To study whether the low contrast visual acuity leads to visual functional difficulties in children with cerebral palsy.
Methodology: Thirty children with cerebral palsy, who had the cognitive ability to detect lea symbols in visual acuity charts were chosen from a vision rehabilitation centre, Chennai. Their high and low contrast visual acuity measurement was done with Lea’s 3 metre translucent distant visual acuity charts with 100% and 2.5% contrast levels against ETDRS light box. These children were clinically examined by ophthalmologists for ocular abnormalities if any. They were also assessed on Jill Keefe’s scale on Functional Vision Assessment. The results were recorded.
Results: 28% of children with cerebral palsy fell in the visual impairment range from mild to severe at 100% contrast. 77% had visual impairment at 2.5% contrast level. The ophthalmic conditions diagnosed were strabismus 63%, Refractive error 43%, Optic Atrophy 10%, Retinal Disorders 10% and Nystagmus 10%. Functional vision assessment in low contrast sensitivity revealed the difficulty in visual communication, mobility, finding inner details and daily living skills.
Conclusion: Though the visual acuity is normal at high contrast, a few children performed very low at low contrast level which certainly led to the functional difficulties like identification of face, reading contours in face during visual communication, depth perception for near and far activities, mobility, reading and writing and also performing other academic tasks. Environmental adaptations and training in special skills are the key rehabilitation measures for inclusion of these kids into the society.