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Home/Just Jess/Autism/WHAT DOES JESSICA SEE?

WHAT DOES JESSICA SEE?

Over the years, I have been asked what Jessica can see. That is a really difficult question to answer for two reasons. First of all, Jessica is not able to explain it to us. Secondly, her cortical vision impairment stems from congenital cortical brain damage rather than from her eyes.

Missing Brain Tissue - Cortical vision impairment

Cortical Vision Impairment

For Jessica, there is a disruption in the nerve pathways that typically go from the eyes to the part of the brain that interprets what is being seen. This type of vision loss is called cortical vision impairment.

REPRESENTATION OF VISUAL PATHWAY
TYPICAL PATHWAY
Jessica's Visual Pathway is disrupted by damaged and missing brain tissue.
JESSICA’S PATHWAY

Although she can see through her left eye, how her brain interprets what she sees is not  known. Her right eye may have some light perception, but that may be all.

As a young adult, the best description of Jessica’s vision came from an evaluation done when she entered high school. A team conducted a Functional Vision and Media Assessment within the school setting. Using an eye doctor’s report as a starting point, they tested her in her familiar environment at the school and ultimately the process culminated into an excellent report.

DIAGNOSES FROM DOCTOR REPORT INCLUDED:

No Light Perception in Right Eye – No light perception is considered total visual impairment, or total blindness

Nystagmus – A vision condition in which the eyes make repetitive, uncontrolled movements, often resulting in reduced vision. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern. As a result, both eyes are unable to old steady on objects being viewed.

Prom 16, Cottage friend and roommate Latoria
Tilting head back to see better

Nystagmus may be accompanied by unusual head positions and head nodding in an attempt to compensate for the condition.

Hyperopia – Farsightedness. A vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus.

Large Alternating Esophoria – is a condition characterized by inward deviation of the eye, usually due to extra-ocular muscle imbalance.
IMG_3709IMG_3710

IMG_6526IMG_6528

Information from the Functional Vision Assessment

MUSCLE BALANCE

(affects attention, effort to maintain focus and fatigue) – IMG_1755IMG_1758Large alternating esophoria is the tendency of the eyes to turn inward and then back again. This makes objects appear smaller than they are so the child must move the object close to make it larger. Convergence, simultaneous inward movement of eyes toward each other, is not possible when the eyes have significantly different acuities. Jessica tracks with head movement and eyes simultaneously once she becomes aware of the object

PERIPHERAL FIELDS

(The amount of visual information obtained which can result in misjudgments and restrictions of movement) Vertical Visual FieldJessica appears to have visual field limitations. Severe field limitation on the right and minimal attending on the left – about 30 degrees when presented horizontally. Best field – lower quadrant.

COLOR DISCRIMINATION

Jessica was able to see and name colors and was able to match colors during a vocational and recreational activity.

NEAR ACUITY AND DISCRIMINATION

(affects ability to read and distinguish objects at near and intermediate ranges) – The following objects were recognized:

From a distance of 20 inches sugar packets (presented in lower quadrant)
From a distance of 30 inches 3″ black letters on a wall
From a distance of 6 inches 2″ black letters (dark blue on light blue)
From a distance of 5 inches 1″ letters (black on gray)
From a distance of 36 inches 4 inch salt and pepper shakers
From a distance of 20 inches scissors
From a distance of 5 feet 0.5 inch black letters (E’s in the word December) and numbers on a calendar 
From a distance of 5-6 feet 1 inch letters (word ‘boy’) at eye level, black on gray
From a distance of 3-5 feet the women’s restroom sign

PRINT FUNCTIONING

Jessica can read upper case block letters but did not recognize letters in lower case or in mixed fonts. When presented with different words in block print, all caps, spaced ¼” apart, she could read 18-24 pt type without error. Jessica could read cards presented on the desk, but usually picked up the card, named the letters, then said the word. After reading several words individually, she could read them in a 3 or 5 word sentence (while placed on the desk.)

  • Crowding greatly reduced success.
  • Inferior lighting and contrast also reduced success when Jess was attempting to locate items in the vending machine.

DISTANCE VISION

(affects ability to read and distinguish objects at distances of 20 feet) – The  following were recognized to name:

From 20 feet school bus
From 25 feet 5 foot Christmas tree with lights
From 10 feet 1 foot tall letters on a wall banner
From 10 feet 13″ red letters outlined in black
From 10 feet people
Jess could visually locatesigns, doorways, objects even when she was unable to read what it said.

Functional Vision Variances

This functional vision evaluation report, with seemingly random items Jess was reported to have seen, represents the difficulty in identifying her visual capabilities. It is not uncommon to see such varying abilities in someone with a cortical vision impairment.

Currently, we continue to experience variances in visual abilities that leave us shaking our heads some days. Recently, she came into our small kitchen, talked with me for more than just a few minutes, and never saw that someone else was in the kitchen sitting at the table. Then, a few days ago, as we were driving down the road, she spontaneously asked a question about a red car that had just driven past us going in the other direction. That kind of moment still just leaves me shaking my head in wonder.

Edit – This post did not originally include an important reference to the results of Jessica’s Visual Evoked Potential (a test that measures electrical activity in the vision system) that was performed at the age of 12 months. The report stated “Measurable responses to flash stimulation were absent.” A second Visual Evoked Potential performed 5 years later demonstrated the same results due to Jessica’s cortical vision impairment. 

…

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February 19, 2017 By Val 10 Comments

Filed Under: Autism, Blindness, Blog Post, FAQ Tagged With: Cortical Vision Impairment, Esophoria, Hydrocephalus, Hyperopia, No Light Perception, Nystagmus, Ventriculoperitoneal Shunt, Visual Acuity

Reader Interactions

Comments

  1. Cami

    October 5, 2022 at 8:29 pm

    I have nystagmus myself and low vision, so I can somewhat relate to Jess. I also have autism and other health issues.

    Reply
  2. Anja

    July 21, 2021 at 7:32 am

    Wow, that is not for “normal” people, there is some smart doctors behind all these tests. My sisters son is autistisk and such a warm and caring soul. Thank you for sharing. Wish you are you family all the best ♥️

    Reply
  3. BevErly

    June 25, 2021 at 11:28 am

    Jess is my hero! Ive struggled with autism all my life. As a child I was undiagnosed . I was bullied and called the R word daily. I was told I was weird , different , stupid. BUT God is good! Where I was lacking in someways , I excelled in others. My love for nursing. It was easy for me to comprehend complex medical information.
    I studied SO HARD! it took me longer but I graduated from nursing college. Woohoo!! Tested I actually have a high IQ. Authism sucks! Some days I can’t stop fixating on things. It plays over in my head until I get upset.
    Ive learned to dustract myself with music when a thought gets stuck in my head , I put my headphones on and it helps.
    I think Jess is a lot like me! She’s a true nurse at heart! And Jess is very intelligent!
    I watched her zip through her Braille medical word cards! And I knew!! Jess is a nurse like me! We make great nurses because we are blessed ! I don’t tell people about my authism
    They don’t understand how I can Excell in one area . I struggle with my vision . I wear glasses and they help some. I just love Jess ! She’s my sister I never had before! She inspired me .

    Reply
  4. Pamel Williams

    February 11, 2021 at 11:55 pm

    You good Jess you Mum make day Thankyou

    Reply
  5. Sylvia

    February 9, 2021 at 7:04 pm

    Thank you for all the info!

    Reply
  6. Emily. Little

    January 24, 2021 at 10:03 pm

    Love your beautiful Daughter, she inspired all of us♥️

    Reply
  7. Maureen Mooney

    November 13, 2020 at 2:26 pm

    I wish you love and much happiness.

    Reply
    • Nilaburch

      February 11, 2021 at 6:43 pm

      Jess is so smart so glade she has a great mom who takes care of her

      Reply
  8. Melissa

    November 6, 2020 at 9:06 pm

    Thank you for sharing all of this with the world. I’m sure you are blessing other parents and families by sharing yours and Jess’ story. I’m not sure how I come across you all on fb but I find myself thinking of you all ever since and praying for you and Jess. Much love and prayers. ?❤️

    Reply
    • Val

      November 6, 2020 at 9:16 pm

      Thank you!

      Reply

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