From darkness to light – improving visual function in children with visual impairment

By Sarit Levy, National Vision Instructor at Elia.
How do you help children with visual impairment improve vision skills even when there are few visual residies and why is this so important? Meet the DarkRoom – the therapeutic tool for improving vision function that holds great light.

There are children with visual impairment who have very few visual residies, who do not learn to use them or who learn not to use them. If they learn to use them effectively, they can preserve them and eventually improve vision function. As the children grow and develop, the skills required of them will increase and require greater accuracy and attention to detail. If they do not maintain and develop the use of the remnants of vision, their ability will not increase according to the requirement, and in fact the functioning of the vision will worsen and they may lose the remains of the vision completely and reach a full state of blindness.
How can vision function be improved in children? You’d be surprised, but the work on visual function is done in a completely dark room, devoid of any external stimulation such as light, color, movement and noise – a darkroom is one of the tools that helps visually impaired children preserve and develop the visual remains so that they can make the most of them, where they will learn to monitor stimuli, reach out to them and decipher from them and where they originate.
Why in a dark room? Because in a dark room we have the ability to control environmental factors that affect vision function such as lighting, field of view, movement and load, so that we can provide children with the most optimal conditions for working on the remains of their vision. The darkness neutralizes the visual load and allows focus on the illuminated stimulus, and without distractions and noise from the environment, the child’s attention span and concentration also increases.
Our goal in the darkroom is to ‘illuminate’ children’s attention to the sense of vision through visual stimuli. Children with visual impairment see stimuli but do not always understand what they see, and in the dark room they learn how to decipher the stimulus. The visual function of children with visual impairment relies on different cues that help them identify objects, such as color and contrast, object size, distance and angle of view. In fact, children with visual impairment see the details before they see the whole.
During darkroom treatment, various factors are taken into account that can influence the functioning of vision and the success of the treatment, for example the mother has the ability to process strong central information, that is, the ability to focus and identify/decode objects sharply and clearly, or with the ability to process strong peripheral information, that is, attention to stimuli that occur on the margins of the gaze, and do not require sharp vision. Moreover, we examine the optimal position for the child since the position in which he is in has a great influence on the functioning of vision and so on.

The first time the child arrives in the darkroom, we will check if there are indeed useful visual residuals, when in fact any reaction to visual stimulation such as a reaction to a light source, to the movement of stimulation more than once, to the object and the face is the basis for building a work plan in the darkroom. The therapists then help children acquire basic skills, such as focusing their gaze on visual stimulation and developing hand-eye contact, monitoring visual stimulation, the ability to move a look from place to place to scan for different stimuli, and decoding the object facing them such as an object, figure, or image. After obtaining the basic skills, you will do work on preserving and strengthening them, as well as imparting new content. The treatment in the darkroom is done both in one-on-one work and in small groups that are determined, with children participating in each group whose visual characteristics are the same.
The darkroom uses various accessories such as a computer with software adapted to the child’s ability, CCTV and a light table, as well as accessories used for activity on the carpet such as a light snake, fiber optics, glowing objects, bubble column, various headlights, and so on – all of which help practice the various skills including focusing on looking, tracking, scanning, etc.
For the children, it is a very enjoyable experience accompanied by a social and experiating game, and therefore it motivates them in a move that motivates them to succeed and thus ultimately allows for a better result that ensures them improved visual function in their future.

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