[AERNet] Optic Nerve Hypoplasia

[Andrea Story]

One thing to consider is that the optic nerve hypoplasia is only in  
the left eye.  Patching may be a moot point.

It's not about eye muscles although her eye muscles are being  
effected.   Its the left optic nerve which is underdeveloped and will  
never match the ability of the right eye's optic nerve.  Yes, an  
ophthalmologist or other eye specialist will be the best resource for  
these patching questions.

It would seem that the reason she is being seen by you is the  
nystagmus since the ONH is only in one eye. Eye gaze may be a good  
option for choice making for this child.  Vision may be a strength  
for the child if she can find a null point and her functional vision  
is good enough otherwise.

On the other hand she is at risk for cortical vision impairment which  
appears at a higher rate with seizure disorders and often goes along  
with ONH.  Does she do better visually when the background is a  
simple solid color and visual clutter is limited?  It is worth  
exploring the characteristics of CVI.
http://www.aph.org/cvi/articles/greeley_1.html

Also it's important to find out what motivates this child.  An  
assessment/intervention strategies book like "Every Move Counts" can  
help with the choice/ language and motivation issue.  Maybe someone  
in your district has this? (check with the OT and/or SLP).

Every Move Counts - Sensory Based Communication Techniques
Therapy Skills Builders - A division of Communication Skills Builders
3830 E. Bellvue
P. O. Box 42050
Tucson, Arizona 85733
(602) 323-7500

-Andrea

On Oct 2, 2007, at 2:28 PM, joanne gonnella wrote:

>
> I would start with the low vision doc's report and his/her  
> suggestions for patching; have hearing checked; switches for making  
> choices as a start.
> Date: Tue, 2 Oct 2007 15:21:22 -0400
> From: Sally.Holloman at VBSchools.com
> To: aernet at lists.aerbvi.org
> Subject: [AERNet] Optic Nerve Hypoplasia
>
> Any suggestions on working with a 3 year old with Optic Nerve  
> Hypoplasia (left eye) who has a seizure disorder, is fed with a G- 
> tube, dependent on a wheelchair for mobility and is nonverbal?  I  
> see her once a month for 20 minutes for the ONH and Nystagmus.  The  
> preschool teacher is using a light box with her.  We are  
> brainstorming ideas about how to have her make choices.  It may be  
> eye gaze, not sure yet.  What about patching to help with the  
> muscles of the eye and to help her gain a little control over it?   
> Your expert opinions are appreciated.
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