Child Assessment Service


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Health Promotion

Developmental Disorders Series

Visual Impairment

I. What is visual impairment?

Visual impairment (VI) refers to a significant functional loss of vision that cannot be corrected by medication, surgical operation, or ordinary optical lenses such as spectacles.

Visual impairment can be classified into three levels:

Mild VI:

  • Can read relatively larger characters
  • No difficulty in identifying shapes, colours and brightness contrasts

Moderate VI:

  • Can tell shapes and colours of objects and can distinguish between brightness and darkness
  • Can only read characters with larger size and broader strokes

Severe VI:

  • Can only distinguish more obvious changes in brightness and darkness
  • May not see anything (completely blind)

II. What are the symptoms of children with visual impairment?

During infancy:

  • Lack of eye contact
  • No blinking to bright light
  • Do not look at his/her hands
  • Do not visually follow moving objects in front of his/her face
  • Slow response to voiceless toys or parents' faces; respond only to sound
  • No imitation of others' expressions and actions
  • Do not actively reach out for his/her favourite toys
  • Fear of gross motor activities, such as crawling

During early childhood:

  • Often keep his/her head down; lack eye contact with others
  • Limited facial expression and body language
  • Tend to hold objects very close to the eyes when looking at them
  • Abnormal responses to bright light (gazing at light excessively or trying to avoid it)
  • Often bump into objects or fall over, and get confused with directions
  • Search for his/her way using hands
  • May press on eyeballs with fingers
  • Jerky movements of the eyeballs

III. What causes visual impairment?

  • Infections during pregnancy, e.g. rubella infection
  • Congenital eye diseases, e.g. congenital cataract
  • Factors during delivery, e.g. asphyxia, retinal problems of prematurity
  • Acquired eye diseases, e.g. corneal infection, tumour of eyeball

IV. Why is it necessary to arrange for early assessment and treatment?

  • Parents can understand their child’s developmental problems at an early stage and provide appropriate and timely support to maximize the potentials of their child
  • Visual impairment or even blindness can be avoided if eye diseases such as glaucoma and cataract are detected and managed at an early stage
  • Secondary problems on areas including emotion, behaviour and learning can be prevented
  • Parents can understand their child’s developmental problems at an early stage and provide appropriate and timely support to maximize the potentials of their child
  • Visual impairment or even blindness can be avoided if eye diseases such as glaucoma and cataract are detected and managed at an early stage
  • Secondary problems on areas including emotion, behaviour and learning can be prevented

Overall Cognition

  • Encourage children with VI to touch physical objects more frequently and use simple verbal descriptions, to strengthen conceptual understanding of objects and events

Sensory Training

  • Strengthen sensory training on senses other than vision, e.g. the sense of touch, hearing, smell and taste

Residual Vision

  • Assist children with VI in protecting and making good use of their residual vision

Personal Experience

  • Encourage children with VI to participate actively in activities so as to enrich life experience. Avoid helping them on everything and allow them learn independently as appropriate

V. Where can parents seek help if their child is suspected to have visual impairment?
Preliminary Screening

Maternal and Child Health Centres / Paediatric departments of hospitals / Private practitioners

Further Assessment

Child Assessment Centres

Ophthalmic departments of hospitals

Treatment, Training and Education

Medical service

  • General and Low Vision Clinic
  • Occupational therapy
  • Physiotherapy
  • Speech therapy

Social Welfare Department / Education Bureau

  • Early Education and Training Centres
  • Integrated Programme in Child Care Centres
  • Special Child Care Centres
  • Special schools, e.g. Ebenezer School and Ebenezer Training Centre
  • Supportive Remedial Service for pupils with visual impairment

  • Ebenezer Early Intervention Programme for visually impaired children

After adolescence:

Continuing Education:

  • Vocational Training Council
  • Tertiary institutions

Employment:

  • Hong Kong Society for the Blind
  • Selective Placement Division of the Labour Department
  • Employment service of the Hong Kong Council of Social Service

Enquiry Numbers and Related Websites

Government Bureau / Departments

  • Department of Health

 

Child Assessment Service

2246 6633
www.dhcas.gov.hk

Family Health Service
(Maternal and Child Health Centres)

2961 8855
www.fhs.gov.hk

  • Social Welfare Department

2343 2255
www.swd.gov.hk

  • Education Bureau
    (24-Hour Hotline)
    Special Education and Special Schools
    Special Education Resource Centre
2891 0088
http://serc.edb.gov.hk
  • Vocational Training Council

2836 1000
www.vtc.edu.hk

Other Organisations

  • Hospital Authority
    (General Enquiry)

2300 6555
www.ha.org.hk

  • Hong Kong Blind Union
    The Trailwalker Education & Resources Centre

2337 2736
www.hkbu.org.hk

  • The Hong Kong Society for the Blind
    Parents Resource Centre for the Visually Impaired Children

2994 9655
www.hksb.org.hk

  • Ebenezer Early Intervention Programme for Visually Impaired Children

2817 0329
www.ebenezer.org.hk

Copyright @ 2008
Child Assessment Service, Department of Health, HKSAR

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Last revision date: 25 May 2010