ The Teacher of Students with Visual Impairments (TVI) recently conducted a Functional Vision Assessment (FVA) with Ana. The purpose of this assessment is to learn more about how Ana uses her vision within the school environment. This information can then be used to make helpful adjustments and accommodations as well as to help Ana improve her visual functioning skills.

Ana wears glasses, however she reported not wearing them at times due to glare in the classroom from natural light sources. Ana uses a 4 power hand held lighted magnifier for reading. Her font preference is 12-point font but she was able to read 8-point font during the assessment. She typically reads 3-6 inches from the reading material and this distance did not change when presented with different font sizes. Ana also uses an 8 power monocular for distance vision and is able to copy from the chalkboard for certain tasks. However, Ana reported fatigue when attempting to read projected material with her monocular. Ana reported not wanting to use her visual aides in the classroom due to teasing by other students. In the professional opinion of Ana's TVI, these optical aides may be adequate for some reading tasks but may not be sufficient in meeting her print access needs for lengthy or complex reading materials. Therefore, the TVI has recommended a Learning Media Assessment and Technology Assessment as well as a thorough Low Vision Evaluation to explore the use of alternative aides and technologies that may be helpful to Ana.

Ana appears to navigate well within environments that are familiar and routine to her. She uses large landmarks as cues and is able to locate her locker and classrooms independently. She may have trouble following a demonstration in class if objects move too quickly or if there is too much background clutter. Similarly, visual clutter may make it difficult for Ana to locate specific objects within a given area. Ana has difficulty tracking fast moving objects; this may affect her performance in P.E. when addressing ball sports (e.g. tennis, softball, etc.). Ana demonstrates a preference to using her right eye; this eye has better visual acuity and better field of vision than her left. The FVA revealed a muscle imbalance between Ana's eyes; this misalignment is consistent with her current diagnoses. Ana prefers to use a blue or black pen when writing. Her color and contrast sensitivity were normal.

__**SUMMARY AND RECOMMENDATIONS**__ Ana is a student who is legally blind with a permanent eye condition. Ana's visual impairment affects her access to educational content and may negatively impact her educational performance. Therefore, Ana meets the eligibility criteria to receive Special Education services as a student with a vision impairment.
 * Summary:**

Ana is currently using a handheld magnifier for reading and a monocular for distance vision. Ana often chooses not to use her optical aids which might improve her visual efficiency. Additional evaluations are recommended, including a Low Vision Evaluation, Learning Media Assessment, and Technology Assessment. Results from these assessments will determine if different optical aides and/or technologies may be helpful to Ana. This report reflects the findings of the optometrist and TVI in different settings during different time periods. The IEP team should consider information contained in all the aforementioned reports when determining educational programming, placement, and upcoming transitional issues.


 * Recommendations**
 * Seating: Ana should sit near the front and to the left in each of her general education classrooms
 * Normal lighting conditions are adequate, however glare from windows should be monitored and controlled
 * Explore strategies, with Ana's IEP Team, that will allow her to develop more confidence in using her optical aides in class
 * A Low Vision Evaluation may explore the use of glare-reducing lenses in her glasses or contact lenses and sunglasses to address light sensitivity
 * Ana should receive extra time for exams (time and 1/2) as well as one resource period per day to assist her in keeping up with schoolwork
 * Ana's IEP Team shall address strategies that make board work and projected material more accessible to Ana. Examples include...
 * Classroom teacher provides copies of board work and projected material to Ana at the beginning of class.
 * Classroom teacher verbalizes as he/she writes on the board or reviews projected material
 * A classmate takes visual notes for Ana (legible printing with black pen)
 * Explore the use of a classmate buddy to direct Ana's visual attention to specific areas during demonstrations
 * Explore the use of a reading stand to allow for better posture when reading and to reduce neck and back strain
 * The TVI and OMS will provide adaptations and/or strategies to Ana's physical education teacher to address Ana's difficulty tracking fast moving objects
 * Adapted PE equipment may be explored to ensure Ana's safety during PE class
 * Additional evaluations are recommended; LMA, Technology, O&M, and Low Vision Evaluation