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Vision

2010-08-01 13:01:00

Optic nerve dysfunction

Question: My 6-year-old son was recently diagnosed with juvenile optic nerve atrophy and is having difficulty performing schoolwork and seeing colors correctly. What can I do to help him?

Answer: There are multiple causes of hereditary optic neuropathies. From what you have stated, it appears your son has Kjier’s, or juvenile optic nerve atrophy, which is the most common hereditary optic neuropathy. Another common hereditary optic nerve disorder is Leber’s Optic Neuropathy (LHON), a mitochondrial disorder that is inherited through the mother. Hopefully, there have been multiple tests performed by more than one eye care practitioner, including a neuro-ophthalmologist. Continue to maintain follow-up care as directed. It is critical that your child receive guidance and resolution to the difficulties in school, now and in the future. This must include guidance from your optometrist and/or ophthalmologist along with vision rehabilitation professionals. If there is a significant need for glasses, they should be instituted as quickly as possible. However, your child may not need a prescription to correct for being near or far-sighted and/or having astigmatism. Rather, vision loss could be solely due to the optic atrophy for which conventional prescriptive glasses will not resolve. In that case, vision rehabilitation is imperative to prevent a lack of learning due to impaired vision. Therefore, I would recommend that you discuss with your optometrist and/or ophthalmologist whether referral for vision rehabilitation is needed. Vision rehabilitation seeks to maintain or improve visual function to ensure performance of all visual tasks, regardless of vision impairment. The vision rehabilitation process involves an interdisciplinary rehabilitation team. This may include a low vision rehabilitation practitioner, occupational therapist, certified low vision therapist, orientation & mobility specialist and a teacher of the visually impaired (TVI) to oversee your son’s present and future academic achievements and to ensure that activities of daily life are not compromised. It is imperative that you consult with your child’s primary teacher to establish a relationship with a teacher who specializes in working with individuals that are visually impaired (TVI). Your son’s TVI can help oversee his educational curriculum and learning process throughout his academic career. There are countless reasons for visual impairment. The good news is that healthcare professionals are being educated and choosing to practice solely or significantly in the area of vision rehabilitation. There are also many companies emerging that develop technology and assistive devices to help visually impaired individuals perform nearly all avocational, educational and many occupational requirements. For your son, the emphasis at this time would be to ensure that he has all the tools and resources needed to see the blackboard, perform in the classroom, complete academic requirements, participate in extracurricular activities of his choosing and enjoy life to its fullest, regardless of his visual impairment. William L. Park, OD, FAAO is in private practice in Wichita, KS. He works exclusively with patients referred for low vision evaluation, low vision rehabilitation and neurological vision loss. He is a past Director of Low Vision Services, Lions Research & Rehabilitation Center, Wilmer Eye Institute-Johns Hopkins University. Dr. Park can be reached at William L. Park, OD, LLC, www.parklowvision.com, 610 N. Main, Suite 201, Wichita, KS 67203, (316) 440-1690 or drpark@parklowvision.com.