Phakic children with acuity greater than 6/60 generally prefer to utilize reduced working distances and increase accommodation to tackle short-to medium-term near vision tasks. As demands increase and accommodation lags, low vision aids have to be used more routinely. Dome magnifiers are often the aid of choice for albinos and those with congenital nystagmus. Aphakic children require higher levels of magnification and benefit from stand magnification (x3 to x12). Low vision aids must be used in conjunction with spectacle or contact lens distance correction.
Children with retinitis pigmentosa and central visual loss benefit from closed circuit televisions (CCTVs) (such as desktop video magnifier) and, as they get older, special software or hardware that they can utilize with a personal computer thus gaining access to on-screen enlargement and speech conversion.
Distance low vision aids (such as portable video magnifier) can be used by virtually all school-aged visually impaired children, although there is sometimes resistance to use these in the public domain. The children should be encouraged to enjoy the device and consider it as a leisure appliance as well as an educational device.
It is important to remember that the older child or young adult who is diagnosed as having a serious visual problem may have the added psychological adjustment of adopting a modified life-style and career choice. Career plans may have to altered, the patient may come suddenly to the understanding that driving will now not be an option when he or she comes of age, and sometimes the driving license must be surrendered having often just been acquired. This is tragic for those who are already in employment, particularly if they depend on driving for their livelihood. There is no legal requirement for the use of a pushbike.
Common sense and caution should prevail, and advice to parents of children should err on the side of caution.
