FUNCTIONAL VISION ASSESSMENT

Background Information:
Student: N. Ross
Date of Birth: 10/28/2003
Functional Vision Evaluation Date: 02/10/2016
Report Date: 02/12/2016
Eye Medical Report Date: 11/6/2013
Name of Eye Doctor: Dr. Scott Lambert MD, The Emory Eye Center Atlanta,
Georgia
Doctor Credentials: Pediatric Ophthalmologist
Age: 12
Grade: 6

Eye Report Information:

Distance Acuity OD: 20/40
Distance Acuity OS: 20/40
Visual Field: None Reported
Diagnosis: High Myopia OU (both eyes) Degenerative Myopia, Associated Macula
Atrophy
Prescription lenses: OD 15.00+1 x 055, OS -14.00+1.00 x 11OS

Presence of other disabilities: None

FUNCTIONAL VISION ASSESSMENT

Appearance of eyes: N. Rosss eyeballs are symmetrical and circular in size and
position. His eyelids are free of mucus, pus or discharge, scales, or lumps. His lids fit
smoothly against the eyeball. His eyebrows are evenly aligned; He had equal
movement as his facial expressions changed. His cornea was transparent and visible
through his pupil. The small lachrymal gland is recognizable. His eyes both blinked in
response to an approaching object (hand, fingers spread apart) when within 3 to 5
inches of his face. His pupillary response when the penlight was directed into each
eye and observed was that each pupil constricted in response to the presence of the
light, but slower since he has dark eyes. N. Rosss pupillary reflection when the pen
light was directed from 30 inches away toward the bridge of her nose was that the
light reflected in the middle of each of her pupils, indicating that his eyes are properly
aligned and the muscles are balanced in each eye.
Muscle Balance: When N. Ross fixated on an object at 16 inches away, and the object
(12) was moved toward the bridge of his nose, the eyes converged up to 2 inches
from the bridge of the nose. His fixation on the object was continuous and smooth.
His eyes remained steady during the process.
Eye Preference: N. Ross was handed an empty paper towel tube and asked to locate a
specified object at 5 feet (stapler) to 10 feet (tape dispenser) and 10 to 20 feet away
(large red ball). He preferred his left eye upon observation of these activities. He
exhibited left eye dominance.
Eye Movement /Teaming (Motility): A pencil with a topper (red heart 3 in height)
was held at 14 inches away from his eyes, he was able to visually follow the object as
it moved vertically, horizontally, diagonally and circularly. His eye movements were
smooth, he crossed midline, and no nystagmus was present.
Visual Field: N. Ross was wearing his glasses, and asked to look straight ahead. He
was asked to focus on the examiners nose. A small object placed on top of a penlight
was used (star 2). The penlight was held at 14 inches away from his face. Moving the
object in an arc from each side of his head and around in front of his nose and from

his waist upward and from above the head downward, he had 180 degree of field of
vision from side to side (horizontally) using both eyes he had 150 degree field of
vision with each eye. He was able to see 50 degrees in the upper field, 70 degrees in
the lower field for a total of 120 degrees vertically. He displayed no field deficits to
the left, right, upper, and lower fields.
Color Vision: Using the Ishihara Test for Color Blindness test, N. Ross was able to
match all of the colors (18) correctly wearing his prescribed glasses.
Depth Perception: When N. Ross was asked to name one of three objects by
proximity in relationship to his (objects in this order closest to her on a black tray at
16 inches; pink eraser, yellow box of staples, small silver gift box) in a vertical line he
named the closest one to him, a pink eraser, the one farthest from him the silver gift
box, and the one in the middle as the yellow box of staples. When two of these objects
were rearranged in a horizontal line (silver box on left, pink eraser on right) and the
box of staples above these two, he was able to name that the silver box was on the left
and the pink eraser on the right. N. Ross does not present with depth perception
problems when wearing his glasses.
Sensitivity to Light: N. Ross was observed looking at near material at 16 inches, in a
classroom with fluorescent lighting. He was able to read text orally to the examiner
and no observable squint, or head tilt was noticed. Walking out into bright sunlight on
the way to the lunchroom he was able to find a person (friend from class) at a distance
of 3 feet. He did not appear to squint upon going from indoors to outdoors. On a
previous eye report, it recommended extra lighting if needed due to his degenerative
eye condition, to reduce glare and avoid back lighting. He was also prescribed NoIr
sunglasses for outside/bright lighting environments. (Color: Dark Amber 4% light
transmission)
Sensitivity to Glare: N. Ross does exhibit sensitivity to glare when the blinds are
open in the classroom when the Smartboard is used. He exhibited a head tilt and asked
to have the material on the Smartboard given to him. At the computer, N. Ross
becomes visually fatigued reading when there is natural lighting from the window vs.
the window blinds being closed after 20 minutes.
Near Visual Acuity: N. Ross was tested (using both eyes) with his glasses on in a
classroom with overhead fluorescent lighting; there was no natural lighting. The

Logarithmic Near Visual Acuity Chart was used at 16 inches. He was able to read
down to the 20/125 line missing 1/5. He was then asked to read the 20/100 line, and
missed 3/5. Small objects less than 6 were used to see if he could name them at 16
inches. He named all (heart, button, macaroni noodle, bear, button, paper clip, and
dime) correctly while wearing his glasses. N. Ross was tested using his right eye (OD)
with his glasses on and was able to read down to the 20/160 line missing 0/5, when
asked to read the 20/125 line, he missed 3/5. He was then tested using his left eye
(OS) with his glasses on and was able to read down to the 20/125 line missing 0/5,
when asked to read the 20/100 line he missed 3/5. When asked to test without his
glasses, he was able to using both eyes read the 20/320 line missing 2/5. Using his
right eye (OD) he was able to read the 20/400 line 5/5, when asked to read the 20/320
line he missed 3/5. Using his left eye (OS) he was able to read the 20/400 line 5/5,
when asked to read the 20/320 line he missed 1/5, and on the 20/250 line he missed
3/5.
Distance Visual Acuity: The HOTV letter chart was used to assess N. Rosss distance
vision at 20 feet. N. Ross was tested (using both eyes) with his glasses on in a
classroom with overhead fluorescent lighting; there was no natural lighting. He was
able to read down to the 20/80 line missing 0/5, on the 20/60 line he missed 3/5.
Using his right eye (OD) with his glasses on, but left eye (OS) occluded, he read down
to the 20/80 line missing 0/5, on the 20/60 line he missed 3/5. Using his left eye (OS)
with his glasses on, and his right eye (OD) occluded he was able to read the 20/60
line; missing 0/5, on the 20/50 line he missed 2/5. Without wearing his glasses, he was
unable to read the 20/200 line using both eyes (OU) from 20 feet.
Print Size: N. Ross has had a low vision evaluation from the Smokey Powell Low
Vision Clinic. He is able to read regular print with his optical device. He was
prescribed for Near: 3.5X Powerlux magnifier with his best acuity at 20/50.
Handwriting:
N. Ross exhibits poor visual motor skills and was assessed by an Occupational
Therapist. The following recommendations were made, to continue to use a slant
board, especiallyfor long assignments, use notebook paper with bold dark lines, give
breaks after approximately 10 to 15 minutes of writing.
Summary:

N. Ross is a bright student who has been identified as gifted, with degenerative
myopia and associated macula atrophy. He exhibits good near vision using his optical
device with both eyes (OU) for near tasks while reading. His distance vision is poor
and N. Ross cannot see text or objects clearly at a distance using both eyes (OU).
Recommendations:
1. Freedom to move for best visual access.
2. Work copied and given to him ahead of time from board or distant source,
overhead, or smartboard. Can be regular size print.
3. Slant board
4. Up-dated eye reports
5. Braille instruction taught as a 2nd code due to ocular diagnosis

Evaluator: Justin Schanck