Documento 28200

Low Vision
Curriculum
Optometrists
IAPB Low Vision Work Group
International Agency for the Prevention of Blindness
November 2016
The Curriculum for Optometrists guidelines are a guide that can be adapted
according to local circumstances. It is envisaged that it shall have the following
intended uses:
o Undergraduate optometry program to facilitate the updating of the low
vision modules
o Optometry training centres already running or planning to conduct low
vision training for qualified optometrists in low vision
o Optometry training centres planning to offer accredited certificate level
training of optometrists in low vision
o Multi-specialty training centres planning on offering distance learning
courses in low vision for optometrists with the practical component
undertaken at the parent or nearby hospital with a well-established low
vision clinic or low vision centre
The Curriculum has been developed by a team from the IAPB Low Vision
Working Group:
Dr Haroon Awan
Mr Joseph Cho
Professor Jill Keeffe
Mr Hasan Minto (lead writer)
Dr Ramachandra Pararajasegaram
Ms Sumrana Yasmin
Mr Andrew Au Yeung
Professor Ian Bailey
Professor Jonathan Jackson
Dr May Ho
Ms Pirindha Govender
Cover photo: Karen Sparrow, Vision Aid Overseas (from the #StrongerTogether
Photo Competition)
Optometrist Curriculum 2
Low vision Curriculum for Optometry Training
Programme
Table of Contents
Session
Session Title Duration
No.
1. Introduction to the Course and Low Vision 2 hours
2. Global, national and local policies 1 hour
3. Epidemiology 1 hour
Causes and implications of visual impairment and
4. 2 hours
prevention
5. Psychosocial impact of low vision 2 hours
6. Clinical low vision assessment 38 hours
7. Understanding low vision devices 15 hours
Adaptations to the environment and non-optical
8. 4 hours
devices
Functional Assessment of Low Vision and case
9. 8 hours
studies
Training in the use of vision, visual skills, and low
10. 10 hours
vision devices
11. Counselling 4 hours
12. Pediatric Low Vision Care 26 hours
13. Accessibility 2 hours

14. Models of low vision care 2 hours
15. Research in low vision 3 hours
Total duration: 120 hours
Session Plan 1
Introduction to the Course and Low Vision

Time : 2 hours
Outcomes : At the end of the session participants will know the overall
objectives of this course, be familiar with one another and have
an overview of the significance of low vision.
Objectives : understand the objectives of this course
understand the effects of low vision
Session Plan
Stage Content Method Material

Stage-1 Introduction of participants Discussion
in pairs
Stage-2 Objectives of the course Discussion
Stage-3 Assess expectations Discussion
Stage-4 Develop an understanding of Practical Materials for low

low vision through simulation vision simulators
Process:
Stage-1: Introduction
Introduction of course leader.
Prepare an orientation exercise to have participants work in pairs to get to know one
another. Select participants to work in pairs. Give participants five minutes to
introduce themselves to their partners. After the time is up, have them introduce their
partner to the group.
Stage-2: Course Objectives
Share the objectives of the course with the participants and follow this with a
question and answer session about the overall course. Use the objectives of the
curriculum as a guide.
Stage-3: Assess expectations
Ask the participants about their expectations of this course and write these on a
board or flip chart for the entirety of the course.
If there are any expectations that are relevant to the subject matter and have not
been included as part of the training curriculum/schedule, consider adding them
where appropriate.
The flip chart with the expectations should remain hanging on the wall during the
entire course. At intervals during the course check that the listed expectations have
been met.
Stage-4: Develop an understanding of low vision through simulation
Provide instruction on the creation of low vision simulators and have the participants
create their own simulators.
Once the participants have completed their low vision simulators provide them with
exercises to complete while wearing the low vision simulators.
Examples: Viewing PowerPoint slides, reading notes, moving around the room in
pairs
Session Plan 2
Global, national and local policies
Time : 1 hour
Outcomes : At the end of the session participants will have an awareness of
global, national and local policies and statutory benefits for
people with vision impairment
Objectives : To introduce major global programs and policies relevant to
To discuss regional and local programs and their benefits for
Session Plan :

Stage-1 Global programs and Discussion Websites (see
policies references)
Stage-2 National and local policies Discussion Websites (see
references)
Stage-3 Preparing submissions and Practical Sample forms
applications
Process:
Stage-1: Global programs and policies
Share the global programs and policies with the participants

VISION 2020 – IAPB & WHO
EFA –VI - ICEVI, WBU
UN Declaration of Human Rights
UN Declaration of Child Rights
UN Declaration on the Rights of People with Disabilities
UN Millennium Development Goals
Discuss the local country’s involvement in these agreements and implications for the
country and region.
Stage-2: National and local policies
Outline national welfare schemes, education support, employment opportunities,

pensions, and other benefits provided for people with disabilities. Also discuss
funding and benefits provided to non-government organisations working to support
people with disabilities.
Discuss the roles and activities of disabled peoples’ organisations.
Describe the responsibility and advocacy roles of a Teacher for a child with low
vision and effective ways to advocate for their access to appropriate education.
Stage-3: Preparing submissions and applications
Case Study
Present a case study outlining a national or local situation where a teacher has
gained support for a student with vision impairment.
Practical
Select submission forms and applications from available sources of support and
funding. Discuss the process of completing these forms and have the participants
complete a sample form.
References:
International Council for Education of People with Visual Impairment:

http://www.icev.org
Nordstrom, K. (2007). Convention on the rights of persons with disabilities. The
Educator, 20 (2). http://www.icevi.org/january_07/educator_january-07.html
UNESCO. (1994). The Salamanca Statement and Framework for Action on Special
Needs Education. Salamanca, Spain: UNESCO and Ministry of Education and
Science Spain.
http://portal.unesco.org/education/en/ev.php-
url_id=7939&url_do=do_topic&url_section=201.html
Session Plan 3
Epidemiology
Time : 1 hour
Outcome : Participants will have an understanding the World Health
Organization (WHO) terminology of visual impairment, and the
prevalence and causes of visual impairment
Objectives : Understand the definitions and classification of visual

impairment, low vision and blindness
Understand the sources of data and their limitations
Able to present data on global epidemiology of visual
impairment
Able to present data on national epidemiology of visual
impairment
Session Plan :

Stage-1 Describe and compare the Instruction, ICD-10, ICF
ICD-10 and ICF Discussion handouts
Stage-2 Definitions and Instruction, WHO website

classification of visual Discussion
impairment, low vision and
blindness
Stage-3 Global epidemiology of Instruction, WHO website
visual impairment Discussion
Stage-4 National epidemiology of Instruction, WHO
visual impairment Discussion publications,
National
websites
Stage-5 Sources of epidemiological Instruction,
data and their limitations Discussion
Process:
Stage-1: Describe and compare the ICD-10 and ICF
Describe and explain the epidemiological and functional definitions of visual

impairment as stated by the World Health Organization (WHO). Describe the ICF
and compare the implications of the medical and social models of health for the
assessment and understanding of low vision.
Stage-2: Definitions and classification of visual impairment, low vision and

blindness
Refer to the 2008 WHO definition of visual impairment. Highlight the importance of
presenting compared to best corrected vision. Outline and discuss the critical
differences between visual impairment, low vision and blindness.
Explain the differences between none, mild, moderate, severe, and profound visual
impairment categories.
Stage-3: Global epidemiology of visual impairment
Share information regarding the global prevalence and causes of visual impairment.
Highlight the regional differences and their importance for planning of prevention,
treatment, correction, and rehabilitation programs.
Explain the differences between avoidable, preventable and treatable causes of

visual impairment.
Discuss the following standard references:

Bulletin of the World Health Organization 2004 - Global Prevalence
Bulletin of the World Health Organization 2008 - Refractive Error
WHO website
Stage-4: National epidemiology of visual impairment
Explain how prevalence data can be applied to a country to establish the number of
people with visual impairment and how this will vary across regions of a specific
country.
Discuss the common problems related to lack of accurate and recent data on the
causes of visual impairment. Discuss possible solutions, such as the use of regional
data.
Exercise
Use the data on causes of vision impairment to plan the human resources needed
for eye care within a country.
Stage-5: Sources of epidemiological data and their limitations
Discuss the following:
Sources of data need to be critically reviewed to establish if the data is truly

representative of a region or country.
Differences in the methodology of data collection that affect its accuracy
Categorisation of vision
Age and location of the population studied.
The size of the sample studied
The sources of the sample (particularly in children)
Do the data give information on the disadvantaged and under-served populations
References:
Gilbert, C., & Foster, A. (2001). Childhood blindness in the context of VISION 2020 –
The Right to Sight. Bulletin of the World Health Organisation, 79(3), 227-232.
World Health Organization. (2006). Blindness and visual impairment. Priority eye
diseases. http://www.who.int/blindness/causes/priority/en/print.html
World Health Organization. (2005). Refractive error and low vision.
http://www.who.int/pbd/blindness/vision_2020/priorities/en/index5.html
World Health Organization. (1992). Management of low vision in children.
WHO/PBL/93.27.
Session Plan 4
Causes and implications of visual impairment and prevention
Time : 2 hours
Outcomes : Participants will be able to describe the common causes,
symptoms and implications of visual impairment in children and
adults and list intervention and prevention strategies.
Objectives : To understand the most common causes of visual impairment in
children and adults
To be able to relate visual symptoms with the structures of the
eye affected by the common causes of visual impairment
To outline prevention and interventions for common causes of
vision impairment
Session Plan :

Stage-1 Common causes of visual Discussion, WHO website,
impairment in children Demonstration BHVI Low Vision
Optometry
Resources, Model
of the eye
Stage-2 Common causes of visual Discussion, WHO website,
impairment in adults Demonstration BHVI Low Vision
Optometry
Resources, Model
of the eye
Stage-3 Signs and symptoms of Discussion ICEH and WHO
common causes of visual posters, BHVI
impairment Low Vision
Optometry
Resources,
Model of the eye
Stage-4 Implications of the common Discussion, Simulators, Model
causes of visual impairment on Practical of the eye, BHVI
parts of the eye Low Vision
Optometry
Resources
Stage-5 Treatment and prevention Instruction, Model of the eye,
Discussion Diseases of the
eye textbooks (eg
Will’s Eye Manual,
Kanski’s Clinical
Ophthalmology)
Process:
Stage-1: Common causes of visual impairment in children
List congenital, hereditary and acquired diseases and disorders of the eye that
commonly cause low vision in children, including:
 Congenital and traumatic cataracts
 Cornea degenerations/dystrophies
 Albinism
 Microphthalmos
 Aniridia
 Leber’s congenital amaurosis
 Optic atrophy
 Retinal disorders – retinoblastoma
 Amblyopia
 Retinopathy of prematurity
 Rubella
 Vitamin A deficiency – xerophthalmia
 Trachoma – eye lids and corneal changes
Intervention measures for all of the relevant diseases should be discussed in detail
during this session. Emphasize the diseases that are a treatment priority.
List the diseases that cannot be treated or cured, but can be easily prevented.
Stage-2: Common causes of visual impairment in adults
List hereditary and acquired diseases and disorders of the eye that commonly cause
low vision in adults, including:
 Cataracts – congenital and acquired
 Age related macular degeneration (ARMD)
 Diabetic retinopathy – vision loss from disease and consequent treatment
(laser photocoagulation)
 Glaucoma
 Retinitis pigmentosa
 Corneal degenerations/dystrophies
 Trachoma – eye lids and corneal changes
 Optic atrophy
 Multiple sclerosis
 Stroke and acquired brain injuries
 Macular dystrophies/degenerations – Best’s disease, Stargardt’s disease
 Myopic degeneration
 Ocular colobomas
Intervention measures for all of the relevant diseases should be discussed in detail
during this session. Emphasize the diseases that are a treatment priority.
Stage 1 & 2 Group work.

Divide the participants into small groups and ask each group to draw and label a
diagram of the eye. Ask the participants to point out which parts of the eye are
affected by each disease. Diseases of the eye lid, cornea, lens, retina and optic
nerve
This task should take around 40 minutes.
Each group will present their findings and assist with any problems.
Use slides/transparencies to show examples for different eye diseases from case
studies.
Stage-3: Signs and symptoms of common causes of visual impairment
Description of signs and symptoms of each of the causes of low vision as described
in Stages 1 and 2.
Cataracts
Signs and Symptoms include:
 Clouding of lens, opacities
 vision may seem cloudy and blurry;
 glare, where light sources appear too bright, and halos around lights
 double vision
 reduced contrast acuity
 poor night vision
 in the final stages, sight diminishes to the extent that the patient cannot see
Age related macular degeneration (ARMD)

Wet and dry ARMD
 choroidal neovascular net – bleeding, leakage of fluid, thickening of macula
 atrophic changes at the macula
 decreased visual acuity
 central scotoma – relative and absolute
 possible glare sensitivity
 possible effects on colour vision
Diabetes
 retinal and vitreous haemorrhages
 retinal exudates and infarcts
 neovascular changes at the retina and iris
 scotomas associated with retinal bleeding and scarring from treatment with
laser photocoagulation
 possible glare sensitivity
 possible effects on colour vision
Glaucoma
 loss of retinal nerve fibre layer
 optic nerve head changes – notching, increased cupping, pallor
 narrow anterior angle – partial/complete occlusion
 visual field chages
 possible glare sensitivity – haloes if cornea affected
Retinitis pigmentosa
 peripheral retinal changes – typical bone spicule like pigmentary changes
(there is a sine pigmento variant of the disease where pigmentary changes
are absent)
 attenuation of retinal blood vessels
 optic atrophy
 loss of peripheral visual field – bumping into objects, peripheral neglect
 decreased visual acuity at end stage of the disease
 increased glare sensitivity
 deafness as part of syndrome – Usher’s syndrome
Corneal degenerations/dystrophies
 corneal haze, opacities, thickening, ectasias
 haloes
Trachoma
Corneal and lid scarring
 corneal haze, opacities, thickening, ectasias
 trichiasis
 scarring of eyelid conjunctiva
 decreased visual acuity with cornea scarring
 watery and sticky eyes
Stage-4: Implications of the common causes of visual impairment on parts of

the eye
Relate low vision symptoms to the structures of the eye affected by the common
causes of visual impairment described in Stages 1 and 2
Corneal disease – symptoms of decreased visual acuities, increased glare, haloes

and decreased contrast
Iris disease – symptoms of increased glare
Lens opacities - symptoms of decreased visual acuities, increased glare, haloes and
decreased contrast
Central retinal disease - symptoms of decreased visual acuities, loss of central vision
(relative and absolute), possibly increased glare, possible colour vision anomaly and
decreased contrast
Peripheral retinal disease - symptoms of loss of peripheral visual field ie tunnel

vision, bumping into objects
Optic nerve - symptoms of decreased visual acuities, loss of central vision (relative
and absolute), loss of peripheral visual field, possible anomalous colour vision,
possible increased glare and decreased contrast
Distribute the handouts on the list of eye diseases and effects on visual function.
Stage-5: Treatment and prevention
Detailed discussion on treatment measures for all of the relevant diseases in Stage 1
and 2.
Onset, diagnosis, course of disease, prognosis, prevention and treatment. Consider
recent developments in treatment of wet ARMD and diabetic maculopathy with anti-
VEGF agents.
Prevention
Lifestyle considerations
 dietary – for disease prevention (eg diabetes, vitamin A deficiency),
supplementation for ARMD (controversial, AREDS), vitamin A
supplementation for vulnerable children
 smoking
 alcohol consumption
 UV exposure
 eye protection – safety eye wear
Distribute handouts on the causes, signs, prevention and interventions for eye
diseases.
References
Beaton GH, Martorell R, L'Abbé, et al. Effectiveness of Vitamin A supplementation in
the control of young child morbidity and mortality in developing countries. UN,
ACC/SCN State-of-the-art Series, Nutrition policy Discussion Paper No. 13,
1993.
Brien Holden Vision Institute (2013). Causes and symptoms of low vision. Low Vision
1. Optometry Resources. http://education.brienholdenvision.org/en/optometry-
resources/category/10-student-notes.html (Accessed 5 October, 2015).
Ching P, Birmingham M, et al. Childhood mortality impact and costs of integrating
Vitamin A supplementation into immunization campaigns. American Journal of
Public Health, 2000, 90(10):1526–1529.
Goodman T, Dalmiya N, et al. Polio as a platform: using national immunization days
to deliver Vitamin A supplements. Bulletin of the World Health Organization,
2000, 78(3): 305–314.
Kalloniatis M, Fletcher EL. (2004). Retinitis pigmentosa: understanding the clinical
presentation, mechanisms and treatment options. Clin Exp Optom. 87:65-80
Helen Keller International and WHO. Integrating Vitamin A with immunization: An
information and training package (CD-ROM) 2000.
Integrated management of childhood illness: a WHO initiative. Bulletin of the World
Health Organization, 1997, 75 (Suppl 1: 119–128).
Integration of Vitamin A supplementation with immunization. Weekly Epidemiological
Record, 1999, 74:1–6 and on the Internet at
http://www.who.int/wer/pdf/1999/wer7401.pdf.
Vitamin A Supplementation http://www.who.int/vaccines/en/Vitamina.shtml
WHO/UNICEF/IVACG. Vitamin A supplements: a guide to their use in the treatment
and prevention of Vitamin A deficiency and xerophthalmia (2nd edition.)
Geneva: World Health Organization; 1997.
Gilbert, C., & Foster, A. (2001). Childhood blindness in the context of VISION 2020 –
The Right to Sight. Bulletin of the World Health Organisation, 79(3), 227-232.
World Health Organization. (2006). Blindness and visual impairment. Priority eye
diseases. http://www.who.int/blindness/causes/priority/en/print.html
Weiss, NJ. (1991). Low Vision Management of Retinitis Pigmentosa. J Am Optom
Assoc. 62(1):42-52.
West, S. (2007). Epidemiology of Cataract: Accomplishments over 25 years and
Future Directions, Ophthalmic Epidemiology, 14 (4). 173-178.
Session Plan 5
Psychosocial Impact of Low Vision
Time : 2 hours
Outcomes : Understanding of the psychosocial impact of low vision and
strategies to manage coping difficulties
Objectives : able to identify and describe potential psychosocial effects of
low vision at developmental stages
aware of the signs and symptoms of psychosocial problems and
disorders
aware of appropriate intervention and referral strategies to
promote healthy psychosocial development and coping
Session Plan :

Stage-1 Social and emotional Instruction, References on
development and effects of group work, child
low vision class sharing development
Stage-2 Awareness of psychosocial Instruction DSM-IV (book,

problems and handout or
psychological disorders internet site).
Social skills
assessments
Stage-3 Intervention strategies to Discussion and Intervention

promote healthy instruction programs or
psychosocial development manuals. Local
referral
information
Stage-4 Case study Group work Case scenarios
Process:
Stage-1: Social and emotional development and effects of low vision
Describe current knowledge regarding the psychosocial impact of low vision

Highlight that differences exist between people with low vision; while many people
function at high levels and demonstrate good social competence, develop strong,
meaningful friendships and do not experience psychological problems, others can
experience difficulties coping.
Explain how low vision can lead to problems with the psychosocial well-being of
students and adults with low vision. Describe these to the class, based on current
literature.
Social impact of vision impairment:

it is more common for children with vision impairment to interact with adults in
classes rather than peers and spend less time interacting with peers. Sighted
children more often choose sighted peers to interact with;
breakdown in communication with peers (particularly for younger children) is
common;
isolation and or rejection by peers due to differences in appearance; stereotypical
behaviours, social behaviours or specially adapted equipment.
potential for overprotection by peers and adults;
difficulties learning social norms. Children with vision impairment often lack skills to
appropriately enter groups, hold conversation and negotiate conflicts;
difficulties in locating peers for play.
Potential psychosocial impact of low vision:

a feeling of difference to others;
adjustment difficulties. Often children with low vision have greater difficulties than
those who are blind. Because their impairment is not obvious, adults often impose
similar expectations for children with low vision as they do for sighted children.
Unlike blind children, children with low vision are often not afforded modifications or
support they require;
loneliness or isolation;
adjusting to vision loss later in childhood, grief regarding the loss of vision;
vision impairment is associated with depression amongst adult populations
often receive distorted and unreliable visual information, and as a result, may grow
up lacking confidence or develop a poor self-image or behavioural difficulties;
adolescents with vision impairments have significantly lower self-concept than their
sighted peers. Feelings of inferiority and inadequacy caused by vision impairment
could be a significant factor behind the problem of poor self-image (Beaty, 1991).
Adolescents who cannot conform to group norms are prone to peer rejection. Peer
rejection and acceptance is a predictor of later academic success, social success
and behaviour problems.
Stage-2: Awareness of psychosocial problems and psychological disorders
Discuss the range of normal emotions and difficulties faced in life and potential
difficulties faced by students with low vision. Instruct the class on the difference
between a typical or developmentally appropriate psychosocial problem / difficulty
and a psychological disorder. Discuss psychological classifications for disorders
(ICD-10, DSM-IV) compared to the range of normal experiences that people may
face in their daily life.
Class discussion.
Ask participants to name childhood / adolescent experiences and the spectrum
which exists among these experiences. Provide cues and additional information
regarding disorders. For example:
sadness through to depression
Periods of sadness are common aspects of life and should not be diagnosed as a
Major Depressive Episode unless criteria are met for severity (see ICD-10, DSM-IV)
developmentally appropriate separation anxiety through to Separation Anxiety
Disorder.
worry and anxiety through to generalized anxiety disorder.
social shyness or embarrassment through to Social Anxiety.
problem behaviours through to Conduct Disorder.
Instruct the class about the signs and symptoms of disorders discussed above using
the DSM-IV or ICD-10 classifications and diagnostic criteria. Provide a handout of
the signs and symptoms.
Instruct the class regarding identification and assessment of psychosocial disorders:

awareness of signs and symptoms allow the teacher to monitor a child’s well-being;
if any concerns are raised, discuss with parents;
assessment and diagnosis is required by a professional (psychologist, psychiatrist or
counselor). Referral is important if signs are noticed; do not hesitate to refer them to
a mental health professional for assessment;
if immediate assessment is needed, contact parents and take the child to the
hospital emergency room;
discuss the procedure for referring to health professionals in the local area;
specialists may implement interventions such as counseling, medication and/or
cognitive behavioural therapy.
Social skills deficits

Discuss the signs of social skill deficits that are common among children with low
vision. For example: difficulties interacting with peers and adults, inappropriate
verbal or non-verbal communication skills, inappropriate social behaviours, overly
assertive, aggressive or submissive behaviours.
Discuss ways to assess social skills

Informal observation of social interaction.
observe the frequency of interaction with peers,
the nature of the interactions,
does the child initiate interactions?
does the chid respond to other’s interactions?
are their interactions appropriate?
Standardized assessments. Teacher and parent questionnaires can be completed to
measure the child’s social skills relative to the expected skills of the age range.
Examples included the Matson Evaluation of Social Skills with Youngsters (MESSY),
Social Skills Rating System, Vineland Adaptive Behaviour Scale. Demonstrate the
procedures to administer, score, and interpret the assessments. Allow the
participants to practice using the assessments.
Stage-3: Interventions to promote healthy psychosocial development
Describe interventions to promote healthy psychosocial development.
Building social competence:

early exposure to social interaction is important. Encourage parents to mix the child
with other children from an early age.
Teaching social skills:

children with vision impairment may require explicit instruction regarding social
norms, as well as suggestions for improving social competence. This may take the
form of social skills groups (a good chance to put the social skills into practice) or
one-on-one training. Provide an example of a social skills training program, manual
or video.
topics may include: interpersonal communication skills; awareness of appropriate
and inappropriate verbal and non-verbal behaviours, assertive communication;
consideration of the perspective of others; joining groups; beginning and maintaining
conversations.
using trained peers or adults to reinforce social skills and provide feedback has been
shown to be effective for some children with vision impairment and other disabilities.
involve parents in teaching and reinforcing appropriate social skills.
Strategies to increase interaction between peers

balance of adult involvement in promoting interaction
‘Cooperative Learning Activities’ and group games in class
Buddy systems
teaching peers and educators about vision impairment
adapt activities to increase participation in class and increase a sense of belonging
Strategies to deal with stress:

relaxation and meditation techniques,
diversion techniques such as going for a walk,
exercise
rational and non-rational thoughts.
teaching compensatory techniques for a realistic understanding of visual problems
Strategies to increase confidence and self esteem:

mastery of skills, achievement and having positive experiences
developing interests / hobbies, extracurricular activities
rewards and praise in class, setting achievable goals in class
Strategies to deal with bullying or isolation:

instruction regarding assertive, aggressive and submissive behaviour styles
involvement in extra-curricular activities, groups and developing interests
Family relationships and role of the family:

discuss the importance of parent involvement, encouragement and positive, healthy
relationships with the child
family barriers (expectations, poor family relationships, sibling rivalry)
family facilitators (support, rewards and praise, listening and discussing problems,
stability and safety for the child)
referral to counselors, psychologists, or psychiatrists. Who to refer to, when to do so.
Provide details of mental health specialists in the local area and how to find details
Case study.
Give participants a case study regarding a student with low vision who is
experiencing adjustment problems. Group members to examine and suggest:
Signs and symptoms the student is displaying
How to identify the severity of the problem
Suitable coping strategies
Referral to specialists, local community organizations and groups
References:
Social/Emotional impact of vision impairment

Baird, S. M., Mayfield, P., & Baker, P. (1997). Mothers' interpretations of the behavior
of their infants with visual and other impairments during interactions. Journal of
Visual Impairment & Blindness, 91, 467-491
Beaty, L. A. (1991). The effect of visual impairment on adolescents' self-concept.
Journal of Visual Impairment & Blindness, 85(129-130).
Best, A. B., & Corn, A. L. (1993). The management of low vision in children: report of
the 1992 World Health Organization consultation. Journal of Visual Impairment &
Blindness, 86), 307-309.
Erwin, E. J., Alimaras, E., & Price, N. (1999). A qualitative study of social dynamics in
an inclusive preschool. Journal of Research in Childhood Education, 14(1), 56-67.
Kroksmark, U., & Nordell, K. (2001). Adolescence: the age of opportunities and
obstacles for students with low vision in Sweden. Journal of Visual Impairment
and Blindness, 95(4).
Peavey, K. O., & Leff, D. (2002). Social acceptance of adolescent mainstreamed
students with visual impairments. Journal of Visual Impairment and Blindness,
96(11).
Sacks, S. Z., Kekelis, L. & Gaylord-Ross, R. The Development of Social Skills by
Blind and Visually Impaired Students: Exploratory Studies And Strategies. New York:
American Foundation for The Blind.
Warren, D. H. (2000). Developmental Perspectives. In B. Silverstone, M. A. Lang, B.
P. Rosenthal & E. E. Faye (Eds.), The Lighthouse Handbook on Vision Impairment
and Rehabilitation (Vol. 2, pp. 325-336). New York: Oxford University Press.
Effect of peer acceptance/rejection on well-being in typically developing populations

DeRosier, M. E., Kupersmidt, J. B., & Patterson, C. J. (1994). Children's Academic
and Behavioral Adjustment as a Function of the Chronicity and Proximity of Peer
Rejection. Child Development, 65, 1799-1813.
Ladd, G. W., Kochenderfer, B. J., & Coleman, C. C. (1997). Classroom peer
acceptance, friendship, and vicitmization: distinct relational systems that contribute
uniquely to children's school adjustment? Child Development, 98(6), 1181-1197.
O'Neil, R., Welsh, M., Parke, R. D., Wang, S., & Strand, C. (1997). A longitudinal
assessment of the academic correlates of early peer acceptance and rejection.
Journal of Child Psychology, 26, 78-92.
Vitaro, F., Trembley, R. E., & Gagnon, C. (1992). Peer rejection from kindergarten to
grade 2: outcomes, correlation and prediction. Merril-Palmer Quarterly, 38, 382-400.
Counselling and preventative interventions for children with emotional difficulties

Herbert, M. (2005). Developmental problems of childhood and adolescence
prevention, treatment, and training / 1st ed. Malden, MA: BPS Blackwell Pub.
Hill, M. (1999). Effective ways of working with children and their families. London;
Philadelphia: Jessica Kingsley Publishers, 1999.
Pushkar, D., Gold (1998). Improving competence across the lifespan: building
interventions based on theory and research .New York: Plenum Press.
Rutter, M. (1995). Psychosocial disturbances in young people: challenges for
prevention. New York: Cambridge University Press, 1995.
Sutton, C. (2000). Child and adolescent behaviour problems: a multi-disciplinary
approach to assessment and intervention. Leicester : British Psychological
Society.
Diagnosis
American Psychiatric Publishing. (2007). DSM-IV-TR®: Diagnostic and Statistical
Manual of Mental Disorders (Fourth ed.): American Psychiatric Publishing.
Session Plan 6
Clinical low vision assessment
Time : 38 hours
Outcome : The participants will be able to undertake a comprehensive
assessment of the visual functions of a client and suggest the
most appropriate solutions.
Objectives : After the completion of this session the participants will be able
to:
undertake a detailed case history
assess the residual visual function
collate the residual vision with the individual’s needs
suggest appropriate interventions
refer the client to the appropriate service provider
advise on statutory and legal provisions
Session plan :
Stage Content Time Method Material

Stage-1 Undertake a detailed 2 hr. Instruction and
case history practical
demonstration
Stage-2 Assess the residual 10 hr. Instruction and Functional low vision
visual function practical clinic
demonstration
Stage-3 Collate the residual 2 hr. Instruction and
vision with the practical
individual’s needs demonstration
Stage-4 Suggest appropriate 2 hr. Instruction and
interventions discussion
Stage-5 Referral to the 2 hr. Instruction and
appropriate service discussion
provider
Stage-6 Clinical Practice 20 hr. Clinical Assessment materials.
assessment Arrange field visits
with a client,
class
discussion &
feedback
Process:
Stage-1: Undertake a detailed case history
Discuss how participants can undertake a detailed history especially the ocular and
general health history, family history, occupation and life style.
Teach the participants to determine the main complaints and challenges being faced
by the client, and undertake a needs assessment. Discuss how the participants can
assess the emotive state of the client.
Stage-2: Assess residual visual function

Demonstrate the assessment of visual acuity using the following tests:
LogMar charts
LVRC flip charts
Feinbloom test
Lea’s symbols etc
Demonstrate the assessment of near vision using the following tests:
LVRC near vision cards

Lea symbols
Lighthouse near vision test etc
Demonstrate the assessment of reading acuity using various materials e.g.

newsprint, telephone directory, price tags etc. The participants should able to assess
the ability to read more congested type sets and note the speed and distance at
which the individual clients can read.
Demonstrate the techniques for refraction of a low vision patient:
 Bracketing
 Over-refraction
 Dynamic retinoscopy
Demonstrate the assessment of contrast sensitivity using the following tests:
Lea low contrast flip cards

Bailey Lovie low contrast chart
Contrast sensitivity assessment software etc
Demonstrate the assessment of visual fields using the following tests:
 Disc perimetry
 Confrontation method
 Hand held perimetry
 Amsler grid
Demonstrate the assessment of colour vision using the following tests:
 D-15 test
 Ishihara test
 Functional colour vision assessment
Stage-3: Collate the residual vision with the individual’s needs
Demonstrate to the participants how the above assessments can be correlated with
the client’s needs:
 in identifying the areas of strengths and weaknesses

 in determining the most feasible interventions
 in deciding on the appropriate referrals
Stage-4: Suggest appropriate interventions
Discuss how the information obtained from the assessments can help in selection of
the most suitable optical and non-optical low vision devices, environment
modifications and independence and mobility.
Demonstrate to the participants how to calculate the magnification needs, selection

and trial of devices and the training of the client in the use of the prescribed devices.
Demonstrate how to explain to the client on the use of adaptive devices and other
assistive technology.
Stage-5: Referral to the appropriate service provider
Discuss how the participants can identify vertical and horizontal referral pathways in
their settings.
Demonstrate how case report and referral letters are written.
Discuss how participants can advise clients to make best use of available statutory
and legal provisions for people with disability.
Stage-6: Clinical Practice
Participants to first observe a full clinical and functional vision assessment routine in
at least 5 clients with various causes and severity of low vision; then to participate in
supervised clinical and functional assessments of at least 5 clients with low vision,
leading to skills to conduct and perform a low vision and functional assessment
independently.
Where possible, participants should have the opportunity to observe and assess
children with:
Age related macular degeneration
Glaucoma
Diabetic retinopathy
Retinitis pigmentosa
Optic Atrophy
Retinal dystrophy
Participants to learn how to communicate the assessment findings and the plan for
intervention to the clients and other professional colleagues.
Following their assessments provide feedback to participants as a whole group

Correct any mistakes. Let participants check each other’s way of assessment,
documentation and communication.
Session Plan 7
Understanding low vision devices
Time : 15 hours
Outcome : The participants will be able to determine the need for and
teach people with low vision how to use appropriate optical low
vision devices.
Objectives : After the completion of this session the participants will be able
to:
classify the types of optical devices available for people with low
vision;
understand the principles of and formulae for magnification;
comprehend the optics of low vision devices;
understand the advantages and disadvantages of these devices
determine the required and the actual magnification and
prescribe the appropriate devices;
in the correct use of the optical low vision devices
Session plan :
Stage-1 Types and classification 2 hr. Instruction and Range of optical low
of optical low vision demonstration vision devices
devices including spectacle
hand-held, stand
magnifiers with and
without internal
illumination,
telescopes, field
expanders, near vision
and reading vision
charts, training
software for telescope
training
Stage-2 Types of magnification 2 hr Instruction
Stage-3 Optics of low vision 4 hr. Practical
devices exercise
Stage-4 Advantages and 1 hr Instruction
disadvantages of
different devices
Stage-5 Prescription of low vision 4 hr Instruction and
devices and verification practical
exercise
Stage-6 Training in the correct 2 hr.
use of optical low vision
devices
Process:
Stage-1: Classify the types of optical devices available for people with low
vision
Describe the types of optical low vision devices and discuss the difference between
optical and non-optical materials.
Explain how these devices are used to magnify the objects. Group them as:
 Devices for near vision

 Devices for distance vision
Describe the commonly used optical devices and give examples of the following
three types:
 Magnifiers
 Telescopes
 Field Expanders
Describe the aids available for peripheral field loss. Explain the theory behind these
aids and describe and demonstrate their operation.
Stage-2: understand the principles of and formulae for magnification
Describe the various types of magnification and the rationale. Discuss the different
formulae used to calculate magnification. Illustrate with examples using the types of
magnification below:
 Relative Size Magnification

 Relative Distance Magnification
 Angular or Optical Magnification
 Electronic Magnification
Explain how the magnification of hand-held, stand, spectacle magnifiers and

telescopes is calculated. Demonstrate and explain how magnification from various
sources is calculated.
Stage-3: Optics of low vision devices
Describe the optics of a convex lens. Discuss the optics of stand, hand-held,
spectacle magnifiers and telescopes.
Explain how the optics of the device affects its functions. Discuss how the placement
of the following affect the magnification and the field of view:
 Eye to device
 Device to the target
 Describe the factors which influence the field of view and the image
brightness in a telescope.
Stage-4: Advantages and disadvantages of different devices
Describe the advantages and disadvantages of Galilean and Keplerian telescopes,

and hand-held, spectacle and stand magnifiers.
Stage-5: Prescribing low vision devices
Discuss how the needs for vision enhancement through optical systems are
determined. Explain how this may be done using the following principles of
prescribing low vision devices:
 Determine the resolution ability for near and distance tasks

 Predict the distance required to meet the resolution goal
 Verify that the predicted EVD allows the resolution goal
 Consider other optical systems to provide the same EVD
Discuss how the following options can address the needs:

 Spectacles with reading addition
 Hand held magnifier
 Stand magnifier
 Near vision telescope
 Video magnifier or other projection system
In all these cases, explain what the magnifying systems are doing and how they
provide the required Equivalent Viewing Distance (EVD).
Describe the method for determining the power of a distance viewing telescope.
Explain to the participants how to measure the magnification of optical devices:

 Checking the dioptric power
 In-office measurement of equivalent power
 In-office determination of image loc.
 Finding the enlargement ratio for a stand magnifier
 Measuring lens power
 Measuring equivalent power for:
 spectacles
 hand held magnifiers
 stand magnifiers
 Prescription Verification
Stage-6: Train the patient in the correct use of the optical low vision devices
Explain how various devices function and the best way of using them to enhance
vision. Demonstrate to the participants the correct method of handling low vision
devices for obtaining the desired outcome:
 hand held magnifiers

 spectacle magnifiers
 stand magnifiers
 CCTVs
 Telescopes
Demonstrate where the object needs to be placed with regards to the magnifier and
the eye. Discuss and demonstrate how optical and non-optical devices can be sued
together to achieve the best possible visual function.
Develop a training programme for the appropriate use of the appropriate devices for
distance, near and for peripheral awareness.
Advise the clients on the correct posture and positioning of the client and advise on
the ergonomics.
Demonstrate on how the clients may care and maintain their prescribed devices.
Practical work
Ask participants to split into pairs (one to act as clinician, the other as person with
low vision). Participants to teach each other how to use the near and distance optical
devices.
Case study
Assign the participants cases studies of clients with different visual problems, age
and physical function who participate in different occupations or activities. Ask
participants to prescribe suitable low vision aids for the individuals.
Session Plan 8
Adaptations to the environment and non-optical devices
Time : 4 hours
Outcomes : Able to adapt the environment to assist people with low vision
and demonstrate the use of non-optical low vision devices
Objectives : Understand environmental adaptations to assist people with low
vision
Selection of non-optical materials for people with low vision
Session plan :

Stage-1 Environmental adaptation Discussion
Stage-2 Description of non-optical Demonstration Non-optical low

low vision devices and vision devices
discussion
Stage-3 Prescribing non-optical Practical, Case studies
devices group work and non-optical
materials
Stage 4 Visit of a class room
Process:
Stage-1: Environmental adaptation
Discuss the key fundamentals of environmental adaptation and consideration to

make the environment accessible. Share suggestions for adaptive techniques and
materials that will help people with low vision function more effectively.
Environmental modification can include; changing the size, distance, color and
contrast of things being used in daily living activities, and the use of suitable light.
Simple placement of furniture and other items in the house can also be very helpful
for a person with low vision in everyday life.
Stage-2: Description of non-optical materials
Ask the participants what they know about non-optical low vision devices and why a
person would use non-optical rather than optical devices?
Review the elements of vision (light detection, colour, shape, form, and position).
Explain how non-optical devices are used to modify the different elements of vision
to assist people with low vision.
Demonstrate the following materials. Ask participants to brainstorm their uses and
advantages.
 Lighting: adjustable table lamps, wall lamps, globes
 Reading: enlarged and high contrast print, typoscopes (reading guides),
reading stands (fixed, adjustable, illuminated), tape recorders, reading
material in Braille, flash cards, tactile cards, cards with enlarged and high
contrast alphabets, numbers, pictures.
 Writing: bold-line papers (English and Math), writing guides (letter, signatures,
cheque, envelope), markers, stencils, writing pens with light
 Activities of daily living
 Time: large print and regular high contrast clocks (wall clocks, table clocks,
wrist watches), talking clocks and watches
 Date: large print calendar, teledex
 Pouring liquids, identifying and labeling
 Domestic activities:
 Cooking: contrast handles and borders, large print and high contrast labelling
 Sewing: needle threading devices, blind needles, frames, washing clothes
 Gardening: high contrast
 Recreation: chess, high contrast playing cards, footballs, audible balls
 Self-care activities: magnifying mirror, lipstick, nail polishes,
 Health care
Electronic Devices
In cases of severe visual loss where optical visual devices do not provide adequate
help, electronic devices can be helpful. These are two basic types of electronic low
vision device. One type displays the task in a magnified or enhanced form on a
monitor, and the other type is used to convert text into speech. Discuss how these
work and demonstrate usage.
Stage-3: Prescribing non-optical aids

Explain the assessment process used to decide when to prescribe non-optical
materials:
Explain the interview process to determine the activities that the client performs or
would like to perform, and areas of difficulty. Participants should practice their
interview technique and determine important activities in a patient’s life. They should
also attempt to solve any problems the persons with low vision encounter in daily life
due to their visual impairment and consider other physical or cognitive impairments
that may impact on their ability to use the materials.
Discuss availability of non-optical materials in the local areas and methods of

accessing or purchasing materials.
Group work.
Break the class into groups and assign person in each group to act out a case study.
Group members should interview the person with the case study to determine
meaningful activities, strengths and areas of difficulty. Each group should brainstorm
devices that would be useful to help this person with low vision participate in daily
tasks. Members of the group should teach the ‘client’ how to use the non-optical
device. Groups should swap case studies and have another person from the group
act out the new case study.
At the end, distribute a written work plan card to every participant and ask them
individually what materials will be needed for a person with low vision to finish that
particular plan, and how that will help them.
Stage 4: Visit a class room
Arrange a class room visit and ask participants to make environmental adaptations -
modifications for a case study to maximize the use of vision, i.e. changing lighting,
contrast, color, distance, and size of object in the environment.
Session Plan 9
Functional Assessment of Low Vision and case studies
Time : 8 hours
Outcome : The knowledge to assess the functional vision of a person with
low vision and identify needs for vision training program
Objectives : To train participants the methods to assess functional vision of people
with vision impairment
Stage-1 Why conduct a functional Discussion
visual assessment?
Stage-2 Observing, interviewing and Discussion, Form to record
recording the history and instruction, functional vision
current observations of a practical, assessment
person with low vision
Stage-3 Apply the stages of normal Discussion WHO Low Vision Kit
visual development to the
context of functional vision
assessment
Stage-4 Testing the eight areas of Instruction Example of materials to
functional vision use
Stage-5 Functional vision assessment Practical Assessment form,
collection of materials
for functional vision
assessment
Stage-6 Analysing the functional vision Discussion, WHO Functional Low
assessment results for Practical, Vision Assessment
development of a training Case studies Manual
program
Stage-7 Reporting the findings of a Discussion, Assessment form
functional vision assessment Practical
and training program
To train participants to use the results of the functional vision
assessment to design an intervention program; such as the
training of visual skills
To write a functional vision assessment report.
Session plan :
Process:
Stage-1 Why conduct a functional visual assessment?
Discuss the limitations of visual acuity testing and refer to the International
Classification of Function (ICF) for the contextual factors that influence functioning
i.e. the environment and personal factors.
Stage-2 Observing, interviewing and recording the history and current

observations of a person with low vision
Outline the prerequisites of a functional assessment, to ensure that treatment

refraction and vision has been formally assessed.
Observe how the person uses vision in an informal situation, coming into the room
Provide instruction for interviewing a person with low vision
Take a history related to eyes and vision.
Ask the person or family questions such as:
When was poor vision first noticed?
Does anyone else in your family have poor vision? What is the cause?
Have you had any treatment for poor vision?
Do you have glasses or contact lenses? When should they be used?
What can you tell me about your vision?
Practical exercise.
In pairs, participants to practice interviewing each other and recording information.
Stage-3: Apply the stages of normal visual development to the context of

functional vision assessment
Revise the contents of session 12 “Normal Visual Development”. Discuss methods

to informally assess each of the stages. Introduce the process of assessment of
functional vision.
Stage-4: Testing the eight areas of functional vision
Ask participants to name and define the areas of functional vision that they are
aware of. Prompt participants if they are having difficulty. Identify and describe each
area.
1. Response to light and reflected light (accommodation)
2. Response to approaching objects (fixation)
3. Response to moving objects (track, saccade)
4. Response in visual fields
5. Response to contrast
6. Response to large, medium and small objects
7. Response to faces
8. Vision for mobility
Explain that each test should be administered to measure the functional vision of a
patient.
Demonstrate all of the tests to the class, using one of the participants wearing a low
vision simulator.
The participants should be confident that they understand all of the tests by the end
of the session.
Demonstrate the tests for the detection of light, color and contrast on a participant
wearing a low vision simulator.
Practice
Divide the participants into groups to practice each test. Each participant should
practice all of the tests. Observe the participants and help if required. Ask the
participants to write an assessment report of their test results. Provide feedback to
class - discuss the results of the tests and any difficulties experienced.
Arrange a visit to a vision clinic, or organize participants to meet with people who are
willing to participate in a functional vision assessment. With supervision, participants
to conduct a functional vision assessment with a willing client. Participants to write
the functional vision assessment report.
Stage-5: Practical functional assessment

History – include history of vision loss, vision needs – occupational and leisure,
current treatment and prognosis
Inform the participants that tests of light, color and contrast can be conducted in
various ways but we will follow the by the WHO manual. Explain to the participants
the importance of using the correct size and colorful objects. Explain any further
questions regarding light, color and contrast tests.
Visual skills used to enhance visual functioning
• Fixation
• Tracking
• Scanning
• Discrimination of objects
• Discrimination of details of objects
• Discrimination of details in pictures
• Identification and perception of patterns, numbers and words
Observation – observe patient’s gait and mobility, confidence in negotiating

obstacles, patient’s appearance and grooming
Observe how the patient functions in their usual environment. What is their visual
behavior when asked to perform tasks?
Response to direct and reflected light (accommodation)

Observe the illumination of the patient’s environment – home, school, workplace
Do environmental adjustments need to be made to reduce disability glare?
Response to approaching objects (fixation)

Ask patient to look at and fixate on objects approaching them. Does the patient
notice approaching objects without prompting? Look at accuracy and smoothness of
eye movements
Response to moving objects (track, saccade)

Assess by getting the patient to use their eyes to follow (track) objects and look from
one object to another – observe ocular motility, smoothness and accuracy in tracking
and fixating on objects
Response in visual fields
Introduce objects of various sizes, colour and contrasts into the patient’s visual field
an observe if patient is able to detect and identify them without prompting
Response to contrast
Use different colour contrasts (eg black on white, yellow on blue) to gauge patient
response and seek patient preference. Educate patient on strategies in using colour
contrasts to highlight objects and make them easier to see
Response to large, medium and small objects

Observe the patient’s response to objects of different shapes and sizes to obtain an
idea of what they can identify
Response to faces
Show pictures of familiar faces to patients and see if they can identify them by using
scanning and eccentric fixation if required
Get the patient to imitate different facial expressions
Vision for mobility

Contrast and visual fields are important measures for mobility. Observe the patient’s
mobility in familiar and unfamiliar environments. Observe the patient’s ability to
negotiate an obstacle course which may include low contrast and high contrast steps
and obstacles of various sizes and contrast.
Stage-6: Analysing the functional vision assessment results for development

of a training program – Case studies
Review vision needs of patient and results of functional vision assessment in Stage
7. Provide appropriate optical and non-optical aids based on the patient’s needs and
results of functional vision testing. Develop a plan to train the patient to use their
remaining vision to be able to function independently, focusing on:
 Stimulation of vision – awareness of remaining vision and how this can be
used
 Vision efficiency – maximizes usage of remaining vision
 Knowing when and how to use vision – modification of environment, when to
use low vision aids
Counselling on adaptive strategies and referral for further assistance may be
required eg orientation and mobility, integration aide in school.
Reduced visual acuities – best spectacle correction, high near additions, magnifiers,
telescopes, binoculars, enlarged print, CCTVs, tablets and computers with enlarged
print, voice activation and voice readers, tactile markers
Reduced contrast – direct and indirect illumination, CCTVs, tablets and computers,
use colour contrasts, tactile markers
Increased glare – hats, caps, tennis shades, reverse contrast print (white on black),
filters – wraparound sunglasses
Central scotoma – eccentric fixation training, CCTVs
Peripheral visual field loss – field expanders, scanning techniques, mobility canes,
orientation and mobility training
A combination of strategies may be required depending on the patient’s

requirements
Group work
A series of Case Studies – ARMD, RP, Glaucoma, Cornea dystrophy, Diabetic
retinopathy, Albinism, Aphakia, Childhood cataracts – is presented with the results of
functional vision assessments. The groups work together to develop individual
training programs for the cases.
Stage-7: Reporting the findings of a functional vision assessment and training

program
Develop functional vision assessment and training reporting form which contains
information about the patient’s remaining vision and environmental adjustments and
visual aids that could be made to enable the patient to function optimally in their
environment. A summary of the areas of training required to maximize remaining
vision and to improve vision efficiency and which health/rehabilitation professional is
involved should also be included. This information is to be shared with caregivers
and health care providers of the patient.
References
Brien Holden Vision Institute (2013). Using functional and residual vision to achieve
independent living. Low Vision 1. Optometry Resources.
http://education.brienholdenvision.org/en/optometry-resources/category/10-student-
notes.html
Centre for Eye Research Australia. Functional vision assessment. Low vision online.
http://www.lowvisiononline.unimelb.edu.au/Function/index.htm
Keeffe, J (1995). Assessment of Low Vision in Developing Countries. Assessment of
Functional Vision. Book 2. World Health Organization Programme for the Prevention
of Blindness and Low Vision Project International Planning Committee, Department
of Ophthalmology, University of Melbourne.
https://extranet.who.int/iris/restricted/bitstream/10665/58719/1/WHO_PBL_95.48_bo
ok2.pdf (Accessed 5 October, 2015)
World Health Organization (2013). How to use the ICF: A practical manual for using
the International Classification of Functioning, Disability and Health (ICF). Exposure
draft for comment. October 2013. Geneva: WHO
Wright D (2004). Functional Vision Assessment: What, When, Where, How! A PRCVI
Professional Development Workshop. New England Eye Institute Clinic Perkins
School for the Blind, Boston, Mass.
https://www.prcvi.org/files/workshops/FVAhandouts.pdf
Session Plan 10
Training in the use of vision, visual skills, and training in the use
of low vision devices
Time : 10 hours
Outcomes : Able to assist people with low vision to best utilize their vision.
Objectives : identify the concepts of low vision training
describe general training (learning/teaching) concepts and
strategies to motivate clients
development of visual skills training programme
demonstrate training of basic visual skills
Outcomes : Participants will be able to use, and provide training on, the
appropriate materials for people with low vision.
Session plan :

Stage-1 Factors affecting vision Discussion, Pictorial
instruction
Stage-2 Visual skills required to Instruction
perform functional tasks
Stage-3 Training on how to optimize Instruction
the function of the areas of
deficiency
Stage-4 Development of visual Discussion Training
skills training programme programme
format
Stage-5 Training of visual skills Discussion, Completed
instruction, functional
brainstorm, assessment form
small group Optical low vision
work devices
Process:
Stage-1. Factors affecting vision
Describe and discuss the concepts of vision. Discuss myths about using vision (e.g.
clarify with participants that people’s vision will not deteriorate if they use it).
Discuss why it is important for people to use vision.
People must be acquainted with how to make best use of their vision. Use of vision
can be explained using; guidance, counselling, rehabilitation, training on special tips,
techniques to perform different tasks, and environmental modification.
Discuss the features that affect how well a person can see and recognize objects:
 Familiarity
 Distance
 Size
 Details or simplicity
 Light
 Contrast
 Colour
 Mobility
 Complication
 Position
 Time given
Ask participants, how can we adapt features to enable people to make better use of
their vision?
Stage-2: Visual skills required to perform functional tasks
Describe that in order to encourage the use of vision, vital information needed about
a person with low vision is h/her:
 Visual Acuity (near and distance)
 Visual Field
 Colour Vision
 Day Vision
 Night Vision
 Contrast Sensitivity
 Illumination preferred
 Visual skills - how the person is able to use vision for a particular purpose
Define and describe the visual skills which are used to enhance functional vision:
 Awareness
 Attention
 Visual Fixation
 Peripheral Vision
 Tracking
 Scanning
 Contrast Sensitivity
Define and describe the perceptual skills used to enhance functional vision:
 Visual Identification
 Matching
 Identification (of patterns, numbers and words)
 Classification
 Colour Concept
 (Pre-reading skills and reading skills)
 Perceptual Constancy
 Discrimination (discrimination of details of the objects and pictures) and
figure-ground
 Visual Memory
 Visual Closure
 Visual Spatial Relations Perception
 Visual-motor Coordination – gross and fine motor skills
 Pre-writing skills and Writing Skills
Stage-3: Training on how to optimize the function of the areas of deficiency
With a completed functional assessment form:

participants to write down the problem the case study client demonstrated
identify the specific areas where they may face problems in daily living activities.
Based on these areas, the next course of action should be considered.
Stage-4: Development of visual skills training programme
Provide an overview for developing a visual training programme based on the

functional assessment.
Participants to identify different types of activities according to the different functional
problem and write a plan (e.g. task analysis) for teaching the activity (this may be
training in visual skills or an activity of daily living).
Skill can be improved through practice and increasing everyday use gradually.
Each group will present their activity to the class.
Stage-5: Training of visual skills
Discuss the purpose of visual skills training – write a list of aspects (e.g. attention,
visual acuity, visual field, scanning etc.). Ask participants to correctly identify aspects
which can be modified and those that cannot be changed (e.g. visual acuity).
Identify the three aspects of vision training

Encouraging use of vision (early intervention)
Visual efficiency – how vision is used, interpreting meaning of shapes, using vision in
combination with other senses
Changing the environment
Revise the key components of training programme.
Look at the results of the functional vision assessment
Identify areas – 7 areas of visual skills
Is there a particular area that stands out? E.g. Problems with areas 7 (a and c). 7a
is only outlines, so is easier, therefore train this first.
In the areas identified, what is the particular problem?
Set objectives
Start with easy to more difficult. E.g. change fixation – horizontal, vertical, diagonal.
Scanning – is general, speed or distance scanning the problem?
Set a clear objective
Select activities
Age-appropriate
Related to tasks person needs to learn
Training
Set time limits
Relate training to objectives. You may want to break the long term objective into
shorter term ones.
Evaluation
Assess the results of your programme. Decide how and how often to assess results.
Provide an overview of intervention for training visual skills
General principles (e.g. simple to complex)
Four stages of training (touch, touch and vision, vision confirmed by touch, vision
only)
Activity and environmental hints for increasing attention and motivation
Brainstorm.
Brainstorm with the participants a sequence of simple activities for one of the skill
areas (e.g. attention and awareness), using the sequence outlined (four stages).
Group work.
In small groups, discuss the functional assessment results of two children or case
studies with low vision. Provide the group with completed functional assessment
forms. Provide each group a selection of primary school books and/or other relevant
materials to assist in identifying useful training activities. Participants to:
Choose two different areas of difficulty for vision training
Set objectives
Select activities in a good sequence for each area on a flipchart. Relate activities to
what the child does and how she lives e.g. classroom, ADL, farm work. Include one
children’s game
Set a time limit for the training and details of evaluation.
Discuss each flipchart

Is the problem correctly identified?
Is the sequence of activities correct?
Are the activities appropriate?
Low vision devices: Divide participants into groups. Ask each group to examine a
case study of someone with low vision using the completed assessment forms.
Participants to:
Determine what type of optical low vision device the case-study would need, and
what prescription.
Determine what type of non-optical materials would be needed after providing
information on light, colour and contrast vision.
Provide a rationale for these decisions. In order to determine the best materials for
someone, a person’s age, profession and condition are important factors to take into
account. For instance, age, and if a person is in school are important factors for
determining the approach for education. If the client is involved in a job, the nature of
the work should be a major factor in determining the appropriate materials.
Session Plan 11
Counselling
Time : 4 hours
Outcomes : Ability to the use of basic counselling skills
Objectives : List the characteristics of teachers who effectively use
counselling skills
Articulate the benefits of using counselling skills
Understand the concepts of counselling and techniques
Session Plan :

Stage-1 Characteristics of teacher / Discussion,
counsellor group work
Stage-2 Benefits of using counselling Instruction
skills
Stage-3 Counselling techniques Discussion,
group work
Process:
Stage-1: Characteristics of teacher / counsellor
Ask participants to list down the characteristic of an effective teacher and share
these with the group. Discuss the key traits of an effective teacher that are;
Friendly and understanding
Organized
Personable
Generous in their appraisal of others
Child-centered in their educational approach
Positive about students
Fair
Emotionally adjusted
And students are successful when they have effective teachers
The combination of these characteristics results in quality education and impacts on

the quality of life of people with LV. The teacher/counselor:
is trained in interpersonal skills and models them for students.
understands the basics of helping skills and applies them in the classroom.
is attentive, genuine, understanding, respectful, and knowledgeable of culture.
assists students with self-exploration
assists students with understanding problems and making a commitment to change
assists students with taking action to alleviate problems
Above all, the teacher/counselor listens and helps without controlling or judging.
Stage-2: Benefits of using counselling skills
Ask participants to list down the benefits of counselling and share these with the
group.
Discuss the reasons; why people with LV need counselling. Often, clients have
encountered distressing or stressful experiences or situations which they'd like to talk
about and get some advice to cope with it. In addition to help with specific goals or
difficulties, clients who undertake counselling may experience general improvements
in quality of life, including:
increased self-esteem
decreased defensiveness
increased ability to express themselves
improved relationships with other people.
Stage-3: Counselling techniques
Discuss the basic techniques of counseling by learning which a teacher can become
an effective counselor as well.
Getting the environment right: create a space to talk which is private and quiet and
where you know you will be free from interruptions (always seek the advice of a
colleague about the safety and appropriateness of this action). Where possible,
make sure the seating is comfortable. Get the message across that you have time to
attend to the issue that you want to address.
Getting the listening right: One way of encouraging a person with low vision is to
make sure that they know you are listening. You can do this by just being attentive
that you are listening. Try not to interrupt when the child/young person with LV is
talking. By occasionally saying "yes" or "aha" the child/young person should be
encouraged to open up. Make sure you look and sound calm, unhurried and caring.
Asking the right questions: Try to ask more open questions than closed questions.
An open question is one which cannot be answered with yes or no and which
encourages a more detailed answer, for example:
“What are your feelings about this?”
“What are the advantages of doing things the way you have suggested?”
“What are the disadvantages?”
Avoid closed questions such as:
“Are you sad?”
“Are you managing your work?”
Another disadvantage of closed questioning is that the desired answer might be
implied within the question and you might inadvertently steer the person with LV to
give an answer that they wouldn’t otherwise have given. An example of this would
be:
“Are you going to stop speaking to that boy who has been upsetting you?”
The implied expected answer here is quite clearly “yes”.
Being affirming: To encourage the flow of conversation it is important that you show
respect by taking an accepting attitude. The message you are trying to get across is
"I have respect for your opinions and your view of the world at this present time".
This is not the same as saying that you agree with the child’s opinions or actions and
it is okay for you to make it clear that your opinions and moral view are different, as
long as this is done in a respectful way.
Carer
Limiting the advice: Try to limit the direct advice that you give during your
conversation. This is more important for older than for younger children who clearly
need more guidance. This is especially the case at the beginning of a problem-
solving conversation. For example, it is usually better to start with "What do you
think is the best thing for you to do next?" than to say, "What you should do next
is..."
References
Session Plan 12
Pediatric Low Vision Care

Time : 26 hours
Outcome : At the end of the session participants will have a broader
understanding of the various needs of a child with vision
impairment and the clinical expertise to perform a low vision
assessment and recommend appropriate management
Objectives : After the successful completion of this session, participants will
be able to:
describe visual development and how it relates to the overall
growth of a child
assess the visual functions of pre-verbal, verbal and school
aged children using appropriate assessment techniques and
tools
prescribe and train in the use of optical and non-optical low
vision devices according to the child’s needs
list sequence of activities as appropriate to develop each of the
seven visual skills
advise the parents, teachers and caretakers on environment,
learning medium and education
Session Plan :
Stage-1 Normal visual 2 hr. Brainstorm, individual Audio-visual
development exercise, instruction, materials
discussion
Stage-2 Clinical assessment in 4 hr. Instruction and Access to a low
children practical vision clinic
demonstration
Stage-3 Prescription 2 hr. Instruction and Access to a low
practical vision clinic
demonstration
Stage-4 Early intervention and 2 hr. Discussion, Access to an early
training of visual skills instruction, intervention facility
brainstorm, small
group work
Stage-5 Advice and 2 hr. Discussion,
counselling instruction,
brainstorm, small
group work
Stage-6 Clinical Practice 14 hr. Clinical assessment Assessment
with a child, class materials. Arrange
discussion & feedback class visits
Process:
Stage-1: Normal visual development and functional vision assessment
Use visual development exercise. Ask participants to fill match visual responses and
skills to age groups using their own experiences and observations. E.g. Name the
age at which you would typically expect a child to start to: 1) follow moving objects
and lights, 2) watch movements and scribbling, 3) match geometric forms, 4) fit
objects together, 5) reach towards objects, 6) play looking games, 7) imitate facial
expressions
Provide participants with a handout of normal visual development skills and ages
adapted from Barraga “development of efficiency in visual functioning. Rationale for
a comprehensive program”. (available Low Vision Online). Participants to compare
their responses to the handout.
Describe that functional vision assessment and training is based on a comparison of

normal visual functioning to the functional level that a person who is vision impaired
achieves.
With the participants, relate the normal visual skills to the visual skills assessed in
the functional assessment:
near and distance visual acuity: Fixation 1-2
follows slow moving objects: Tracking 0-1
awareness of outlines of familiar objects, simple pictures: Awareness 2-4
fixates on mothers face: Fixation 0-1
walks around freely in own environment and similar places: Mobility 2-4
inspects objects with eyes only: Fixation / focus 1-2
moves eyes to search and explore visually: Scanning 0-1
response to light: Awareness 0-1
identifies actions, objects in complex pictures: Awareness 5-7
glances at small objects of 2cm : Attention 0-1
copies symbols, starts writing; Attention 5-7
follows rapidly moving objects in all directions: Tracking 1-2
Brainstorm problems of a blind/low vision young child. Highlight main areas, e.g.: no
imitation, eating, concepts, body image, movement, dressing, washing, latrine,
playing, use of senses like hearing, smell, taste; use of residual vision;
communication, language; social skills.
Teach students to perform a functional vision assessment.
Stage-2: Clinical assessment in children
List the 7 visual skills included in a functional assessment
Visual functions – ask the class what can you assess? Discuss the relevance of
these visual skills to children and come to a consensus of whether they are
applicable at each age range: near, distance, field, colour, contrast, fixation, tracking,
scanning, mobility etc.
Small group exercise.

Participants to work in small groups. Review normal visual skills for age. Groups to
write on flipchart practical ways of assessing the following for a child (1, 2 or 3 year
old):
Visual acuity – preverbal using preferential looking test, verbal using matching and
pointing tests, and school aged using LogMar charts, near vision and reading vision
charts
Specialized techniques for refracting children with low vision
Visual field – including confrontation, static and dynamic perimetry using visual fields
testing software, hand held perimeter
Colour perception – using D-15 and matching colour
Contrast sensitivity – using Hiding Heidi, contrast sensitivity function software
Binocular vision – using Lang stereo test and other standard stereo tests
Light adaptation – using Cone adaptation test
Provide feedback to whole class.
Describe suggestions of activities to assess vision in children (see "Assessment of
Low Vision in Developing Countries" in the Low Vision Kit). Emphasize:
the use of every day materials,
choosing good assessment materials and backgrounds
Age-relevant activities
Stage-3: Prescription for children
Discuss the purpose of prescribing optical and non-optical devices and interventions
for children. Ask participants to name and correctly identify a variety of optical and
non-optical low vision devices and their uses.
Describe the prescription process and applications, and train in the use of various
low vision devices, egonomics and adaptive technology:
Magnifiers – stand and hand-held
Telescopes
Electronic devices including CCTVs
Adaptive devices - including reading stands, typoscopes, writing guides
Ergonomics – lighting, colour and contrast
Demonstrate the use and limitations of the various low vision and adaptive devices
mentioned above in a child’s education, recreation and daily living skills.
Develop a training and follow-up programme for children with low vision for
developing their skills in using the above mentioned low vision and adaptive devices.
Stage-4: Early intervention and training of visual skills
Discuss the purpose of visual skills training – write a list of aspects on the board (e.g.
attention, visual acuity, visual field, scanning etc.). Ask participants to correctly
identify aspects which can be modified and those that cannot be changed (e.g. visual
acuity).
Identify the three aspects of vision training

Encouraging use of vision (early intervention)
Visual efficiency – how vision is used, interpreting meaning of shapes, using vision in
combination with other senses
Changing the environment
Provide an overview for developing a visual training program based on the functional
assessment
Look at the results of the functional vision assessment
Identify areas – 7 areas of visual skills
Set objectives
Select activities
Training
Evaluation
Provide an overview of intervention for training visual skills

General principles (e.g. simple to complex)
Four stages of training (touch, touch and vision, vision confirmed by touch, vision
only)
Activity and environmental hints for increasing attention and motivation
Brainstorm
Brainstorm with the class a sequence of simple activities for one of the skill areas
(e.g. attention and awareness), using the sequence outlined (four stages).
Group work
In small groups, discuss the functional assessment results of 2 children or case
studies with low vision. Provide the group with completed functional assessment
forms. Provide each group a selection of primary school books and/or other relevant
materials to assist in identifying useful training activities.
Provide a list of activities for young children to practice to encourage the use of
vision
Stage-5: Advice and counseling
Participants to learn to advise and counsel parents, teachers, children and other
professional colleagues on the prognosis, treatment options, low vision
management, referrals to other service providers and consumer/support groups.
Participants should also be able to advise on the appropriate educational needs
(including school examinations) and suitable learning medium e.g. visual, tactile or
mixed, orientation and mobility training needs, psycho-social counseling, access to
social welfare and other statutory bodies, participate in a multi-disciplinary team to
develop a plan for rehabilitation, and write referral letters.
Stage-6: Clinical Practice

Participants to first observe a full clinical and functional vision assessment routine in
at least 5 pre-verbal, verbal and school aged children with various causes and
severity of low vision; then to participate in supervised clinical and functional
assessments of at least 5 children with low vision, leading to skills to conduct and
perform a low vision and functional assessment independently.
Where possible, participants should have the opportunity to observe and assess
children with:
Aphakia
Albinism
Nystagmus
Optic Atrophy
Retinal dystrophy
Participants to learn how to communicate the assessment findings and the plan for
intervention to the parents, teachers, children and other professional colleagues.
Following their assessments provide feedback to participants as a whole group

Correct any mistakes. Let participants check each other’s way of assessment,
documentation and communication.
Reference
This lesson plan was extracted from

Van Dijk, K., Keeffe, J., & Nottle, H. Low Vision Training Manual: for use in
developing countries. Melbourne: Centre for Eye Research Australia
Session Plan 13
Accessibility
Time : 2 hours
Outcomes : Understanding of adaptive daily living skills and practical
techniques for training people with low vision. Knowledge on
how to adapt an environment to promote independence.
Objectives : aware of the impact of low vision on activities of daily living;
able to train a person with low vision in adaptive daily living skill
techniques;
aware of modifications that can be made to the environment
and building design to assist people with low vision.
Session Plan :

Stage-1 Independence and low Practical Low vision folds,
vision exercise, bowls, cups, food,
discussion drink, utensils
Stage-2 Evaluating Practical
independence / ADL skills exercise,
discussion,
Stage-3 Teaching and learning Instruction,
strategies practical exercise
Stage-4 Training techniques in Instruction, Clothes, coins,
adaptive living demonstration, food,
practical exercise
Stage-5 Physical access and Instruction, group Photographs or
environmental work community visit
modifications
Process:
Stage-1: Independence / activities of daily living and low vision:
Discuss the concept of independence taking into the consideration of “Culture for All”
and activities of daily life.
Practical demonstration
Have participants attempt to complete some daily living tasks using low vision
goggles. For example: eating a meal, pouring a drink.
Discuss the activity with the group. Ask the participants questions about:
Was the task difficult?
What effect can low vision have on independence?
What difficulties may exist with different eye conditions and types of vision loss (e.g.
peripheral, central vision loss, glare)?
What other factors may impact upon performance? For example age, habit,
motivation, co-existing disabilities, cognitive impairment/ memory.
Stage-2: Evaluating independence / adaptive skills
Describe how to obtain information about the person’s independence / safety

1) Interviewing
Obtain a client history – find out about the client’s meaningful activities, social
support, financial situation, access to services, age/developmental stage.
Determine activities where they currently experience difficulty or cannot participate
in, but want to. Discuss different attitudes (e.g. some people may be satisfied with
receiving assistance from other people, whilst others may want to do most things for
themselves).
2) Observation of tasks – observe areas of difficulty, safety precautions.
Stage-3:Teaching and Learning concepts
Describe concepts of learning and training skills

Task analysis – breaking the skill down into small steps
Chaining – forward chaining: teaching the skill from beginning to end; and backward
chaining: teaching the skill from the last step to the first step
Removing assistance when the client is learning – reducing the physical or verbal
assistance, reducing visual, verbal or situational cues, increasing the complexity of
the task (e.g. reduce the size of the objects)
Motivating the client to continue practice – reinforcement (what is motivating to the
client e.g. colour, sound, reward, completion of the task), meaningful activity, learning
in context, practicing in the environment.
Stage-4: Adaptive living techniques:
To promote independent living in people with low vision some basic factors should be
considered and implemented. Describe and demonstrate key strategies and
techniques to facilitate independence:
Routine activities: e.g. eating, identifying and accessing money, signing name, using
telephone, accessing and recoding information,
Educational activities: e.g. learning concepts, recording work
Employment activities: e.g. needlework, farm work, desk work
Domestic activities: e.g. laundering clothes, cooking, cutting, serving, organizing
cupboards, using appliances
Recreational activities: e.g. modifying rules games, sports, watching TV.
Self and health care activities: e.g. choosing clothes, applying makeup, shaving,
identifying medicines
Outdoor activities: e.g. gardening, transport or mobility.
Practical demonstration.
In pairs, participants practice implementing the adaptive daily living training
techniques by teaching each othere.g. folding clothes, serving rice, selecting the
correct money for payment, selecting a particular object from several objects.
Stage-5:Physical access and environmental modifications
Discuss the essential elements of physical access. It is pleasant and easy to move
around in an accessible environment. Physical access means accessible parking
spots, level passageways, large enough elevators and toilets and comfortable rest
places. Works of art and other objects, as well as texts, are placed so they can be
looked at from different heights. There are places for wheelchairs in halls with
audience seating, and chairs are available in exhibition halls. Emergency plans take
account of visually impaired, wheelchair users and others.
Small changes that make a big difference: minor improvements can be done without
delay: remove thresholds; add seats, handrails and mini ramps, high contrast signs,
etc
Review the concepts of environmental facilitators for low vision:

Bigger (e.g. large print signs)
Brighter or reduce glare (use of general lighting or daylight and task lighting)
Bolder and contrast (e.g. contrasted coloured door frames to identify where the door
is)
Simplified layout (e.g. uncluttered environment, clear pathways)
Use of tactile or audio features (e.g. door mat at front door, personal assistance).
Group work.
In groups, have participants to describe and assess the following of a building:
The facilitators that are present in the building (interior and exterior) for people with
low vision considering the five factors above.
Environmental barriers of the building that reduce access for people with low vision
Make recommendations for improving the design, layout or features of the building.
Session Plan 14
Models of low vision care
Time : 2 hours
Outcomes : An understanding of different models of low vision care
Objectives : aware of the elements and objectives of a low vision program
Know effective resource and human resource strategies
required to implement a low vision service
Be able to develop a model for a low vision service and
recommend short and long term actions
Session Plan :

Stage-1 Inclusion/ exclusion of low Instruction Journal articles/
vision reference books
Stage-2 Essential elements of a low Brainstorm

vision program
Stage-3 Models of Low Vision Community

Service consultation &
group
assignment
Process:
Stage-1: Inclusion / exclusion of low vision in Community Based Rehabilitation

(CBR) programs
Describe the disadvantages of non-inclusion of low vision in traditional CBR

programs
techniques used by CBR workers are geared towards non-sighted methods
training in low vision is inadequate to offer effective services to low vision clients.
children with visual impairment usually do not fall under the responsibility of CBR
workers and their education is primarily seen as the responsibility of specialist or
itinerant teachers
Describe the potential effects of adding low vision services (refer to Yasmin & Minto,
2007)
children with low vision could re-enter mainstream education
interventions to create an enabling environment and motivate the teachers and the
families for the education of these children
provision of basic materials CBR workers can play an effective role in rehabilitation
of persons with low vision in general and children in particular.
Stage-2: Elements of a Low Vision Program
For tertiary, secondary, primary levels of low vision care and community
rehabilitation, brainstorm with the class:
objectives of a low vision program
personnel involved
roles and functions of personnel (including teachers)
For example, case finding and referral, assessment, advocacy, provision of basic
needs, skills training, medical services, equipment provision, monitoring, eye health
education, health promotion, early intervention and visual stimulation, employment,
welfare
equipment required
personnel training/ human resource requirements
Stage-3: Models of low vision service
Participants to conduct a community survey/ field visit to determine the needs of the
local community and assess how people with low vision are identified, assessed and
provided with intervention or training in the local area. Participants are to propose
the implementation of a low vision model in their local area, identifying the roles of
personnel, training, referral procedures and services provided to people with low
vision.
Participants to make recommendations for plan of action

Short term
Medium Term
Long Term
Reference
Yasmin, S. & Minto, H. (2007). Development of CBR Services for Children with Low
Vision. The Educator, 20 (1), 34-41.
Session Plan 15
Research in low vision
Time : 3 hours
Outcome : At the end of the session participants will have a better
understanding of the research needs for a low vision
programme
Objectives : After the successful completion of this session, participants will:
Be aware of the need for baseline data for a low vision
programme
Be aware of research to determine whether the programme is
achieving its objectives
Be aware of the need for an evidence base to inform
interventions
Session Plan :

Stage-1 Baseline data for a low 1 hr.
vision programme
Stage-2 Research to determine 1 hr.

whether the programme is
achieving its objectives
Stage-3 Need for an evidence base 1 hr.

to inform interventions
Process:
Stage-1: Baseline data for a low vision programme
Participants to learn to interpret situation analysis data and to establish a baseline of

low vision statistics that would be used for a low vision programme. Practical
examples of use of baseline data at a hospital, district and national levels to be used
for explaining importance of baselines. Examples of research options can include
surveys, quantitative and qualitative data, clinical research etc.
Stage-2: Research to determine whether the programme is achieving its

objectives
Participants should be aware that research can also be undertaken to determine the
overall progress of a low vision programme e.g. if there is a programme being run at
national level or even at district level. Use examples of action research, operational
research to help participants understand research implications for programmes.
Stage-3: Need for an evidence base to inform interventions
A sound evidence base is required to convince professionals and policy makers and
in advocacy work. Explain to the participants how building an evidence base will help
in maintaining the quality of services, determining the impact of interventions and the
changes in quality of life of the affected individuals. Institutional collaboration for
research can be achieved through clinical eye departments, special education
departments, universities, field studies etc.

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Low Vision

11. Counselling 4 hours

12. Pediatric Low Vision Care 26 hours

13. Accessibility 2 hours

Total duration: 120 hours

Introduction to the Course and Low Vision

Stage Content Method Material

Stage-3 Assess expectations Discussion

Stage-4 Develop an understanding of Practical Materials for low

Introduction of course leader.

Stage-2: Course Objectives

Stage-3: Assess expectations

Stage-4: Develop an understanding of low vision through simulation

Global, national and local policies

Stage Content Method Material

Stage-1: Global programs and policies

Share the global programs and policies with the participants

Outline national welfare schemes, education support, employment opportunities,

Discuss the roles and activities of disabled peoples’ organisations.

Stage-3: Preparing submissions and applications

International Council for Education of People with Visual Impairment:

Objectives : Understand the definitions and classification of visual

Stage Content Method Material

Stage-2 Definitions and Instruction, WHO website

Stage-1: Describe and compare the ICD-10 and ICF

Describe and explain the epidemiological and functional definitions of visual

Stage-2: Definitions and classification of visual impairment, low vision and

Stage-3: Global epidemiology of visual impairment

Explain the differences between avoidable, preventable and treatable causes of

Discuss the following standard references:

Stage-4: National epidemiology of visual impairment

Stage-5: Sources of epidemiological data and their limitations

Discuss the following:

Sources of data need to be critically reviewed to establish if the data is truly

Causes and implications of visual impairment and prevention

Stage Content Method Material

Stage-1: Common causes of visual impairment in children

Stage-2: Common causes of visual impairment in adults

Stage 1 & 2 Group work.

Stage-3: Signs and symptoms of common causes of visual impairment

Age related macular degeneration (ARMD)

Stage-4: Implications of the common causes of visual impairment on parts of

Corneal disease – symptoms of decreased visual acuities, increased glare, haloes

Iris disease – symptoms of increased glare

Peripheral retinal disease - symptoms of loss of peripheral visual field ie tunnel

Stage-5: Treatment and prevention

Psychosocial Impact of Low Vision

Stage Content Method Material

Stage-2 Awareness of psychosocial Instruction DSM-IV (book,

Stage-3 Intervention strategies to Discussion and Intervention

Stage-4 Case study Group work Case scenarios

Stage-1: Social and emotional development and effects of low vision

Describe current knowledge regarding the psychosocial impact of low vision

Social impact of vision impairment:

Potential psychosocial impact of low vision:

Stage-2: Awareness of psychosocial problems and psychological disorders

Instruct the class regarding identification and assessment of psychosocial disorders:

Social skills deficits

Discuss ways to assess social skills

Describe interventions to promote healthy psychosocial development.

Building social competence:

Teaching social skills:

Strategies to increase interaction between peers

Strategies to deal with stress: