Swetha Sara Philip1. 1. Department of Ophthalmology, The Cerebral Visual Impairment Clinic, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Sir,I read with interest the article titled, “visual function of children with visual and other disabilities in Oman: A case series” by Gogri et al.[1] The authors have not defined what they mean by visual function. It is already well accepted in literature that vision is not only just “visual acuity” but also how a person interprets his surroundings.[2] Visual function not only involves neurophthalmological assessment such as strabismus, nystagmus, and saccades but also higher visual function assessments such as visual field, visual attention, visual search, visual task performance, and visual recognition and orientation.[3] This information seems to be missing in the article. The article is a bit confusing as the topic is on visual function in children with special needs, but the article is mainly emphasizing on refractive error and low vision aids. In the abstract, the authors have mentioned that this paper presents the different methods of assessing visual function, outcomes and interventions. However, there is no mention of the outcomes of the interventions carried out except to state in the methodology section that glasses and low vision were prescribed and outcomes discussed with institution in-charge and timely follow-up recommended. In the result section of the article, the age group mentioned is 3–8 years (mean age 8.7 years), however, in the abstract, the age group studied is 3–18 years. Likewise, the numbers in Group 4 need some clarification. Assessing visual function in children with other disabilities like cerebral palsy cannot be limited to the tests mentioned in this article as many of these children can have a cerebral visual impairment (CVI).CVI is emerging as the commonest cause of visual impairment in children both in the first and third world countries.[4] This condition due to its varied clinical presentation often goes unnoticed.[5] To assess CVI, it is important for pediatric ophthalmologist and optometrist to undergo specialized training. A proper assessment and management can give a much fuller life to these children.