GR1010647B - Depiction system of the visual function parameters of non-speaking children - Google Patents

Abstract

The invention relates to a system meant to depict parameters of the visual function of non-speaking children via tools, with the aim of depicting visual-reflective, sensory, oculomotor and visual-perceptual parameters in healthy and unhealthy children. It applies to non-speaking children, according to age. It consists of six steps, each step depicting a separate group of visual parameters. Using four tools / graphics [A, B, C, D] and a scoring method, the system also comes with tables of normal values of parameters, according to age.

Description

DESCRIPTION

System for Recording Parameters of Visual Function in Non-Speaking Children

The invention refers to a system for recording parameters of the visual function of non-speaking children, using tools, with the aim of recording visual-reflexive, sensory, oculomotor and visual-perceptual parameters.

Vision is a primary sense and significantly affects the overall development of a child. Children with abnormal visual parameters show delays in communication, motor control, socialization, learning, etc. Consequently, the early detection of disturbed parameters of visual function, as well as their evolution over time, is very important.

The visual system utilizes light and, through complex processes, feeds reflexive, sensory, oculomotor and visual-perceptual mechanisms, with the aim of visual perception of the world and the development of visually guided skills and actions.

Today, all existing visual parameter recording tools for non-speaking children record some parameters and none simultaneously record visual-reflex, sensory, oculomotor and visual-perceptual parameters. This fact leads to the formation of a limited picture of the functioning of the visual system, but also to the need to purchase and use different individual tools.

The invention relates to a system for recording parameters of the visual function of non-speaking children, using tools, with the aim of recording visual-reflex, sensory, oculomotor and visual-perceptual parameters, both in healthy and unhealthy children. It is applied to non-speaking children, depending on their age.

It consists of six Steps and each Step captures a distinct group of visual parameters:

Step 1) captures parameters that express the level of communication and integrity of the eyes,

Step 2) captures optical reflex parameters,

Step 3) captures sensory parameters of visual function, Step 4) captures binocular cooperation and oculomotor parameters of visual function,

Step 5) captures visual-perceptual parameters of visual function and

Step 6) captures visual-motor coordination parameters of visual function.

Using specific tools and scoring methods, the system is also accompanied by tables of normal values of parameters by age.

The four paddle-type tools/visual charts are:

- Optical chart [A] (Figure 1, 4) with a diameter of 16.00 centimeters (cm-cm) on one side of which is imprinted a mask (1) formed with alternating vertical black and white stripes (contrast sensitivity 100% and stripe thickness 0.40cm), with a red round nose with a diameter of 1.80cm, inside a triangular frame with a base of a triangle of 3.00cm and equal sides of 3.20cm, a mouth of 9.20cm x 1.80cm and two eyes of 5.00cm x 1.60cm each, while the surface of the other side is white (1).

- Optical graph [B] (Figure 2, 4) with a diameter of 16.00 cm. on one side of which a mask (2) is imprinted formed with alternating vertical black and white stripes (contrast sensitivity 25% and stripe thickness 0.40 cm.), with an isosceles triangle nose with a base of 3.00 cm. and equal sides of 3.20 cm., a mouth of 9.20 cm. X 1.80 cm. and two eyes of 5.00 cm. X 1.60 cm. each, while the surface of the other side is red (2).

- Optical graph [C] (Figure 3, 4) with a diameter of 16.00 cm. on one side of which a mask (3) is imprinted formed with alternating vertical black and white stripes (contrast sensitivity 10% and stripe thickness 0.40 cm.), with an isosceles triangle with a base of 3.00 cm. and equal sides of 3.20 cm., a mouth of 9.20 cm. X 1.80 cm. and two eyes of 5.00 cm. X 1.60 cm. each, while the surface of the other side is yellow (3).

- Optical graph [D] (Figure 4) with a diameter of 8.00 cm. on one side of which a mask (4) is imprinted formed with alternating vertical black and white stripes (contrast sensitivity 100% and stripe thickness 0.20 cm.), with a red round nose with a diameter of 0.90 cm., inside a triangular frame with a base of a triangle of 1.50 cm. and equal sides of 1.60 cm., a mouth of 4.60 cm. X 0.90 cm. and two eyes of 2.50 cm. X 0.80 cm. each, while the surface of the other side is white (4).

The invention is a technical solution, a new holistic tool. It is designed to capture visual parameters at any time, as well as their evolution over time, starting from the first month of life.

In Step 1, parameters that express the level of communication and the integrity of the eyes are captured, and more specifically:

- the level of consciousness with observation,

- the integrity of the eyeball using a magnifying lens & ophthalmoscope, - the patency of the optical axis to light using an ophthalmoscope,

- the refractive power with chiasmoscopy (with or without cycloplegia).

In Step 2, optical reflex parameters are captured, more specifically:

- the oculo-vestibular reflex (OVR) with doll head manipulation - blinking

by suddenly moving the paddle-like visual chart [A] (Figure 1) towards the child's face and activating the muscle between the child's eyebrows with finger pressure

- the reaction of the pupil to light with a lens

shining a flashlight into the child's eyes, using binoculars, and checking to see if the pupils are getting smaller

- light/dark adaptation with a paddle-type visual chart [D] (Figure 4)

recording the time of locating the visual chart [D] (Figure 4) after the child is exposed to a bright and then to a dark environment - the reflective visual capture with a paddle-type visual chart [A] (Figure 1)

by presenting the visual chart [A] (Figure 1) suddenly in the child's peripheral field

- the visual-motor reflex (VMR) with a visual graph [A] (Figure 1) of the paddle type

using the visual chart [A] (Figure 1) moving in a circular motion horizontally and then vertically in front of the child's face from a specific distance of 30 cm in circular motions, asking him to watch the red nose and checking whether the child makes corrective movements to refocus on the red nose

- the focusing mechanism with dynamic shadowing or using ready-made specific glasses

- the fusion reflex / solid with Lang Stereo Test.

In Step 3, sensory parameters of visual function are captured, and more specifically:

- central vision with a pen torch or a bright toy, with a paddle-type visual chart [A] (Figure 1) and a paddle-type visual chart [D] (Figure 4), depending on age

- color vision with visual chart [A] (Figure 1) of paddle type, with visual chart [B] (Figure 2) of paddle type, with visual chart [C] (Figure 3) of paddle type

applying the attachment preference technique

- peripheral vision with a paddle-type visual chart [A] (Figure 1) or a paddle-type visual chart [D] (Figure 4) or pen torch, presenting them in specific quadrants in space at a distance of 50 centimeters (cm) from the child's face

- the contrast sensitivity with optical graph [A] (Figure 1) of the paddle type, with optical graph [B] (Figure 2) of the paddle type, with optical graph [C] (Figure 3) of the paddle type

applying the attachment preference technique from 50cm.

- the perception of movement with a visual graph [D] (Figure 4) of the paddle type

moving it in front of the child's face, slowly at first and then faster, observing whether the child focuses on the target or not.

In Step 4, parameters of binocular cooperation and oculomotor function of visual function are captured, and more specifically:

- focusing on a pen torch or a paddle-type optical chart [D] (Figure 4)

applying the Hirschberg or Krimsky test or the Prism Alternating Cover test to assess binocular cooperation in the primary gaze position, but also in 9 specific different gaze positions

- saccadic movements with a visual graph [D] (Figure 4) of the paddle or pen torch type

moving it abruptly to specific positions at a distance of 50cm from the child's face

- the sequence movements with a visual graph [D] (Figure 4) of the paddle type or with a pen torch, moving it continuously with slow movements at a distance of 50 cm from the child's face.

- convergence / divergence with a visual graph [D] (Figure 4) of the paddle type

moving it slowly towards the child's nose and stopping twice (at a distance greater than 10cm from the nose and at a distance less than or equal to 10cm from the child's nose).

In Step 5, visual-perceptual parameters of visual function are captured using the necessary methods/ways, and more specifically:

- the recognition of familiar faces and facial expressions (imitation)

- route recognition (if he knows the route to his room)

- visual stability with a paddle-type visual chart [D] (Figure 4) by showing it and hiding it, observing if the child looks for it and repeating it twice

- the recognition of sizes with a paddle-type visual chart [A] (Figure 1) and a paddle-type visual chart [D] (Figure 4) by asking the child to point to the larger of the two and repeating this twice.

In Step 6, visual-motor coordination parameters of visual function are captured, and more specifically:

- the visual estimation of time with a paddle-type visual graph [D] (Figure 4)

moving it like a pendulum and asking the child to catch it as it passes in front of their nose and repeating this twice

- hand-eye coordination with a paddle-type visual chart [D] (Figure 4)

asking the child to catch it and repeating by changing the position of the racket

- eye-foot coordination (ability to go up or down stairs).

The reliability (effectiveness) of the system was assessed in two ways: - by assessing it when applied by different examiners and

- when applied by the same examiner at different times.

For these reasons, samples of children of various ages, with or without vision problems, as well as children with developmental disorders and two examiners were used. The results were analyzed with special statistical methods and it was shown that the system is very reliable / effective. The corresponding tables are listed below.

To demonstrate the reliability/effectiveness of the system, the correlation coefficient (ICC) and 95% confidence intervals (CI) of the results were estimated using statistical programs (IBM SPSS for Windows, Version 22.0. Armonk, NY: IBM Corp).

On the one hand, the reliability/effectiveness of the system was assessed when applied by two different examiners, who examined three groups of children under the same conditions:

1) 200 healthy children with healthy eyes,

2) 122 healthy children with "pathological" eyes and

3) 56 children with developmental problems with this specific system.

While, the reliability/effectiveness of the system was then assessed when applied by the same examiner at different times and applied to three groups of children under the same conditions with a seven-day difference in assessments:

1) 184 healthy children with healthy eyes,

2) 122 healthy children with eye problems and

3) 56 children with developmental disorders.

The ICC coefficient was 1 in both cases, which testifies to the high reliability/effectiveness of the system (Table 1 & Table 2).

Table 1

N=number, ICC=correlation coefficient, CI=confidence intervals Table 2

N=number, ICC=correlation coefficient, CI=confidence intervals

Claims (2)

1. System for recording parameters of visual function for non-speaking children, using tools aimed at recording visual reflex, sensory, oculomotor and visual-perceptual parameters, characterized by four paddle-type tools / visual graphs: - diameter 16.00 centimeters (cm) on one side of which is imprinted a mask (1) formed with alternating vertical black and white stripes (contrast sensitivity 100% and stripe thickness 0.40 cm), with a red round nose of diameter 1.80 cm, within a triangular frame with a base of a triangle of 3.00 cm and equal sides of 3.20 cm, a mouth of 9.20 cm. X 1.80 cm. and two eyes of 5.00 cm. X 1.60 cm. each, while the surface of the other side is white (1) - optical graph [A] - diameter 16.00cm. on one side of which a mask (1) is imprinted formed with alternating vertical black and white stripes (contrast sensitivity 25% and stripe thickness 0.40cm.), with an isosceles triangle nose with a base of 3.00cm. and equal sides of 3.20cm., a mouth 9.20cm.X1.80cm. and two eyes 5.00cm.X1.60cm. each, while the surface of the other side is red (2) - optical graph [B] - diameter 16.00cm. on one side of which a mask (1) is imprinted formed with alternating vertical black and white stripes (contrast sensitivity 10% and stripe thickness 0.40cm.), with an isosceles triangle with a base of 3.00cm. and equal sides of 3.20cm, a mouth 9.20cm.X1.80cm. and two eyes 5.00cm.X1.60cm. each, while the surface of the other side is yellow (3) - optical graph [C] - 8.00 cm in diameter, on one side of which is imprinted a mask (1) formed with alternating vertical black and white stripes (contrast sensitivity 100% and stripe thickness 0.20 cm), with a red round nose of 0.90 cm in diameter, within a triangular frame with a base of 1.50 cm and equal sides of 1.60 cm, a mouth of 4.60 cm x 0.90 cm and two eyes of 2.50 cm x 0.80 cm each, while the surface of the other side is white (4) - optical graph [D], 2. System for recording parameters of visual function for non-speaking children, using tools for the purpose of recording visual reflex, sensory, oculomotor and visual-perceptual parameters, according to claim 1, characterized by dimensions that are not binding and can be changed on a case-by-case basis.