Visually Impaired / 2026, featuringVisually
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
Visually Impaired
Referral Process for Vision Services
Step 1: Identifying concerns is the starting point of the referral process
Step 2: school must receive current (within one year) eye report from child's optometrist
(For students with Cortical Visual Impairment, report from neurologist diagnosing CVI is permissible)
Step 3: TVI will review the Eye Report. If student meets eligibility criteria, referral process continues, if
not, then referral process STOPS.
Step 4: parents sign permission for TVI to conduct a Functional Vision Assessment and Learning Media
Assessment
Step 5: TVI conducts FVA and LMA
Step 6: Clinical Low Vision Evaluation is scheduled for students with low vision for the purpose of
determining the need of prescribed (low vision devices) for near and distance viewing. (These MUST be
prescribed by a certified low vision specialist—NOT TVI!)
Step 7: student 3-21, and in need of school based services, these will be identified on IEP. Birth through
age 2 IFSP.
Functional Vision Assessment and Learning Media Assessment
Will identify how the student's vision loss is negatively impacting their education and identify strategies
or accommodations could reduce the negative impact. This evaluation will also determine the need for
vision services and identify the need for any additional vision specific evaluations.
Visual Impairments
The loss of vision that CANNOT be corrected by refraction (glasses).
Eye disorders, trauma to brain, and nerve disorders
Amblyopia
"Lazy eye". Decreased vision in one or both eyes without detectable anatomic damage to the retina or
visual pathways. If the eyes are not straight (strabismus), student may suppress the vision in the turning
eye to avoid seeing double. Brain "shuts off" one eye to favor the eye with better vision. May be treated
by patching the good eye, by surgery, or corrective lenses.
"Crossed eyes" patch over an eye or high refractive corrective lenses may cause social adjustment
problems.
Depth perception may be affected. Students may need familiarization to help anticipate distances and
heights.
Aniridia
Visually Impaired Page 1 Questions Answers Updated 2026
,Visually Impaired / 2026, featuringVisually
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
Congenital abnormality. Incomplete formation of the iris. Associated with glaucoma, nystagmus,
sensitivity to light, poor vision.
- corrective lenses may be prescribed, usually tinted to help reduce photophobia (sensitivity to light)
- typically have problems relating to illumination and glare
- student may function best in reduced lighting.
- student may experience eye fatigue when reading for extended periods of time
Anophthalmos
Absence of a true eyeball. May have prosthetic eye
- Students may have problems associated with wearing prosthesis
Teachers become involved in this care and routine. Frequently cleansing and placing the prosthesis , and
care of the orbit.
Aphakia
Absence of the lens of the eye usually is due to surgery for cataract. In rare cases it is a part of the
abnormally small eye (microphthalmos).
Convex lenses are worn to provide refractive power lost because of the absence of the lens. Plus lenses
of high power make the eyes look larger when worn in spectacles.
Achromatopsia
Congenital defect. Rare inability to distinguish colors due to cone malformation and partial or total
absence of cones.
- hereditary and non-progressive
- experience some vision loss, especially in bright light, to which they are extremely sensitive
- severity varies
- bright light and glare should be avoided
- prefer reduced illumination when reading (task lighting from behind directed on the book/paper so
long as the light does not reflect off of a high sheen surface)
- high contrast, tinted lenses, or sunglasses both indoors/outdoors
- may not be able to discriminate colors
Albinism
Congenital defect. Lack of pigment in the eyes, hair, and skin
- decreased visual acuity, nystagmus (rhythmic side-to-side eye movements) and photophobia (light
sensitivity) it is non-progressive
Ocular albinism
Lack of pigment in iris and choroids; results in reddish pupils and iris.
- poor vision
- light sensitivity (photophobia)
- involuntary oscillating eye movements (nystagmus)
- Complete-Glare is more troublesome than illumination — tinted lenses may be prescribed
* function best in reduced illumination but GLARE is the critical concern!
* may be adventitiously blinded throughout the day depending upon lighting and glare conditions
Visually Impaired Page 2 Questions Answers Updated 2026
, Visually Impaired / 2026, featuringVisually
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
* adjust illumination to conditions and individual ( control glare via seating and/or tinted lenses, use
sunglasses and/or hat with visor outdoor
- may be concern over personal appearance. Don't want to stand out more
- classroom seating should be appropriate to the corrected refractive error and photophobia
- student may benefit from high contrast line markers for reading.
Astigmatism
Refractive error.
- inability of an eye to focus sharply (at any distance)
- spoon-like (toric) shape of the normally spherical corneal surface
- light rays entering the eye are bent unequally, which prevents formation of a sharp focus on the retina.
- large amount can result in significant blurring.
- corrected by cylindrical (topic) eyeglasses or contact lens or refractive surgery
Cataract
Pathologic condition.
- opacity or cloudiness of the crystalline lens - may prevent a clear image from forming on the retina.
- surgical removal of lens is visual loss becomes significant
- may be congenital or caused by trauma, disease, or age
** Glare should be avoided
** restriction of physical contact sports may be necessary if there is a danger of retinal detachment
** social/emotional problems may result if lens are noticeably opaque or the glasses lenses are very
thick
Coloboma
Congenital anomaly
- cleft or defect in normal continuity of a part of the eye
- e.g. absence of lower segment of optic nerve head, choroids, ciliary body, iris, lens, or eyelid
- caused by improper fusion of fetal fissure durning gestation
- may be associated with other abnormalities, including a small eye (microphthalmia)
** educational needs and lighting requirements and other accommodations are dependent upon the
severity of the condition and the part of the eye affected.
Color Blindness
May encounter difficulty with tasks involving color discrimination
- student may not be able to discriminate color ( may need to teach the student alternative techniques
for identifying colors.
e.g. the position of the red and green lights in a traffic signal, using color identification tags on clothing
Glaucoma
Pathologic condition
- increased intraocular pressure resulting in damage to the optic nerve and retinal nerve fibers
- typical visual fields defects and increased size of optic cup
* common cause of preventable vision loss*
Visually Impaired Page 3 Questions Answers Updated 2026
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
Visually Impaired
Referral Process for Vision Services
Step 1: Identifying concerns is the starting point of the referral process
Step 2: school must receive current (within one year) eye report from child's optometrist
(For students with Cortical Visual Impairment, report from neurologist diagnosing CVI is permissible)
Step 3: TVI will review the Eye Report. If student meets eligibility criteria, referral process continues, if
not, then referral process STOPS.
Step 4: parents sign permission for TVI to conduct a Functional Vision Assessment and Learning Media
Assessment
Step 5: TVI conducts FVA and LMA
Step 6: Clinical Low Vision Evaluation is scheduled for students with low vision for the purpose of
determining the need of prescribed (low vision devices) for near and distance viewing. (These MUST be
prescribed by a certified low vision specialist—NOT TVI!)
Step 7: student 3-21, and in need of school based services, these will be identified on IEP. Birth through
age 2 IFSP.
Functional Vision Assessment and Learning Media Assessment
Will identify how the student's vision loss is negatively impacting their education and identify strategies
or accommodations could reduce the negative impact. This evaluation will also determine the need for
vision services and identify the need for any additional vision specific evaluations.
Visual Impairments
The loss of vision that CANNOT be corrected by refraction (glasses).
Eye disorders, trauma to brain, and nerve disorders
Amblyopia
"Lazy eye". Decreased vision in one or both eyes without detectable anatomic damage to the retina or
visual pathways. If the eyes are not straight (strabismus), student may suppress the vision in the turning
eye to avoid seeing double. Brain "shuts off" one eye to favor the eye with better vision. May be treated
by patching the good eye, by surgery, or corrective lenses.
"Crossed eyes" patch over an eye or high refractive corrective lenses may cause social adjustment
problems.
Depth perception may be affected. Students may need familiarization to help anticipate distances and
heights.
Aniridia
Visually Impaired Page 1 Questions Answers Updated 2026
,Visually Impaired / 2026, featuringVisually
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
Congenital abnormality. Incomplete formation of the iris. Associated with glaucoma, nystagmus,
sensitivity to light, poor vision.
- corrective lenses may be prescribed, usually tinted to help reduce photophobia (sensitivity to light)
- typically have problems relating to illumination and glare
- student may function best in reduced lighting.
- student may experience eye fatigue when reading for extended periods of time
Anophthalmos
Absence of a true eyeball. May have prosthetic eye
- Students may have problems associated with wearing prosthesis
Teachers become involved in this care and routine. Frequently cleansing and placing the prosthesis , and
care of the orbit.
Aphakia
Absence of the lens of the eye usually is due to surgery for cataract. In rare cases it is a part of the
abnormally small eye (microphthalmos).
Convex lenses are worn to provide refractive power lost because of the absence of the lens. Plus lenses
of high power make the eyes look larger when worn in spectacles.
Achromatopsia
Congenital defect. Rare inability to distinguish colors due to cone malformation and partial or total
absence of cones.
- hereditary and non-progressive
- experience some vision loss, especially in bright light, to which they are extremely sensitive
- severity varies
- bright light and glare should be avoided
- prefer reduced illumination when reading (task lighting from behind directed on the book/paper so
long as the light does not reflect off of a high sheen surface)
- high contrast, tinted lenses, or sunglasses both indoors/outdoors
- may not be able to discriminate colors
Albinism
Congenital defect. Lack of pigment in the eyes, hair, and skin
- decreased visual acuity, nystagmus (rhythmic side-to-side eye movements) and photophobia (light
sensitivity) it is non-progressive
Ocular albinism
Lack of pigment in iris and choroids; results in reddish pupils and iris.
- poor vision
- light sensitivity (photophobia)
- involuntary oscillating eye movements (nystagmus)
- Complete-Glare is more troublesome than illumination — tinted lenses may be prescribed
* function best in reduced illumination but GLARE is the critical concern!
* may be adventitiously blinded throughout the day depending upon lighting and glare conditions
Visually Impaired Page 2 Questions Answers Updated 2026
, Visually Impaired / 2026, featuringVisually
real exam-style
Impaired questions, detailed explanations, and accurate answers with solution
* adjust illumination to conditions and individual ( control glare via seating and/or tinted lenses, use
sunglasses and/or hat with visor outdoor
- may be concern over personal appearance. Don't want to stand out more
- classroom seating should be appropriate to the corrected refractive error and photophobia
- student may benefit from high contrast line markers for reading.
Astigmatism
Refractive error.
- inability of an eye to focus sharply (at any distance)
- spoon-like (toric) shape of the normally spherical corneal surface
- light rays entering the eye are bent unequally, which prevents formation of a sharp focus on the retina.
- large amount can result in significant blurring.
- corrected by cylindrical (topic) eyeglasses or contact lens or refractive surgery
Cataract
Pathologic condition.
- opacity or cloudiness of the crystalline lens - may prevent a clear image from forming on the retina.
- surgical removal of lens is visual loss becomes significant
- may be congenital or caused by trauma, disease, or age
** Glare should be avoided
** restriction of physical contact sports may be necessary if there is a danger of retinal detachment
** social/emotional problems may result if lens are noticeably opaque or the glasses lenses are very
thick
Coloboma
Congenital anomaly
- cleft or defect in normal continuity of a part of the eye
- e.g. absence of lower segment of optic nerve head, choroids, ciliary body, iris, lens, or eyelid
- caused by improper fusion of fetal fissure durning gestation
- may be associated with other abnormalities, including a small eye (microphthalmia)
** educational needs and lighting requirements and other accommodations are dependent upon the
severity of the condition and the part of the eye affected.
Color Blindness
May encounter difficulty with tasks involving color discrimination
- student may not be able to discriminate color ( may need to teach the student alternative techniques
for identifying colors.
e.g. the position of the red and green lights in a traffic signal, using color identification tags on clothing
Glaucoma
Pathologic condition
- increased intraocular pressure resulting in damage to the optic nerve and retinal nerve fibers
- typical visual fields defects and increased size of optic cup
* common cause of preventable vision loss*
Visually Impaired Page 3 Questions Answers Updated 2026
