Esmail Hareem, Arblaster Gemma, Haslam Laura
Orthoptic Department, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
School of Allied Health Professions, Nursing and Midwifery, Faculty of Health, University of Sheffield, UK.
Br Ir Orthopt J. 2024 Mar 27;20(1):94-104. doi: 10.22599/bioj.324. eCollection 2024.
Children with learning difficulties that require a vision assessment may not be able to perform standard clinical vision tests, for example, Forced Choice Preferential Looking (FCPL). There is a lack of standardisation on the procedure of vision assessment in this group of children. The aim of this literature review was to identify and evaluate methods of vision assessment when standard clinical vision tests are not possible in children with severe learning difficulties.
Three databases (CINAHL, PubMed, Web of Science) were searched from inception to Nov 2022 for methods of vision assessment in children with learning difficulties. Reference lists and grey literature were also searched. The McMaster University Critical review form for quantitative studies was used to assess the methodological quality of the primary studies identified.
Five-hundred and seventy one papers were identified from databases and 16 were identified from searching reference lists and grey literature. Of the 587, five studies were relevant and fulfilled all the inclusion and exclusion criteria. Three methods of vision assessment were identified: Visually Evoked Potentials (VEP), questionnaires, and the Bradford visual function box (BVFB).
The VEP method was validated and reliable, although it had a similar success rate to the standardised FCPL tests in children with learning difficulties. The BVFB was a standardised method for measurement of vision threshold in children that cannot successfully complete FCPL tests, however it has not been validated. Questionnaires are an efficient way to gather descriptive information on the child's functional vision, however no guidance on the interpretation of the information is available. The BVFB and questionnaires require further development and validation. All three methods (VEP, questionnaires, and BVFB) can be useful as part of the assessment of vision in a child with severe learning difficulties where standard clinical tests are not possible, when used in a standardised manner.
需要进行视力评估的学习困难儿童可能无法完成标准的临床视力测试，例如强制选择优先注视（FCPL）测试。这组儿童的视力评估程序缺乏标准化。本综述的目的是确定和评估在重度学习困难儿童无法进行标准临床视力测试时的视力评估方法。
检索了三个数据库（CINAHL、PubMed、Web of Science），从建库至2022年11月，查找学习困难儿童的视力评估方法。还检索了参考文献列表和灰色文献。使用麦克马斯特大学定量研究的批判性评价表来评估所确定的原始研究的方法学质量。
从数据库中识别出571篇论文，从参考文献列表和灰色文献搜索中识别出16篇。在这587篇论文中，有5项研究相关且符合所有纳入和排除标准。确定了三种视力评估方法：视觉诱发电位（VEP）、问卷和布拉德福德视觉功能箱（BVFB）。
VEP方法经过验证且可靠，尽管在学习困难儿童中其成功率与标准化的FCPL测试相似。BVFB是一种用于无法成功完成FCPL测试的儿童视力阈值测量的标准化方法，然而它尚未经过验证。问卷是收集有关儿童功能性视力描述性信息的有效方法，但是对于该信息的解释没有可用的指导。BVFB和问卷需要进一步开发和验证。当以标准化方式使用时，所有这三种方法（VEP、问卷和BVFB）作为无法进行标准临床测试的重度学习困难儿童视力评估的一部分可能会很有用。
