Dark to light – Improving visual function in children with visual impairments

By Sarit Levy, National Vision Instructor at Elia.
How do children with visual impairments help to improve their vision skills even when there are few visual impairments and why is this so important? Get to know the darkroom – the therapeutic tool for improving the function of vision that contains great light.

There are children with visual impairments who have very few visual impairments, who do not learn to use them or who learn not to use them. If they learn to use them, effectively, they will be able to preserve them and eventually improve their visual function. As children grow and develop, the skills required of them will increase and require more accuracy and attention to detail. If they do not maintain and develop the use of visual remnants their ability will not increase as required, and in fact visual function will worsen and they may lose their visual remnants completely and reach a state of complete blindness.
How can vision 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 stimuli like light, color, movement and noise – a darkroom is one of the tools that helps visually impaired children preserve their visual acuity and develop it so they can make the most of it. Track stimuli, reach out to them and decipher from them and what their origin is.
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 vision, movement and load so that we can provide children with the most optimal conditions for working on their visual remnants. The darkness neutralizes the visual clutter and allows for a focus on the illuminated stimulus, and without distractions and noise from the environment, the child's range of attention and concentration also increases.
Our goal in the darkroom is to ‘illuminate’ children’s attention to the sense of sight through visual stimuli. Children with visual impairments see stimuli but do not always understand what they are seeing, and in the darkroom they learn how to decipher the stimulus. The visual function of children with visual impairments relies on various cues that help them identify objects, for example color and contrast, object size, distance and angle of vision. In fact children with visual impairments see the details before they see the whole.
During the treatment in the darkroom, various factors are taken into account that can affect the function of vision and the success of the treatment,For example, does the child have a strong central information processing ability, ie the ability to focus and identify / decipher objects in a sharp and clear way, or with a strong peripheral information processing ability, ie attention to stimuli that occur at the edge of the gaze, and do not require sharp vision. Moreover we examine what is the optimal position for the child since the position in which he is found has a great impact on the functioning of vision and so on.

The first time the child arrives in the darkroom we will check if there are any useful remnants of sight, when in fact any response to visual stimulation such as a response to a light source, a movement of stimulus more than once, an object and face is the basis for building a work plan in the darkroom. Therapists then help children acquire basic skills, such as focusing visual gaze stimulation and developing hand-eye contact, tracking visual stimulus, the ability to move gaze from place to place to scan for various stimuli and deciphering the object facing them as an object, figure or image. After acquiring 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 set, with each group involving children whose visual characteristics are the same.
In the darkroom, various accessories are used, such as a computer with software adapted to the child's ability, CCTV and a light table, as well as accessories used for activities on the carpet such as snake lights, optical fibers, glowing objects, a bubble column, various flashlights and so on. Including focus focusing, tracking, scanning, etc.
For the children, it is a very enjoyable experience accompanied by social and experiential play, and therefore it motivates them during which spurs them to succeed and thus ultimately allows for a better outcome that guarantees them an improvement in their future vision function.

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