VISION REHABILITATION

What is Rehabilitation?

Rehabilitation is “a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments. It makes the individual independent to carry out day to day activities by providing assistive devices, adaptations/modifications in the environment and training on various aspects in which the individual finds difficult to overcome.”

What are the aims of Rehabilitation?

It aims at achieving the following broad outcomes
• Prevention of the functional loss
• Slowing the rate of functional loss
• Betterment or restoration of function
• Compensation for the lost function
• Maintenance of the current function.

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Who needs Vision Rehabilitation services?

The person who has,
• Congenital or Acquired Vision Loss (i.e By birth or Sudden vision loss because of trauma,
accidents and infections)
• Partial or Total Vision Loss (i.e Having Light Perception or No Light Perception)
• Progressive Vision Loss (i.e Deterioration or dropping of vision)
• Low vision (i.e Person who has visual acuity less than 6/18 and field of vision less than 20 degrees after best possible corrections)
• For Children who has Global Developmental Delay (i.e Delayed Developmental Milestones)
• For children who has associated problems in hearing, and cognitive and motor areas (i.e Hearing,
Intellectual and Locomotor Impairment)
• For children and adults who has neurological impairment (Cortical Visual Impairment)

How can a child be benefited from Vision Rehabilitation?

In Vision Rehabilitation, the child will be evaluated for Functional Vision (Visual Functioning/ residual vision) through criteria’s like Visual fixation, Focusing, Localization, Tracking, Eye contact, Self Awareness, Imitation, Gaze Shift, Eye hand coordination, Awareness of the environment by using illuminated and non illuminated (animate and inanimate) objects and diagnose how better the child can see after best possible corrections and treatment.

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If the child has less visual functioning, Visual stimulation activities will be given to enhance the child’s visual ability. Vision Stimulation Exercises (VSE) includes showing animate and inanimate objects in illuminated and non- illuminated environments. VSE need to be done with modifications and accommodations in the child’s environment. This is given especially in the Early Intervention Stage (Birth – 6 years) for children with Visual and other disabilities.

VSE enhances improvements in the following areas Motor development, Cognitive development, play,
Speech and Language development

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In Vision Rehabilitation, we concentrate on the other developmental milestones and give therapies to compensate the delays and helps in restoration by providing various indoor and outdoor activities

Holistic/ Comprehensive Rehabilitation:

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Areas of Rehabilitation:

According to the age, the rehabilitation procedures could be categorized as

 

Early Intervention (0-6 yrs)

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Child Rehabilitation (6-18 yrs)

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Adult Rehabilitation (18 yrs and above)

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Process of Rehabilitation Services

 

Early Intervention:

1. History:

▪ Getting demographic details (Basic Details)
▪ Prenatal, Birth and Postnatal History
▪ Medical history (MRI, EEG, BERA etc)
▪ Family history

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2. Holistic Assessment:

   ▪ Functional Vision Assessment (Glow balls, Eye hand coordination)

3. Functional Developmental Assessment

   ▪ Auditory
   ▪ Tactile
   ▪ Gross Motor
   ▪ Fine Motor
   ▪ Receptive Communication
   ▪ Expressive Communication

4. Behavioural Assessment (Mannerisms)

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Child Rehabilitation:

1. History:

   ▪ Educational History
   ▪ Performance of the child – Reading, Writing, Arithmetic
   ▪ Understanding and delivering concepts
   ▪ Storing and retrieving concepts from Memory

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2. Comprehensive Assessment:

   i) Vision Assessment – Near and Distance Vision, Colour, Contrast

 

ii) Eye hand coordination

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iii) Orientation

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iv) Finger Dexterity

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v) Reading – Errors, Difficulties, Postures, Pace of reading

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vi) Writing – Posture, Legibility, pressure in writing, spacing in writing

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vii) Attention – Duration/ Interest based, Sustained attention

viii) Behavioural Analysis – Sitting tolerance, not troublesome

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Visual Processing

i) Visual Memory

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ii) Visual – Spatial orientation

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iii) Figure ground discrimination

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iv) Visual Closure

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v) Visual Sequencing

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vi) Depth Perception

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vii) Auditory Processing – Auditory Memory, Comprehension, Retrieval

viii) Communication – Comprehension, Clarity, Fluency,

ix) Social Interaction and Contribution

x) Community orientation and participation

xi) Sensitivity towards visual (vision), auditory (Hearing), olfactory (smell), gustatory (taste), tactile (touch)

xii) ADL – Independent/ Non independent

Motor Coordination and Balance

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Intervention Procedures and therapies

 

Vision Stimulation Exercises

i) Rope Light Stimulation

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ii) Stimulation with Shiny materials and glow balls/ toys

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iii) Stimulation with Pattern charts and bright coloured toys

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iv) Fixation, Pursuits and Saccades

v) Eye contact

vi) Face recognition

2. Sensory Integration Therapy:

i. Auditory Stimulation with varying frequencies
ii. Olfactory stimulation with varying fragrances
iii. Gustatory stimulation with varying tastes
iv. Tactual Stimulation with different textures

3. Communication:

i. Face to face Interaction
ii. Description of activities
iii. Blowing activities
iv. Sound production
v. Single, Two word, Sentence communication

4. Gross motor Coordination:

i. ROM exercises
ii. Strengthening exercises
iii. Home based Activities on the areas of delay

5. Finger Dexterity:

i. Holding rattles and toys
ii. Kneading activities (Playing with dough)
iii. Free Movements of fingers (water splash)

 

6. Eye hand coordination with Cognition Involvement:

i. Single and double handed activities (threading beads, Stacking rings, connecting links etc.)

7. Concept Awareness:

i. Concepts like Body parts, day to day objects, Colours, Fruits, vegetables , Animals, Transports etc
ii. Big and small, Less/ More weight etc

8. Pre reading skills:

i. Picture comprehension
ii. Rhyming
iii. Matching, Sorting, Numbering
iv. Letter recognition, Direction

9. Pre writing skills:

i. Printing activities
ii. Scribbling, colouring, connecting dots etc

10. Reading Training:

i. Syllabification
ii. Tracking the finger while Reading
iii. Scanning the word appropriately
iv. Improving pace of reading through rehearsals

11. Writing Training:

i. Giving bold lined notebooks and Dark pencils
ii. Appropriate posture and holding pencil
iii. Providing proper spacing while writing

12. Environmental Modifications:

i. Lighting, Seating, tables etc

We Treat:

▪ Visually Impaired (Total Blindness and Low vision)
▪ Intellectual Disability
▪ Physical Impairment (Cerebral Palsy)
▪ Speech Impairment (Delays in Speech, Language and Communication)
▪ Autism and ADHD
▪ Learning Disability

Adult Rehabilitation:

1. History:
▪ Getting details of Visual Prognosis
▪ Educational history (Students)
▪ Work history
▪ Nature of Job – Work complications

 

2. Areas of Assessment: ▪ Functional Vision Assessment – Distance and Near
▪ Reading and Writing
▪ Orientation and Mobility
▪ Spatial organization
▪ ADL – Needs assistance or Independent
▪ Psychological Assessment
▪ Job – Satisfied/ needs support in work place
▪ Awareness of Rights/ Schemes and provisions from the Govt.

3. Counseling:
▪ Psychological – Individual
▪ Family Counselling

4. Govt. Schemes and Provisions:
▪ Disability Certificate (UDID)
▪ Monthly Pension
▪ Bus Concessions, Train Concessions
▪ Reservation of Jobs

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