Spectrum of Visual Dysfunction Detected by a Novel Testing Protocol Within a Special School Eye Care Service.

Introduction: Children with special educational needs are more likely to have vision problems than peers in mainstream education. Reports focus on visual acuity and refraction, overlooking visuoperceptual difficulties, including cerebral visual impairment. This article reports on the feasibility and outcomes of visual function testing performed during in-school visual assessments.

Testing the Hard to Test: A Pilot Study Examining the Role of Questionnaires in Eliciting Visual Behaviours in Children with Autistic Spectrum Disorder.

Purpose: There is a higher prevalence of visual problems in children with Autistic Spectrum Disorder (ASD) compared with the neuro-typical population. Issues relating to visual perception can be evident as atypical visual behaviours (ViBes). The aim of the study was to compare findings of parents and eye health professionals using questionnaires to describe visual function in young children with ASD.

Building partnerships with local schools.

Background: Medical schools have a responsibility to support their students in developing an understanding of the complex concepts of a 'VUCA' (volatile, uncertain, complex and ambiguous) world. To achieve this, service learning approaches have been increasingly successfully employed for students to learn through participating in activities addressing local community priorities. Sharing outcomes and lessons from such programmes is essential for advancing service learning.

Visual Behaviours (ViBes) in Cerebral Visual Impairment: Validating a Descriptive Tool to Support Diagnosis and Monitoring.

Introduction: Cerebral visual impairment (CVI) is the most common cause of visual impairment in children in the UK. Diagnosis is based on identification of visual behaviours (ViBes) relating to visual dysfunction. Examination techniques and inventories have been developed to elicit these in children with a developmental age of two years or more.

Clinical assessment, investigation, diagnosis and initial management of cerebral visual impairment: a consensus practice guide.

Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics offering eye care professionals an opportunity to identify children proactively. In most cases CVI occurs as part of a neurodevelopmental condition or as a feature of multiple and complex disabilities.

Make it easier: 3-word strategies to help children with cerebral visual impairment use their vision more effectively.

Introduction: Cerebral Visual Impairment (CVI) is the most common cause of visual impairment in children in the United Kingdom. Management relies on identifying strategies and adaptations which enable the child to use their vision effectively and efficiently. The majority of published strategies involve lengthy inventories used in a specialist setting.

Referral thresholds for an integrated learning disability eye care pathway: a consensus approach.

Introduction: Local Optometric Support Unit (LOCSU) have published their refreshed clinical pathway for eye care for people with a learning disability. The document sets out the adjustments to practice that a community optometrist might make in order to provide optimal care for a person with learning disability attending a primary eye care assessment. The pathway specifically points to the need to retain patients in primary care where appropriate and 'reduce the number of people with learning disability who are inappropriately referred into the Hospital Eye Service (HES).

"BURSTING THE BUBBLE": Service learning in schools.

Background: At Imperial College, we developed a novel teaching programme for medical students based within a local primary school, with the aim of developing students' teaching skills and centring social accountability in our curriculum. Similar service-learning programmes have shown significant benefit for student participants, including: improving communication skills, developing an understanding of the social determinants of health, and increased empathy. In partnership with a local primary school, the programme involved a group of medical students designing, developing and delivering a teaching session to primary school children.

Are all children with visual impairment known to the eye clinic?

Introduction: There is a growing body of evidence that children with special needs are more likely to have visual problems, be that visual impairment, visual processing problems or refractive error. While there is widespread provision of vision screening in mainstream schools, patchy provision exists in special schools. The aim of the study was to determine the unmet need and undiagnosed visual problems of children attending primary special schools in Bradford, England.

ICO-OSCAR for pediatric cataract surgical skill assessment.

Pediatric cataract surgical skill assessment is important to ensure the competency of the trainees, especially pediatric ophthalmology fellows. Using a rubric would ensure objectivity in this process. The ICO-OSCAR pediatric cataract surgery rubric has been developed with global variations in techniques of pediatric cataract surgery in mind.

Validity of ophthalmology surgical competency assessment rubric for strabismus surgery in resident training.

Unlabelled: The Accreditation Council for Graduate Medical Education (ACGME) requires US residency programs to assess ophthalmology residents for competency in 6 core areas. Ophthalmic surgical skills are currently part of the ACGME "Patient Care" competency, although some have advocated for a seventh competency, "Surgical Skills." The Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery in Resident Training (

Oscar: Strabismus) tool was designed to aid in the assessment of surgical skills using procedure specific behavioral anchors.

Accuracy of Intraocular Pressure Measurement With the Icare Tonometer in Children.

Purpose: The aim of this study was to evaluate the difference between intraocular pressure (IOP) measurements in children with the Icare tonomer (IT) and applanation (AT), pneumatic (PT), or digital tonometers (TT).

Design: A randomized prospective trial of children younger than age 16 attending the pediatric ophthalmology department of Manchester Royal Eye Hospital was conducted.

Methods: Children had IOP measured twice, once with an IT and again with a TT, PT, or AT during the same clinic appointment.

Assessing visual function in children with complex disabilities: the Bradford visual function box.

Background: Assessment of children with complex and severe learning disabilities is challenging and the children may not respond to the monochrome stimuli of traditional tests. The International Association of Scientific Studies on Intellectual Disability recommends that visual function assessment in poorly or non-cooperative children should be undertaken in an objective manner. We have developed a functional visual assessment tool to assess vision in children with complex and multiple disabilities.

The ophthalmology surgical competency assessment rubric for strabismus surgery.

Purpose: To produce an internationally valid tool to assess skill in performing strabismus surgery.

Methods: A panel of 7 content experts adapted a previously published tool for assessing phacoemulsification by using a modified Dreyfus scale of skill acquisition and providing behavioral descriptors for each level of skill in each category. The tools were then reviewed by 12 international content experts for their constructive comments.

Strabismus surgical skills assessment tool: development of a surgical assessment tool for strabismus surgery training.

Purpose: To develop a structured tool to assess strabismus surgical skills and to determine the face and content validity of this tool.

Design: Development of a surgical assessment tool and its validation by an expert panel.

Methods: A structured subjective evaluation form was developed to evaluate a trainee's technique and skill in strabismus surgery.

An audit of the Royal College of Ophthalmologists strabismic amblyopia treatment protocol: a departmental review.

Introduction: Children presenting with strabismus and mixed (anisometropic/strabismic) amblyopia are managed by a local protocol as per guidelines from the Royal College of Ophthalmologists. Decisions regarding intervention for occlusion are currently delayed until a 22 week review allowing for refractive adaptation, with intermediate reviews at 6 and 14 weeks.

Purpose: The purpose of this audit was to determine adherence to the protocol and the benefit of the 14 week review.

Nd:YAG laser goniopuncture after deep sclerectomy: outcomes.

Purpose: This study aimed to investigate the safety and efficacy of Nd:YAG laser goniopuncture (LGP) in lowering intraocular pressure (IOP) after deep sclerectomy (DS).

Methods: We reviewed the outcomes in 258 eyes of 258 consecutive patients who underwent DS or combined phacoemulsification and DS between August 2001 and December 2003. Mitomycin C was used during surgery in 192 eyes (74.