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Who should get a Functional Vision Assessment?
- Krish Zlotin
- Feb 26
- 3 min read
A functional vision assessment looks at how someone actually uses their vision in everyday life, not just how clearly they can see an eye chart.
It helps identify:
What makes it easier or harder for them to see and process visual information
How lighting, clutter, colour, and contrast affect vision
Strengths and challenges in tasks like reading, navigating spaces, or recognising objects and faces
How vision interacts with movement, attention, and other senses
Who should get assessed? Anyone with any neurological or neurodevelopmental presentations should consider getting a functional vision assessment. Why? Because Seeing begins in the brain This helps determine if / how vision is contributing to participation, engagement, learning and daily activities.
Vision and the Brain
In conditions such as:
Cerebral Visual Impairment (CVI) (also known as Cortical Visual Impairment / Neurological Vision Loss)
Cerebral Palsy
Global Developmental Delay
Learning differences (ADHD, Dyslexia)
Autism
Brain Injury, stroke
Premature birth, Hydrocephalus, Periventricular Leukomalacia (PVL)
Genetic differences - Down Syndrome
…the brain pathways that interpret visual information may develop differently.
This can affect:
Object recognition
Depth perception
Visual attention
Navigation
Tolerance of clutter or movement
Often, behaviours are misunderstood as inattention, anxiety, or defiance — when in reality, the visual system is overwhelmed.
How to tell if functional vision is affected?
Behaviours you might notice:
❌ Difficulty finding toys, equipment, utensils in a messy/cluttered space
❌ Avoiding with eye contact, struggling to understand facial gestures
❌ Struggling with visually demanding task such as Lego, drawing, reading, navigating ❌ Tripping over objects or changes in flooring ❌ Struggling to go DOWN the stairs, but confident going UP the stairs ❌ Adopting a head tilt or head turn situationaly
❌ Recognising familiar objects only in specific locations
Sometimes families say:
“It feels like they can see… but they don’t always use their vision.”
This is because the outcome is achieved, whether vision was used or not.
"Pass me the teddy bear."
A child might hand you the bear because they felt around the box for a soft, squishy toy with ears.
‼️NOT because they looked and searched with their eyes!
Similar to how you might feel your way around, in your bag for a lipstick or phone - instead of emptying the contents to find it.
How is functional vision assessed?
A functional vision assessment looks at how vision works in real environments.
So, the assessment is usually done in real environments such as at home, school or workplace and along with comprehensive history taking, may also include observing how an individual interacts with their environment:
how clutter, lighting, contrast, and colours affect engagement
how noise, sensory input affect vision
how they visually engage with people and objects
Identify fatigue and visual overwhelm
The goal is to understand how to support the visual brain.
The visual brain can learn.
With the right strategies, many individuals experience:
Increased confidence navigating spaces
Reduced overwhelm
Better engagement in learning
Greater independence
Sometimes small changes make a big difference:
✨ Simplifying backgrounds
✨ Using consistent object placement
✨ Increasing contrast
✨ Adjusting positioning
✨ Supporting visual breaks
It’s not about fixing... about adapting the environment so their brain can succeed.
Who Can Benefit?
Children with developmental or neurological differences
Individuals with complex communication needs
Minimally or non-verbal children
Adults with acquired brain injury, stroke
Families who feel “something isn’t adding up”
If your child has been told their eyes are fine — but you still have concerns — it may be time to explore how their brain is processing vision.
Looking Beyond the Eye Chart
Vision is more than 20/20.
It’s how we connect with people.
How we learn.
How we move safely through the world.
How we make sense of our surroundings.
When we understand functional vision, we stop asking
“Why aren’t they trying?”
And start asking
“How can we make the visual world clearer?”
Questions?
We can guide you toward the right resources, connect you with services in your area, and help you understand your next steps.
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