Implications of deafblindness on visual assessment procedures: considerations for audiologists, ophthalmologists, and interpreters.

Visual assessment of deaf persons presents a challenge to the ophthalmologist and the optometrist. At the time they want to measure visual function, the interpreter uses visual communication, competing for the patient's attention. Important rules of good assessment of visual functioning include taking turns and giving the interpreter sufficient time to convey the questions related to each test. This has implications for audiologists working with this population as well. Communication should be tailored to the varying needs of people who may have long-standing deafness and good sign language, may have lost their hearing at an advanced age and have limited or no sign language, or may be young persons or children who have congenital or progressive loss of hearing combined with congenital or progressive vision loss. Individuals with sudden hearing and vision loss, as well as those with intellectual disabilities and limited language, are particularly challenging groups for the assessment of vision and require special communication skills for ophthalmologists and audiologists. The ophthalmologist usually knows the nature of vision changes typical of disorders that the patient has. For the clinical follow-up of a condition, a few measurements are usually taken. For a comprehensive assessment of visual functioning for rehabilitation and education, many more measurements, observations, and questions are needed so that vision for communication, orientation in the environment, and performance of near-vision tasks can be reported and the effects of the environment can be evaluated. Testing should cover ocular disorders and vision loss caused by brain damage.